Advances and controversies in prostate cancer:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2010
|
| Schriftenreihe: | Urologic clinics of North America
37,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIII, 148 S. Ill., graph. Darst. |
| ISBN: | 9781437719161 |
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Datensatz im Suchindex
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| adam_text | Titel: Advances and controversies in prostate cancer
Autor: Oh, William K.
Jahr: 2010
XIII
Advances and Controversies in Prostate Cancer
Contents
Preface
William K. Oh and Jim C. Hu
Prostate Cancer: To Screen or Not to Screen?
Alex Shteynshlyuger and Gerald L. Andriole
The debate about the usefulness of population-based prostate cancer screening
has been ongoing for decades. The most current evidence shows limited benefit
of population screening, and significant psychological, physical and financial costs.
Efforts to improve screening with better markers and more selective treatment may
make population-based screening more effective.
Chemoprevention of Prostate Cancer 11
Andrew J. Stephenson, Robert Abouassaly, and Eric A. Klein
Prostate cancer is an appropriate target for primary chemoprevention because of its
ubiquity, disease-related mortality, treatment-related morbidity, and long latency
period. The PCPT and REDUCE trials demonstrate that this cancer can be prevented
by a relatively nontoxic oral pharmacologic agent (5 x-reductase inhibitors). Evi-
dence from the SELECT trial argues against the recommendation of the use of vita-
mins and micronutrients as chemoprevention of prostate cancer. Dietary
modification may substantially alter a man s risk of prostate cancer, but the specific
dietary manipulations that are necessary are poorly defined and these may need to
be instituted in early adulthood to be successful. 5a-reductase inhibitors represent
an effective primary prevention strategy, and these agents should be used more lib-
erally for the prevention of prostate cancer, particularly in high-risk patients.
Update on Prostate Imaging 23
Jalil Af nan and Clare M.Tempany
Successful and accurate imaging of prostate cancer is integral to its clinical man-
agement from detection and staging to subsequent monitoring. Various modalities
are used including ultrasound, computed tomography, and magnetic resonance im-
aging, with the greatest advances seen in the field of magnetic resonance.
High-intensity Focused Ultrasound: Ready for Primetime 27
Kyle O. Rove, Kathryn F. Sullivan, and E. David Crawford
Prostate cancer (CaP) is the second most common cause of cancer deaths in the
United States and the incidence of CaP has remained constant at 165 cases per
100,000 men. Since 1990, the age-adjusted death rate has decreased by 31%. In
this article, the authors review the current literature on the experimental therapy
for HIFU. The HIFU technique, its mechanism of action, patient selection, current ef-
ficacy studies, complications, follow-up after HIFU treatment, and future develop-
ments are discussed.
Contents
Overcoming the Learning Curve for Robotic-assisted Laparoscopic Radical Prostatectomy 37
Marcos P. Freire, Wesley W. Choi, Yin Lei, Fernando Carvas, and Jim C. Hu
Robotic-assisted laparoscopic radical prostatectomy (RALP) has been rapidly
adopted in the last few years despite having a prolonged learning curve. This article
describes the RALP learning curve, reviews in detail the challenging steps of the op-
eration, describes the authors RALP technique, and concludes with tips to over-
come the learning curve.
The Case for Open Radical Prostatectomy 49
Edward M. Schaeffer, Stacy Loeb, and Patrick C.Walsh
Radical prostatectomy is the gold standard surgical treatment for clinically localized
prostate cancer. Over the years, many different approaches to surgical removal of
the prostate have been described. Today, the most common techniques are open
radical retropubic prostatectomy and robotic-assisted laparoscopic radical prosta-
tectomy. Although there are many differences between the 2 approaches, the com-
mon goal is to optimize oncologic and functional outcomes. This article highlights
the background, techniques, and outcomes of open and robotic prostatectomy.
Controversies Surrounding Lymph Node Dissection for Prostate Cancer 57
Ganesh S. Palapattu, Eric A. Singer, and Edward M. Messing
Despite the high frequency with which radical prostatectomy is used to treat pros-
tate cancer, uncertainty exists regarding the merits of a simultaneous pelvic lymph
node dissection. Unresolved issues include identifying the optimal candidate and
selecting the appropriate surgical template, among others. In this article, the authors
discuss the pros and cons of performing a pelvic lymph node dissection and the
staging/diagnostic and therapeutic implications of this procedure. The lack of robust
randomized clinical trials in the literature necessitates a careful analysis of retro-
spective and case series data.
Primary and Salvage Cryotherapy for Prostate Cancer 67
David S. Finley, Frederic Pouliot, David C. Miller, and Arie S. Belldegrun
Cryotherapy is a technique to ablate tissue by local induction of extremely cold tem-
peratures. Recently, the American Urological Association Best Practice Statement
recognized cryoablation of the prostate as an established treatment option for
men with newly diagnosed or radiorecurrent organ-confined prostate cancer.
Emerging data suggest that, in select cases, cryoablation may have a role in focal
ablation of prostate. The current state of the art of cryoablation in these applications
is reviewed.
Current Topics in the Treatment of Prostate Cancer with Low-Dose-Rate Brachytherapy 83
Richard G. Stock and Nelson N. Stone
The treatment of prostate cancer with low dose rate prostate brachytherapy has
grown rapidly in the last 20 years. Outcome analyses performed in this period
have enriched understanding of this modality. This article focuses on the develop-
ment of a real-time ultrasound-guided implant technique, the importance of radia-
tion dose, trimodality treatment of high-risk disease, long-term treatment
outcomes, and treatment-associated morbidity.
Contents
Neoadjuvant and Adjuvant Therapies in Prostate Cancer 97
Fabio A.B. Schutz and William K. Oh
Prostate cancer is the most common cancer in men in the United States and the sec-
ond leading cause of cancer death. Advances in surgical therapies have paralleled
advances in radiation therapy and chemotherapy for metastatic disease. There is
a great interest in neoadjuvant and adjuvant therapies for patients at intermediate
and high risk of recurrence and prostate cancer-specific death. Because high-risk
prostate cancer patients can be readily identified by clinical criteria, many studies
have attempted to use local and systemic adjuvant therapy to reduce the risk of recur-
rence. This review discusses neoadjuvant and adjuvant therapies in prostate cancer,
including hormonal therapy, chemotherapy, and postoperative radiotherapy.
Novel Targeted Therapies for Prostate Cancer 105
Robyn J. Macfarlane and Kim N. Chi
This article reviews the concepts and rationale behind targeted agents that are cur-
rently in clinical testing for patients with castration resistant prostate cancer (CRPC).
Advances in our understanding of the molecular mechanisms underlying prostate
cancer progression has translated into a variety of treatment approaches. Agents
targeting androgen receptor activation and local steroidogenesis, angiogenesis,
apoptosis, chaperone proteins, the insulinlike growth factor pathway, RANK ligand,
endothelin receptors, and Src family kinases are entering, or have recently com-
pleted, accrual to phase III trials for patients with CRPC. There has also been interest
generated by data from early-phase studies evaluating multitargeted tyrosine kinase
inhibitors, agents effecting signal transduction pathways, and novel cytotoxics.
Immunotherapy for Prostate Cancer: An Emerging Treatment Modality 121
Charles G. Drake
This article examines prostate cancer as a target for immunotherapy and investi-
gates active immunotherapy for prostate cancer, combining conventional therapy
with active immunotherapy, immune modulators (brakes and accelerators), and
monoclonal antibodies.
Blood and Tissue Biomarkers in Prostate Cancer: State of the Art 131
Michelangelo Fiorentino, Elisa Capizzi, and Massimo Loda
The prevalence of prostate cancer (PCa) is high and increases with age. PCa is the
most common cutaneous cancer in American men. Prostate-specific antigen (PSA)
screening has impacted the detection of PCa and is directly responsible for a dra-
matic decrease in stage at diagnosis. Gleason score and stage at the time of diag-
nosis remain the mainstay to predict prognosis, in the absence of more accurate and
reliable tissue or blood biomarkers. Despite extensive research efforts, very few bio-
markers of PCa have been introduced to date in clinical practice. Even screening
with PSA has recently been questioned. A thorough analysis of all tissue and serum
biomarkers in prostate cancer research cannot be easily synthesized, and goes be-
yond the scope of the present article. Therefore the authors focus here on the most
recently reported tissue and circulating biomarkers for PCa whose application in
clinical practice is either current or expected in the near future.
Index 143
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