22.05.11
19.03.11
Sipuleucel-T
Imunitní buňky jsou extrahovány z krve pacienta pomocí procesu zvaného leukaferéza.
Pro zvýšení efektivity jsou poté „seznámeny“ s proteinem, který se vyskytuje na buňkách nádoru prostaty, a vráceny zpět do krve ve třech dávkách s dvoutýdenním intervalem.
Odkazy
Medical Tribune
08.03.11
Pomegranate Extract Produces Mixed Results in Prostate Cancer Patients - OncologySTAT
07.03.11
External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study : The Lancet Oncology
06.03.11
Zoledronic acid directly suppresses cell proliferation and induces apoptosis in highly tumorigenic prostate and breast cancers | DocGuide
19.01.11
Neoadjuvantí hornonoterapie zhoubného nádoru prostaty
- karcinomu prostaty vysokého rizika a u vybraných pacientů středního rizika.(NCCN a Evropská urologická společnost (Guidelines on Prostate Cancer 2009)
- redukce objemu prostaty až o 36%
- zmenšení plánovaného cílového objemu
- zmenšení rizika lokální recidivy inhibicí buněčného dělení během radioterapie
- snížení pravděpodobnosti vzniku vzdálených metastáz v době diagnózy i z event. recidivy tumoru
- určujícím faktorem efektu neoadjuvantní léčby není její délka, ale pokles PSA (čím výraznější pokles, tím lepší výsledky)
- Neoadjuvant androgen deprivation for prostate volume reduction: the optimal duration in prostate cancer radiotherapy.
06.11.10
Decline in ADT Not at Expense of Men With Prostate Cancer
29.10.10
Evolucí pošpiněný folikuly stimulující hormon
24.10.10
Fish-Filled Diet May Cut Prostate Cancer Mortality
11.08.10
Včelí produkty
Včelí produkty ve výživě a lékařství
01.08.10
Aggressive Local Treatment Likely With Low PSA - OncologySTAT
Elsevier Global Medical News. 2010 Jul 26, R FINN
Sipuleucel-T Prolongs Survival in Metastatic Prostate Cancer - OncologySTAT
Elsevier Global Medical News. 2010 Jul 28, M Moon
14.07.10
Statins and Prostate Cancer Recurrence: RCT Now Needed, Say Experts
The calls for a prospective trial have been prompted by retrospective observational trials that have shown a significant reduction in the risk for biochemical recurrence in men treated for the disease who were also taking statins. Two such studies have been published recently.
06.06.10
20.02.10
Predikce počtu nádorových onemocnění r. 2010 -2011
Zhoubné nádory kolorekta
Urologické malignity
Zhoubný nádor ledvin
Zhoubný nádor prostaty
Zhoubné nádory varlat
16.01.10
Zachyceno na Twitteru
- (Breast Cancer) Mammography Should Begin at 40, Say New Recommendations http://cli.gs/SE2Wr
- (Breast Cancer) Adjuvant Bisphosphonates in Endocrine-responsive Breast Cancer: What Is Their Place in Therapy?http://bit.ly/6Deit6
- Rare Study of Diet and Prostate Cancer Progressionhttp://bit.ly/8M2IBu
- (Breast Cancer) Acupuncture Reduces Vasomotor Symptoms in Breast Cancer Patients http://cli.gs/XX9JV
- (Lung Cancer) Green Tea May Help Cut Risk for Lung Cancerhttp://bit.ly/55Pkna
- Breast Cancer ZP uhradí od 1. února mamografickou prevenci i ženám nad 70 let: http://bit.ly/4BCKXQ via @addthis
01.10.09
What’s new in prostate cancer screening and prevention?
Cleveland Clinic Journal of Medicine
Prostate cancer is extremely common but causes death in only a minority of men in whom it develops, facts that raise issues regarding screening and treatment morbidity. Two large trials of screening with prostate-specific antigen (PSA) measurements came to seemingly opposite conclusions. Furthermore, a large trial of selenium and vitamin E found that these agents have no value as preventive agents.
- Rather than relying on PSA screening alone, we should stratify the risk of prostate cancer on the basis of race, age, PSA level, family history, findings on digital rectal examination, whether the patient has ever undergone a prostate biopsy, and whether the patient is taking finasteride (Proscar). A simple online tool is available to do this.
-We used to think the cutoff PSA level that had high sensitivity and specificity for finding cancer was 4 ng/mL. However, in the PCPT, 6.6% of men with PSA levels below 0.5 ng/mL were found to have cancer, and 12.5% of those cancers were high-grade. Of those with PSA levels of 3.1 to 4.0 ng/mL, 26.9% had cancer, and 25.0% of the cancers were high-grade. These data demonstrate that there is no PSA level below which risk of cancer is zero, and that there is no PSA cutoff with sufficient sensitivity and specificity to be clinically useful.
-The PCPT risk calculator (http://deb.uthscsa.edu/URORiskCalc/Pages/uroriskcalc.jsp)
is a wonderful tool that came out of that study. It uses seven variables—race, age, PSA level, family history of prostate cancer, findings on digital rectal examination, whether the patient has ever undergone a prostate biopsy, and whether the patient is taking finasteride—and calculates the patient’s risk of harboring prostate cancer and, more important, the risk of having high-grade prostate cancer. This tool allows estimation of individual risk and helps identify who is at risk of cancer that may require therapy.
-Men with a higher body mass index have lower PSA levels.
-New markers under study
- A number of new biological markers probably will improve our ability to detect prostate cancer, although they are not yet ready for widespread use.
- Urinary PCA3. Prostate cancer gene 3 (PCA3) codes for a messenger RNA that is highly overexpressed in the urine of men with prostate cancer. Urine is collected after prostate massage. Marks et al14 reported that PCA3 scores predicted biopsy outcomes in men with serum PSA levels of 2.5 ng/mL or higher.
- Serum EPCA-2 (early prostate cancer antigen 2) is another candidate marker undergoing study.
- Gene fusions, specifically of TRMPSS2 and the ETS gene family, are detectable in high levels in the urine of some men with prostate cancer, and appear to be very promising markers for detection.
- Metabolomics is a technique that uses mass spectroscopy to detect the metabolic signature of cancer. Sreekumar et al15 identified sarcosine as a potential marker of prostate cancer using this technique.
Genetic tests: Not yet
Some data suggest that we can use genetic tests to screen for prostate cancer, but the tests are not yet as good as we would like.
další informace v článku
06.07.09
Hormonálně refrakterní karcinom prostaty
Definice: Podle doporučených postupů schválených Českou urologickou společností (ČUS) i Českou onkologickou společností (ČOS)
- přítomností kostních nebo jiných vzdálených metastáz,
- kontinuálním nárůstem PSA (tři následné vzestupy hodnot v intervalu minimálně 2 týdnů)
- při kastračních hladinách testosteronu a minimálně 4 týdny po vysazení antiandrogenů
Definition of HRPC (Guidelines on prostate carcinoma -
European Association of Urology 2009)
• Serum castration levels of testosterone (testosterone <> 2 ng/mL
• Anti-androgen withdrawal for at least 4 weeks*
• PSA progression, despite secondary hormonal manipulations*
• Progression of osseous lesions: progression or appearance of two or more lesions on bone scan or soft
tissue lesions using the RECIST criteria** and with nodes . 2 cm in diameter
* Either anti-androgen withdrawal or one secondary hormonal manipulation should have been done in order to fulfil the criteria for HRPC.
** From Therasse et al., 2000
Možnosti léčby
Sekundární hormonální terapie
- vysazení antiandrogenu - flutamid - pokles PSA cca za 4 týdny. bicalutamind - k poklesu PSA dochází déle -vyčkat min 6-8 týdnů
doba trvání odpovědi na vysazení antiandrogenu je průměrně 4 měsíce
Chemoterapie
- Docetaxel 75mg/m2 + Prednison 5mg 2x denně á 3 týdny
- u symptomatických pacientů je možno zvážit nasazení mitoxantronu, u kterého bylo prokázáno ovlivnění bolesti
mitoxantron 12 mg/m2 i. v. + Prednison 5 mg per os á 21 dnů - Vinorelbin 30 mg/m2 i.v. inf, 1. a 8. den + hydrocortison 40 mg p.o. denně á 21 dnů
Bifosfonáty
Kortikoidy
mechanismus účinku je jak v tlumivém zásahu do syntézy RNA a proteinů nádorové buňky, tak v potlačení koncentrace DHEA (dihydroepiandrosteronu) a androstensionu
Až u jedné třetiny pacientů pouhým nasazením glukokortikoidů lze dosáhnou poklesu hladin PSA
Ostatní
radionuklidy ,analgetika , estrogeny, pal. radioterapie
Odkazy - hormo refrakterní ca prostaty
Normogram prognozy přežití 1-2 let u hormon refrakterního ca prostaty (Sloan-Kettering Cancer Center