Prostate cancer and prostatic diseases
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Prostate Cancer Prostatic Dis. · Jan 2002
Regulation of Bcl-2 during androgen-unresponsive progression of prostate cancer.
The progression of prostate cancer from androgen-responsive to an androgen-unresponsive state remains the greatest obstacle in the treatment of this disease. Androgen-unresponsive prostate cancer is highly resistant to chemotherapy and radiation treatment that kill cells by the induction of apoptosis. Elucidating the molecular mechanisms of apoptosis regulation in prostate cancer can be useful in the development of new strategies for effective therapy of androgen-unresponsive cancer. ⋯ Both androgen-responsive and androgen-unresponsive cells expressed Bax protein at similar levels. When exposed to oxidative stress, androgen-responsive cells underwent apoptosis but androgen-unresponsive cells exhibited resistance suggesting that the progression to androgen-unresponsiveness was associated with altered regulation of apoptosis. Treatment with paclitaxel or sodium butyrate induced apoptosis in both androgen-responsive and androgen-unresponsive cells suggesting that the apoptotic machinery is still intact in androgen-unresponsive LNCaP cells.
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Prostate Cancer Prostatic Dis. · Jan 2002
ReviewThe role of external radiotherapy in patients treated with permanent prostate brachytherapy.
To examine the difference in Prostate Specific Antigen (PSA)-Relapse Free Survival (RFS) in patients (pts) with prostate cancer treated with permanent prostate brachytherapy (PPB) alone (monotherapy) or combined modality PPB and external radiotherapy (CMT) by a matched pair analysis. There were 1476 pts who were treated loosely based on the American Brachytherapy Society criteria for monotherapy or CMT. PSA-RFS was based upon the Kattan modification of the ASTRO consensus panel definition. ⋯ Actuarial 5-y PSA-RFS was 77.0% for the monotherapy group and 81.1% for the combined therapy group (P=0.54).chi(2) testing by pretreatment PSA value, Gleason score sum, risk stratification, isotope and the addition of neoadjuvant hormones failed to identify any group with a significant difference in 5-y PSA-RFS. In conclusion, this retrospective study presents a large cohort of patients treated with PPB that failed to identify a significant advantage for the addition of combined therapy. A matched pair analysis performed also failed to identify any significant difference based on treatment modality.
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Prostate Cancer Prostatic Dis. · Jan 2002
Can single dose preoperative intrathecal morphine sulfate provide cost-effective postoperative analgesia and patient satisfaction during radical prostatectomy in the current era of cost containment?
We retrospectively analyzed the analgesic efficacy and surgical outcomes of a single preoperative intrathecal long-acting morphine sulfate injection (0.25-0.5 mg) and postoperative intravenous (i.v.) ketorolac in 62 patients who underwent radical retropubic prostatectomy (RRP). Total postoperative analgesic requirement was documented along with assessment of length of hospital stay, pain control and time for resumption of normal activity. Postoperatively, 45% of patients required only nonsteroidal agents (ketorolac), whereas 55% needed a mean of 13.3 mg of supplemental i.v. morphine sulfate. ⋯ Ninety-seven per cent of patients were satisfied with anesthesia selected and 95% of patients considered pain control on postoperative days 1 and 2 as effective. All patients resumed to full physical activity by 5.3+/-0.4 weeks after surgery. We conclude that a single preoperative injection of intrathecal morphine sulfate combined with i.v. ketorolac postoperatively results in effective analgesia, diminished supplemental narcotic requirement and high patient satisfaction during radical retropubic prostatectomy.