Editorial Board About Us

Prostate cancer

All articles from this key word are listed below.

Volume 11, Number 2 Review Articles

Effective Testosterone Suppression for Prostate Cancer: Is There a Best Castration Therapy?

Management Update

Leonard G Gomella

Achieving and maintaining effective suppression of serum testosterone levels in men treated with androgen ablation is one of the essential strategies in the management of prostate cancer. Historically, a serum testosterone below 50 ng/dL was considered to be the castrate level. Current data suggest that the new target for either surgical or chemical castration is a serum testosterone level of lower than 20 ng/dL in an attempt to maximize therapeutic outcomes. Testosterone breakthrough and the acute-on-chronic effects of administration of a luteinizing hormone-releasing hormone analogue may cause testosterone levels to periodically rise, sometimes to noncastrate levels. The goal of androgen ablation is to identify those agents that will most consistently achieve and maintain the lowest testosterone levels possible.[Rev Urol. 2009;11(2):52-60]

Prostate cancer Androgen ablation LHRH analogues LHRH antagonists

Volume 11, Number 1 Review Articles

The Role of Immunotherapy in Prostate Cancer: An Overview of Current Approaches in Development

Treatment Review

Michael Risk John M Corman

Ongoing clinical trials provide promise for the introduction of immunotherapy into the armamentarium against prostate cancer, but the precise role for immunotherapy remains to be determined. Combinations of immunotherapies may be needed to improve the response rates and the duration of response. Investigators have begun to examine the effect of immunotherapy in combination with other standard treatment, including as an adjuvant to chemotherapy or radiotherapy and as a neoadjuvant agent before prostatectomy. Although many studies examine efficacy in men with metastatic hormone-refractory prostate cancer, there is some evidence for improved responses at earlier stages of disease: the ability of the tumor to evade the immune system may be lessened with lower tumor burden, or the immune system may already be weakened in men with later stages of disease.[Rev Urol. 2009;11(1):16-27]

Prostate cancer Immunotherapy Vaccine

Volume 12, Number 3 Meeting Reviews

Oncological Update: New Findings in Bladder and Prostate Cancer

Meeting Review

Markus Margreiter Alexander Farr Roman Herout Franklin E Kuehhas Bob Djavan

Highlights From the 25th Anniversary Congress of the European Association of Urology, April 16-20, 2010, Barcelona, Spain [Rev Urol. 2010;12(2/3):e129-e133 doi: 10.3909/riu0499]

Prostate cancer Androgen deprivation therapy Bladder cancer Radical prostatectomy Radical cystectomy Carcinoma in situ Anastomotic stricture

Volume 12, Number 1 Review Articles

Emerging Vaccine Therapy Approaches for Prostate Cancer

Treatment Update

Jonathan M Levitt David M Spencer Guru Sonpavde Kevin M Slawin

Prostate cancer vaccines attempt to induce clinically relevant, cancer-specific systemic immune responses in patients with prostate cancer and represent a new class of targeted, nontoxic therapies. With a growing array of vaccine technologies in preclinical or clinical development, autologous antigen-presenting cell vaccines loaded with the antigen, prostate acid phosphatase, and poxvirus vaccines targeting prostate-specific antigen have recently demonstrated a significant survival benefit in randomized trials of patients with metastatic castration-resistant prostate cancer, whereas others have failed to demonstrate any benefit. The combination of vaccines with chemotherapy, radiotherapy, and other biologic agents is also being evaluated. Efforts to optimize vaccine approaches and select ideal patient populations need to continue to build on these early successes.[Rev Urol. 2010;12(1):25-34 doi:10.3909/riu0437]

Prostate cancer Immunotherapy Vaccine

Volume 12, Number 1 Review Articles

Complications of Pelvic Lymphadenectomy: Do the Risks Outweigh the Benefits?

Treatment Review

Stacy Loeb Edward M Schaeffer Alan W Partin

The American Urological Association Best Practice Policy states that although pelvic lymph node dissection (PLND) is commonly done with radical prostatectomy, its morbidity must be considered, particularly in cases in which it offers little additional information. The benefits of PLND include more accurate staging and reassurance for the patient. In addition, PLND may be therapeutic for men with lymph node metastases and may result in long-term biochemical cure for selected node-positive patients. However, the incidence of node positivity is declining, and accordingly a greater number of lymphadenectomies must be performed to benefit 1 patient. In addition to the associated cost, PLND has the potential for morbidity, including lymphoceles, thromboembolic events, ureteral injury, and neurovascular injury. Patients and physicians should therefore assess the risk/benefit ratio associated with PLND on an individual basis to permit informed treatment decisions.[Rev Urol. 2010;12(1):20-24 doi:10.3909/riu0422]

Prostate cancer Radical prostatectomy Pelvic lymph node dissection Ureteral injury Lymph node metastases Risk to benefit ratio Lymphocele Thromboembolic events Vascular injury Nerve injury

Volume 12, Number 1 Review Articles

Intermittent Androgen Deprivation Therapy: Redefining the Standard of Care?

Management Update

Neal D Shore E David Crawford

As a clinical strategy, intermittent androgen deprivation therapy (IADT) has the potential to minimize adverse events associated with continuous androgen deprivation therapy while providing comparable efficacy for patients with advanced prostate cancer. Because most studies supporting IADT to date have been somewhat small and underpowered, additional large, randomized, controlled trials are needed before this strategy becomes the standard of care.However, the potential advantages of IADT, which include improved quality of life, the theoretical possibility of delaying hormone resistance, and possible reduction in expenses to the patient and health care payers, suggest it is a strategy worth further exploration.[Rev Urol. 2010;12(1):1-11 doi: 10.3909/riu0490]

Prostate cancer Androgen deprivation therapy Prostate-specific antigen Testosterone Hormonal therapy

Volume 13, Number 4 Review Articles

A Review of Focal Therapy Techniques in Prostate Cancer: Clinical Results for High-Intensity Focused Ultrasound and Focal Cryoablation

Treatment Review

Michael Palese Nihal Mohamed Colin Iberti

The advancement of focal therapy technology for the treatment of prostate cancer (PCa) is emerging as an option for a middle ground between radical therapies and active surveillance for individuals identified with localized, low-grade PCa. Two promising techniques are high-intensity focused ultrasound (HIFU) and focal cryoablation. Both focal cryoablation and HIFU show promise, but additional prospective trials are necessary before any definitive conclusions can be made on either method’s viability. [Rev Urol. 2011;13(4):e196-e202 doi: 10.3909/riu0540] © 2011 MedReviews®, LLC

Prostate cancer High-intensity focused ultrasound Focal cryoablation

Volume 13, Number 4 Review Articles

Review of the Literature: PCA3 for Prostate Cancer Risk Assessment and Prognostication

Diagnosis Review

Stacy Loeb Alan W Partin

Prostate cancer antigen 3 (PCA3) is a novel urine-based prostate cancer biomarker that has recently been studied extensively for the prediction of prostate biopsy results and treatment outcomes. Numerous studies have demonstrated that urinary PCA3 scores are predictive of prostate cancer detection on both initial and repeat biopsy. There is conflicting evidence on the relationship between PCA3 with aggressive tumor features and treatment outcomes. This article reviews the current evidence on PCA3 as a marker for prostate cancer detection and prognosis. [Rev Urol. 2011;13(4):e191-e195 doi: 10.3909/riu0539] © 2011 MedReviews®, LLC

Prostate cancer Prostatectomy Prostate cancer antigen 3 Risk assessment

Volume 13, Number 2 Meeting Reviews

New Frontiers in Imaging and Focal Therapy

Highlights From the Third International Symposium on Focal Therapy and Imaging of Prostate and Kidney Cancer, February 24-27, 2010, Washington, DC

Thomas J Polascik Vladimir Mouraviev

[Rev Urol. 2011; 13(2):104-111 doi: 10.3909/riu0523] © 2011 MedReviews®, LLC

Prostate cancer Focal therapy Kidney cancer

Volume 13, Number 2 Case Review

Malignant Priapism Secondary to Metastatic Prostate Cancer: A Case Report and Review of Literature

Mohit Khera Ned B Stein Jerry J Kim Yu-Hsiang Lin

Penile metastasis of cancers from other primary sites is a rare phenomenon that infrequently manifests as malignant priapism. We outline a case of an 84-year-old patient who presented with a 3-month history of painful priapism after radiation therapy for prostate adenocarcinoma. The patient underwent surgical penile exploration and cavernosal biopsy that revealed poorly differentiated cells suggestive of prostate cancer. Postoperative imaging demonstrated extensive regional and distal metastases. A review of the literature on penile metastases returned approximately 400 published cases, with priapism being the initial presentation in 20% to 50% of cases. Regardless of site of origin or subsequent management, most cases have shown very poor prognosis. [Rev Urol. 2011;13(2):90-94 doi: 10.3909/riu0508] © 2011 MedReviews®, LLC

Prostate cancer Malignant priapism Penile metastasis