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Prostate-specific antigen

All articles from this key word are listed below.

Volume 8, Supplement 2 Review Articles

Prostate Cancer: Epidemiology, Screening, and Biomarkers

16th International Prostate Cancer Update

Gerald W Chodak

Carcinoma of the prostate continues to be a major health problem in the United States. Beginning in 1988, a marked increase in detection of prostate cancer occurred due to the development of a test for prostate-specific antigen (PSA). Controversy exists, however, about the value of PSA as a tumor marker. Although it has prognostic significance both before and after definitive therapy for prostate cancer, it is unclear whether routine PSA screening will translate into a survival advantage for patients. Because of its limitations, PSA may not ultimately be a good enough marker to be used as a screening tool. However, molecular biology has led to a rapid rise in the number of potential new prostate tumor markers, which may eventually overcome the weaknesses of PSA. Considerable progress has occurred in the diagnosis and management of prostate cancer: more is understood about the risk factors for the disease, possible ways to prevent it, and new ways to diagnose and monitor it. These developments have already translated into better patient care, while also identifying where further improvements are needed. [Rev Urol. 2006;8(suppl 2):S3-S8]

Prostate cancer Prostate-specific antigen Biomarkers Prostate-specific membrane antigen Prostate-specific antigen doubling time

Volume 8, Supplement 2 Review Articles

Monitoring Response, Prediction Methodology, Staging, and Imaging in Prostate Cancer

16th International Prostate Cancer Update

Nicholas Vogelzang David Pomerantz

The predictive values of various tests and examinations are assessed as they relate to prostate cancer progression and treatment. The usefulness of post-treatment biopsy specimens is greatest 2 years after radiation therapy completion. Gleason grading is not reliable in the setting of hormonal ablation therapy. For patients with extracapsular extension, the survival curves separate depending on whether positive or negative surgical margins are obtained. Prostate-specific antigen doubling time is increasingly used as an indicator of disease recurrence after local therapy and prostate cancer–specific survival. [Rev Urol. 2006;8(suppl 2):S30-S34]

Prostate cancer Immunotherapy Prostate-specific antigen Predictive modeling Prostate-specific antigen doubling time

Volume 8, Supplement 2 Review Articles

The Treatment of Hormone-Refractory Prostate Cancer: Docetaxel and Beyond

16th International Prostate Cancer Update

Daniel P Petrylak

Two randomized clinical trials demonstrated a survival benefit of 20% to 24% with docetaxel-based therapy when compared with survival with mitoxantrone and prednisone after failure of androgen ablation therapy. These studies supported the approval of docetaxel-based therapy for the treatment of metastatic hormone-refractory prostate cancer by the US Food and Drug Administration in May 2005. Clinical trials in hormone-refractory prostate cancer are now focused on building on the survival improvement seen with docetaxel-based therapy. This article presents a summary of some of the more promising treatments and regimens for advanced prostate cancer. [Rev Urol. 2006;8(suppl 2):S48-S55]

Prostate cancer Prostate-specific antigen Androgen ablation Docetaxel Estramustine Endothelin receptor antagonist

Volume 9, Number 4 Review Articles

Newer Potential Biomarkers in Prostate Cancer

Diagnostic Update

Jonathan L Wright Paul H Lange

Prostate-specific antigen (PSA) screening has led to a significant rise in the number of men diagnosed with prostate cancer and an associated increase in biopsies performed. Despite its limitations, including a positive predictive value of only 25%-40%, PSA remains the only generally accepted biomarker for prostate cancer. There is a need for better tools to not only identify men with prostate cancer, but also to recognize those with potentially lethal disease who will benefit from intervention. A great deal of work has been done worldwide to improve our knowledge of the genetics behind prostate cancer and the specificity of PSA by developing assays for different PSA isoforms. Common genetic alterations in prostate cancer patients have been identified, including CpG hypermethylation of GSPT1 and TMPRSS2:ERG gene fusion. Serum and urine detection of RNA biomarkers (eg, PCA3) and prostate cancer tissue protein antibodies (eg, EPCA) are being evaluated for detection and prognostic tools. This article reviews some of the promising developments in biomarkers. [Rev Urol. 2007;9(4):207-213]

Prostate-specific antigen PCA3 Alpha-methylacyl-CoA racemase Autoantibody arrays Epigenetic markers Gene fusion proteins Human kallikreins PSA isoforms RNA biomarkers

Volume 9, Number 3 Review Articles

Twenty Years of PSA: From Prostate Antigen to Tumor Marker

Diagnostic Update

L Blair Shamel Axel Semjonow Harry G Rittenhouse Stephen D Mikolajczyk Gabriela De Angelis

The measurement of prostate-specific antigen in serum is credited with dramatic advances in the early detection of men with prostatic carcinoma. This report summarizes the history of biochemical research and the current understanding and application of prostate-specific antigen in prostate cancer diagnostics. [Rev Urol. 2007;9(3):113-123]

Prostate cancer Prostate-specific antigen Human kallikrein

Volume 9, Number 3 Meeting Reviews

Best of the 2007 AUA Annual Meeting

Meeting Review

Dean G Assimos Michael K Brawer Claus G Roehrborn Jacob Rajfer J Curtis Nickel Michael B Chancellor Alan W Partin Ellen Shapiro Danil V Makarov

Highlights from the 2007 Annual Meeting of the American Urological Association May 19-24, 2007 Anaheim, CA [Rev Urol. 2007;9(3):133-154]

Prostate cancer Obesity Benign prostatic hyperplasia Antibiotic prophylaxis Nocturia Lower urinary tract symptoms Botulinum toxin Prostate-specific antigen Biomarkers PCA3 Testosterone Urinary tract infections Urolithiasis Laser ablation Endourology Male voiding dysfunction LHRH antagonists Antimuscarinic agents Circumcision Repeat biopsy Human glandularkallikrein Expectant management CRISP-3 MSP Microvesseldensity Endoglin Survivin Telomeres Interleukin-8 PDE-5 inhibitors Acute urinaryretention 5Alpha-reductase inhibitors Doxazosin Finasteride Transurethral microwave thermotherapy TURP Perioperative blood loss Microbialbiofilms HIV Stem cell injection

Volume 9, Number 2 Review Articles

The Impact of Definitions of Failure on the Interpretation of Biochemical Recurrence Following Treatment of Clinically Localized Prostate Cancer

Diagnostic Update

Matthew E Nielsen Alan W Partin

Widespread early detection with prostate-specific antigen (PSA) has radically transformed the clinical management of prostate cancer. PSA has become valuable in the monitoring and risk stratification of recurrent disease following local therapy. In many ways, biochemical recurrence–free survival, or PSA outcome, has become a surrogate measure of treatment efficacy following primary local therapy. Given the inherent differences in PSA kinetics following these treatment approaches, the definition of biochemical success or failure is not uniform among therapies. An appreciation of the inherent strengths, limitations, and biases of the standard definitions of failure can provide a more meaningful context within which to interpret the reported outcomes of different treatment modalities. [Rev Urol. 2007;9(2):57-62]

Prostate-specific antigen Radiotherapy Hormonal therapy Prostate cancer recurrence Biochemical failure Brachytherapy

Volume 9, Supplement 1 Review Articles

Clinical Experience With Gene Therapy for the Treatment of Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Matthew A Stanizzi Simon J Hall

Localized prostate cancer can be treated effectively with radical prostatectomy or radiation therapy. The treatment options for metastatic prostate cancer are limited to hormonal therapy; hormone-refractory cancer is treated with taxane-based chemotherapy, which provides only a modest survival benefit. New treatments are needed. The gene for the initiation of prostate cancer has not been identified; however, gene therapy can involve tumor injection of a gene to kill cells, systemic gene delivery to target and kill metastases, or local gene expression intended to generate a systemic response. This review will provide an overview of the various strategies of cancer gene therapy, focusing on those that have gone to clinical trial, detailing clinical experience in prostate cancer patients. [Rev Urol. 2007;9(suppl 1):S20-S28]

Prostate cancer Prostate-specific antigen Gene therapy

Volume 10, Number 4 Review Articles

Using Biopsy to Detect Prostate Cancer

Diagnostic Review

Shahrokh F Shariat Claus G Roehrborn

Transrectal ultrasound-guided systemic biopsy is the recommended method in most cases with suspicion of prostate cancer. Transrectal periprostatic injection with a local anesthetic may be offered as effective analgesia; periprostatic nerve block with 1% or 2% lidocaine is the recommended form of pain control. On initial biopsy, a minimum of 10 systemic, laterally directed cores is recommended, with more cores in larger glands. Extended prostate biopsy schemes, which require cores weighted more laterally at the base (lateral horn) and medially to the apex, show better cancer detection rates without increasing adverse events. Transition zone biopsies are not recommended in the first set of biopsies, owing to low detection rates. One set of repeat biopsies is warranted in cases with persistent indication. Saturation biopsy (=20 cores) should be reserved for repeat biopsy in patients who have negative results on initial biopsy but who are still strongly suspected to have prostate cancer. [Rev Urol. 2008;10(4):262-280]

Prostate cancer Biopsy Prostate-specific antigen Transrectal ultrasound Nomograms Anesthesia

Volume 10, Number 3 Review Articles

Prostate Cancer Specificity of PCA3 Gene Testing: Examples from Clinical Practice

Diagnostic Update

Leonard S Marks David G Bostwick

A specific marker for early prostate cancer would fill an important void. In initial evaluations of the prostate cancer antigen 3 (PCA3) gene vis-à-vis serum prostate-specific antigen (PSA) levels, the gene offers great promise. At the cellular level, PCA3 specificity for cancer is nearly perfect because of the gross overexpression of the gene by cancer cells. As a clinical test for early prostate cancer, heightened specificity is also seen in urine containing prostate cells from men with the disease. PCA3 gene testing holds valuable potential in PSA quandary situations: (1) men with elevated PSA levels but no cancer on initial biopsy; (2) men found to have cancer despite normal levels of PSA; (3) men with PSA elevations associated with varying degrees of prostatitis; and (4) men undergoing active surveillance for presumed microfocal disease. [Rev Urol. 2008;10(3):175-181]

Prostate cancer Benign prostatic hyperplasia Prostate-specific antigen Prostatitis Watchful waiting Prostate cancer antigen 3 gene Microfocal disease