1/89. Surgical excision of a metastatic adrenal lesion in a patient with prostatic cancer.BACKGROUND: A 64-year-old Japanese man with stage D2 prostatic cancer, after having responded dramatically to androgen ablation, demonstrated a solitary adrenal metastasis without disease progression to any other site. methods: A surgical excision of the lesion and adjuvant systemic chemotherapy was performed. RESULTS/CONCLUSIONS: The patient has since remained alive without any evidence of recurrence 21 months after surgery.- - - - - - - - - - ranking = 1keywords = disease progression, progression (Clic here for more details about this article) |
2/89. Loss of tissue immunoreactive androgen receptor in prostate cancer presenting initially as an intracranial tumor.We report a case of prostate cancer that presented initially as an intracranial tumor. biopsy specimens of the prostate before endocrine treatment were nearly negative immunohistochemically for prostate-specific antigen and the androgen receptors. All metastases including those in the brain expressed neither androgen receptor nor prostate-specific antigen at the protein and mRNA levels. The tumor, which did not respond to the anti-androgen therapy, had an aggressive course. In this case, the androgen-independent growth and rapid progression might be associated with the initial loss of the antigen and androgen characteristics of the prostate. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 0.015244408859826keywords = progression (Clic here for more details about this article) |
3/89. Sarcomatoid carcinoma of the prostate: progression from adenocarcinoma is associated with p53 over-expression.BACKGROUND: The pathogenesis of sarcomatoid metaplasia of prostatic adenocarcinoma is uncertain. The histologic features of sarcomatoid carcinoma arising in two patients with previously irradiated prostatic adenocarcinoma are reported and the relationship between prostatic adenocarcinoma and subsequent sarcomatoid carcinoma is investigated by immunohistochemical detection of epithelial and soft tissue tumor markers, and p53 protein. methods AND RESULTS: Two patients, aged 72 and 67 years, underwent localized radiotherapy for prostatic adenocarcinoma and re-presented with sarcomatoid carcinoma 41 months and 60 months later, respectively. In both cases the tumor consisted of anaplastic spindle cells with occasional osteoclast-like giant cells. The initial tumors showed immunohistochemical staining typical of prostatic adenocarcinoma with absence of expression of p53 protein. The subsequent sarcomatoid carcinomas were positive for vimentin and negative for epithelial cell markers. In both cases serial biopsies showed a temporal increase in tumor expression of p53 protein. CONCLUSIONS: The development of sarcomatoid carcinoma in prostatic adenocarcinoma is associated with progressive accumulation of p53. This is suggestive of increasing clonal dominance of dedifferentiated tumor cells carrying p53 mutations.- - - - - - - - - - ranking = 0.060977635439305keywords = progression (Clic here for more details about this article) |
4/89. Rapid disease progression after the administration of bicalutamide in patients with metastatic prostate cancer.We report 5 patients with advanced metastatic prostate cancer who took bicalutamide 50 mg/day for "second-line" hormonal manipulation and demonstrated a rapid rise in prostate-specific antigen (PSA) shortly after the initiation of bicalutamide. After discontinuation of the drug, PSA levels declined in 4 patients and stabilized in the fifth. In 2 of the patients, the PSA rise was associated with an increase in pain level, which subsided after the treatment was stopped. The timing of the rapid changes in PSA and pain levels suggests a direct effect of bicalutamide. The most probable explanation for this observation is a very early agonist activation of androgen receptor by bicalutamide, similar to the underlying mechanism of the "antiandrogen withdrawal syndrome."- - - - - - - - - - ranking = 4keywords = disease progression, progression (Clic here for more details about this article) |
5/89. Osteoblastic response to successful treatment of metastatic cancer of the prostate.Increasing sclerosis of bone in patients with prostatic cancer most commonly is associated with disease progression. In a study of serial radiographs in a group of 18 patients who experienced objective clinical remission after treatment of metastatic cancer of the prostate, eight (44%) showed an osteoblastic response as part of their healing reaction to successful therapy. The importance of a blastic response as a possible sign of clinical improvement is emphasized. Clinical, biochemical, and bone scan correlations are discussed as they apply to patients who respond favorably to treatment of metastatic cancer of the prostate.- - - - - - - - - - ranking = 1keywords = disease progression, progression (Clic here for more details about this article) |
6/89. strontium and samarium therapy for bone metastases from prostate carcinoma.A review was performed of all patients who received strontium-89 chloride or samarium-153 ethylenediamine-tetramethylenephosphonate for prostate cancer metastatic to bone at the Royal Brisbane Hospital between 1992 and 1997. There were 57 patients, 38 treated with strontium-89 and 19 with samarium-153. Forty patients had radionuclide therapy alone, and 28/40 (or 70%) responded in terms of experiencing a beneficial effect on pain. In the other 17 patients, the effect of the radionuclide on pain could not be assessed because they received external beam radiotherapy concomitant with a therapeutic radionuclide. There was no difference in response rates between the samarium and strontium groups as measured by the effect on pain or in the time to progression. The median time to progression for all patients was 2-3 months. The present study confirms that following administration of a therapeutic radionuclide, a high proportion of patients experienced improvement of pain, but the time to progression is not long, so that the overall degree of benefit is modest.- - - - - - - - - - ranking = 0.045733226579479keywords = progression (Clic here for more details about this article) |
7/89. Intermittent endocrine treatment.Intermittent endocrine treatment or cyclic therapy of prostate cancer aims at prolonging survival by delaying progression to androgen independence and at improving quality of life by avoiding the side effects of continuous androgen ablation. In this paper we first review the available experimental data suggesting the clinical application of this therapeutic strategy and interpret them with caution. We then examine the published reports of phase II clinical studies showing the feasibility of this approach. Intermittent endocrine treatment is capable of inducing multiple apoptotic regressions; improvement in the sense of well-being and quality of life - including sexual function - is regularly reported. A period of 6-9 months on therapy is usually recommended; the mean off-therapy interval approaches 50% of the duration of the treatment cycle. The mean time to disease progression was 32 months. The definitive answer to the important question of prolonged survival awaits the completion of ongoing randomized studies.- - - - - - - - - - ranking = 1.0152444088598keywords = disease progression, progression (Clic here for more details about this article) |
8/89. role of herbal compounds (PC-SPES) in hormone-refractory prostate cancer: two case reports.PURPOSE: Herbal therapies are unconventional treatments that have been used for several different diseases. PC-SPES is an herbal mixture, composed of eight different herbs (chrysanthemum, isatis, licorice, ganoderma lucidum, panax pseudo-ginseng, rabdosia rubescens, saw palmetto, and scutellaria), which has been used as an alternative in the treatment of prostate cancer. We report two cases of hormone-refractory prostate cancer patients, who showed a favorable response to therapy with this herbal combination, controlling the progression of the disease. methods: We report two cases of biopsy proven prostate cancer patients with metastatic disease, treated with total androgen blockade, progressing to an androgen-independent status. These patients were offered traditional therapies for hormone-resistant prostate cancer, and they chose to take PC-SPES. The follow-up as well as their evolution are described. RESULTS: PC-SPES extract decreased the prostate-specific antigen (PSA) value for both patients from an initial value of 100 and 386 ng/mL to 24 and 114 ng/mL after 1 year and 4 months, respectively, remaining stable until now. No gynecomastia or hot flashes were observed in these patients and the treatment was well tolerated. CONCLUSION: PC-SPES has shown a strong estrogenic in vitro and in vivo activity as an alternative tool in the management of prostate cancer patients. These cases suggest that PC-SPES might have some potential activity against hormone-independent prostate cancers.- - - - - - - - - - ranking = 0.015244408859826keywords = progression (Clic here for more details about this article) |
9/89. tibia metastasis without prostate specific antigen (PSA) increase following radical vesiculo-prostatectomy.OBJECTIVES: PSA is regarded as the best method in the follow-up of prostate carcinoma. After radical vesiculo-prostatectomy the prostate carcinoma seldom recurs at zero or nearly zero PSA levels. methods: The authors have used PSA since 1989 and they have found only one case where metastasis in the tibia came without an increase in PSA levels. RESULTS: tibia metastasis showed lower tissue activity of PSA than did the primary tumor in the prostate. The authors think this explains the zero PSA level when the metastasis developed. CONCLUSIONS: The authors think based on their case that PSA free progression prostate cacncers may cases where the metastases do not produce PSA.- - - - - - - - - - ranking = 0.015244408859826keywords = progression (Clic here for more details about this article) |
10/89. Effects of long-term treatment with the anti-androgen bicalutamide on human testis: an ultrastructural and morphometric study.AIMS: To assess the effects of more than 4 years' treatment with the anti-androgen bicalutamide on human testis by clinical, ultrastructural and morphometric analysis. methods AND RESULTS: Two patients (aged 74 and 69 years) with prostate cancer were treated for more than 4 years with bicalutamide 50 mg daily. Clinical characterization and follow-up included luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone and prostate-specific antigen (PSA) measurements and clinical response of the tumours. Due to progression of the disease, patients underwent surgical orchidectomy as a further androgen withdrawal therapy. testis biopsies were studied by light and electron microscopy and analysed by morphometry. Control samples were obtained from the normal testis of two patients with testicular cancer who underwent orchidectomy. Clinical follow-up showed a good response in the control of tumour growth and serum PSA decreased to < 4 ng/mL; concentrations of serum LH, FSH and testosterone were within the normal range. Testicular morphology of treated patients was unexpectedly well preserved; the organization of seminiferous tubules was normal with all the germ line elements and mature spermatozoa present. In some areas, a net increase of peritubular connective tissue was evident which may be a consequence of the age of the patients. CONCLUSIONS: Long-term bicalutamide (50 mg) treatment appears to have very little impact on testis ultrastructure and sperm maturation, while it is effective in the control of androgen-dependent prostatic tumours.- - - - - - - - - - ranking = 0.015244408859826keywords = progression (Clic here for more details about this article) |
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