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Cancer Treatment Reviews Feb 2019Oligometastatic prostate cancer represents an intermediate state between a localized tumor and widespread metastatic disease. Its specific clinical features suggest the... (Review)
Review
Oligometastatic prostate cancer represents an intermediate state between a localized tumor and widespread metastatic disease. Its specific clinical features suggest the existence of a distinct biology which still needs to be elucidated. New imaging techniques like prostate specific membrane antigen (PSMA) PET scans have shown to perform well in the staging and restaging of this category of patients, at different phases of disease evolution. Despite limited prospective evidence, metastasis-directed therapies (MDT) are emerging as valid treatment options able to postpone systemic therapies and probably improve survival outcome. The aim of this review is to shed light on the clinical scenario of prostate cancer patients with limited metastatic disease burden and highlight the role of MDT strategies in this setting.
Topics: Humans; Male; Neoplasm Metastasis; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Randomized Controlled Trials as Topic
PubMed: 30684842
DOI: 10.1016/j.ctrv.2019.01.005 -
Archivos Espanoles de Urologia Mar 2022Prostate cancer is themost prevalent and deadliest neoplasm in men, with adiverse clinical presentantion and oncological outcomes.The diagnosis and treatment remains a... (Review)
Review
INTRODUCTION
Prostate cancer is themost prevalent and deadliest neoplasm in men, with adiverse clinical presentantion and oncological outcomes.The diagnosis and treatment remains a challenge.New essays about biomarkers show their potential asa tool that may influence in clinical decision making,risk stratification and management of the disease.
METHODS
we performed a literature review abouttissue biomarkers in the diagnosis and treatment ofprostate cancer.
RESULTS
Within the last years, a wide number ofdiagnostic and prognostic tests in tissue have been developed(ConfirmMDx, Promark, Oncoytype DX, Decipher),creating an opportunity to improve the diagnosis,prognosis and treatment of prostate cancer.
CONCLUSIONS
Since prostate cancer is the mostprevalent neoplasm in men, it is mandatory to stratifypatients correctly to prevent unnecessary biopsiesand overtreatment in low risk patients, as well as designthe best strategy in those with high risk disease.Tissue biomarkers may become a useful tool in precisionmedicine to guide decision making.
Topics: Biomarkers, Tumor; Clinical Decision-Making; Humans; Male; Prognosis; Prostatic Neoplasms
PubMed: 35332888
DOI: No ID Found -
Current Urology Reports Aug 2017The purpose of this review is to examine prostate cancer racial disparities specific to the African-American population. (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to examine prostate cancer racial disparities specific to the African-American population.
RECENT FINDINGS
African-American men are more likely to be diagnosed with prostate cancer, present at an earlier age; are more likely to have locally advanced or metastatic disease at diagnosis; and have suboptimal outcomes to standard treatments. Prostate cancer treatment requires a nuanced approach, particularly when applying screening, counseling, and management of African-American men. Oncological as well as functional outcomes may differ and are potentially due to a combination of genetic, molecular, behavioral, and socioeconomic factors.
Topics: Black or African American; Age of Onset; Early Detection of Cancer; Healthcare Disparities; Humans; Male; Neoplasm Staging; Prostatic Neoplasms; Treatment Outcome; United States
PubMed: 28808871
DOI: 10.1007/s11934-017-0724-5 -
The Urologic Clinics of North America Aug 2021
Review
Topics: Genetic Predisposition to Disease; Genetic Testing; Humans; Male; Prostatic Neoplasms; Risk Factors; Syndrome
PubMed: 34210484
DOI: 10.1016/j.ucl.2021.04.002 -
Clinical Advances in Hematology &... Feb 2020Prostate cancer is the most frequently diagnosed cancer in men after skin cancer. Owing to the rising popularity of prostate-specific antigen screening, large numbers of... (Review)
Review
Prostate cancer is the most frequently diagnosed cancer in men after skin cancer. Owing to the rising popularity of prostate-specific antigen screening, large numbers of patients are receiving a diagnosis of prostate cancer and undergoing whole-gland treatment. Some patients with a diagnosis of low-risk, localized disease may not benefit from whole-gland treatment, however, given its known morbidity. In response to advances in prostate imaging and evidence suggesting that the prognosis in prostate cancer is related to the index lesion, many patients have begun to opt for focal therapy, which targets a lesion rather than the entire prostate. This "middle ground" of therapy, between active surveillance and whole-gland treatment, is appealing to patients because the risk for side effects is believed to be lower with focal therapy than with whole-gland treatment. This review discusses the oncologic rationale for focal therapy in localized prostate cancer, examines the major therapy modalities, and addresses future directions.
Topics: Combined Modality Therapy; Humans; Male; Prostate; Prostatic Neoplasms
PubMed: 32558805
DOI: No ID Found -
TheScientificWorldJournal 2013
Topics: Animals; Humans; Male; Prostatic Neoplasms
PubMed: 24235880
DOI: 10.1155/2013/265234 -
American Society of Clinical Oncology... Apr 2022The American Cancer Society estimates approximately 268,490 new cases of prostate cancer and approximately 34,500 deaths caused by prostate cancer in the United States... (Review)
Review
The American Cancer Society estimates approximately 268,490 new cases of prostate cancer and approximately 34,500 deaths caused by prostate cancer in the United States for 2022. Globally, a total of 1,414,259 new cases of prostate cancer and 375,304 related deaths were reported in 2020. Well-documented health disparities and inequities exist along the continuum of care for prostate cancer management-from screening to diagnostic and staging work-up, surveillance, and treatment-ultimately impacting clinical outcomes. This session-based article discusses innovative patient-centered approaches to advance equitable prostate cancer care. It begins with a review of domestic health disparities in diagnostic imaging and radiotherapy for prostate cancer, and it summarizes barriers and solutions to achieving health equity, such as equity metrics and practice quality improvement projects. Next, a global perspective is provided that describes approaches to address financial and geographic barriers to prostate cancer care, including specific examples of strategies that emphasize the use of the cheapest method of care delivery while maintaining outcomes for drug delivery and radiotherapy.
Topics: Health Equity; Healthcare Disparities; Humans; Male; Prostatic Neoplasms; United States
PubMed: 35671436
DOI: 10.1200/EDBK_350751 -
The Urologic Clinics of North America Feb 2024Artificial intelligence (AI) is revolutionizing prostate cancer genomics research. By leveraging machine learning and deep learning algorithms, researchers can rapidly... (Review)
Review
Artificial intelligence (AI) is revolutionizing prostate cancer genomics research. By leveraging machine learning and deep learning algorithms, researchers can rapidly analyze vast genomic datasets to identify patterns and correlations that may be missed by traditional methods. These AI-driven insights can lead to the discovery of novel biomarkers, enhance the accuracy of diagnosis, and predict disease progression and treatment response. As such, AI is becoming an indispensable tool in the pursuit of personalized medicine for prostate cancer.
Topics: Male; Humans; Artificial Intelligence; Algorithms; Genomics; Machine Learning; Prostatic Neoplasms
PubMed: 37945100
DOI: 10.1016/j.ucl.2023.06.006 -
Clinics in Laboratory Medicine Jun 2024Molecular profiling studies have shed new light on the complex biology of prostate cancer. Genomic studies have highlighted that structural rearrangements are among the... (Review)
Review
Molecular profiling studies have shed new light on the complex biology of prostate cancer. Genomic studies have highlighted that structural rearrangements are among the most common recurrent alterations. In addition, both germline and somatic mutations in DNA repair genes are enriched in patients with advanced disease. Primary prostate cancer has long been known to be multifocal, but recent studies demonstrate that a large fraction of prostate cancer shows evidence of multiclonality, suggesting that genetically distinct, independently arising tumor clones coexist. Metastatic prostate cancer shows a high level of morphologic and molecular diversity, which is associated with resistance to systemic therapies. The resulting high level of intratumoral heterogeneity has important implications for diagnosis and poses major challenges for the implementation of molecular studies. Here we provide a concise review of the molecular pathology of prostate cancer, highlight clinically relevant alterations, and discuss opportunities for molecular testing.
Topics: Humans; Male; Mutation; Prostatic Neoplasms; Prostate
PubMed: 38821639
DOI: 10.1016/j.cll.2023.08.003 -
Recent Results in Cancer Research.... 2007Prostate cancer incurs a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in the United... (Review)
Review
Prostate cancer incurs a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in the United States. It is inherent as we maximize the detection of early prostate cancer that we increase the detection of both nonaggressive (slow growing) and aggressive (faster growing) prostate cancers. The evidence clearly supports the use of PSA screening in conjunction with DRE as a means of early detection of prostate cancer. Widespread implementation of prostate cancer screening in the United States has led to the phenomenon of stage migration with more cancers being detected at a lower stage. Such a trend has decreased the incidence of metastatic disease at diagnosis and paralleled the decrease of the mortality rate from prostate cancer. Our understanding of the natural history of prostate cancer is progressing over time, but the question of its length is unanswerable. The relatively long doubling time (on average) of early prostate cancer of 3 to 4 years or more indicates a relatively good prognosis for many men with this disease, even without early detection and treatment. Unfortunately, the poor specificity of the PSA test in men with benign prostatic hyperplasia (BPH) leads to high rates of prostate biopsy and attendant illnesses and costs. Early detection is more apt to detect a slow-growing prostate cancer than a faster growing cancer that is associated with a more rapid course of progression to metastatic disease. Hence, the launching of mass screening programs for the early detection of prostate cancer is premature. However, in the absence of solid evidence of benefit, one reasonable approach to screening at the individual level is to involve the patient in decisions about whether or not to perform a PSA test. Thus, "offering" PSA testing must be accompanied by informed discussion within the context of an ongoing patient-physician relationship. This is to be distinguished from the use of PSA testing for the purpose of "mass screening." Concepts that must be explored with the patient include: 1. The long-term ramifications of screening 2. The relatively high probability of further evaluation and biopsy with positive results 3. Potentially difficult decisions that may arise about using treatments that are associated with considerable morbidity and uncertain benefits (at the time) if cancer is discovered We should identify a future path that is evidence-based, focused on the issues that make a difference to patients, and results in better and longer lives of those with the disease and those who are at risk of getting it. If that path leads to treating fewer patients in the future, even if sometimes more aggressively, we should pursue it definitely and consequently.
Topics: Humans; Male; Mass Screening; Prognosis; Prostatic Neoplasms
PubMed: 17432554
DOI: 10.1007/978-3-540-40901-4_5