scholarly journals Current Challenges in Prostate Cancer Management and the Rationale behind Targeted Focal Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Al B. Barqawi ◽  
Kevin J. Krughoff ◽  
Khadijah Eid
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Focal Therapy ◽  
Current Treatment ◽  
Cancer Awareness ◽  
Cancer Statistics ◽  
Cancer Management ◽  
Treatment Techniques ◽  
High Prevalence

Among men, prostate cancer has a high prevalence, with relatively lower cancer-specific mortality risk compared to lung and colon cancer. Prostate-specific antigen (PSA) screening has increased prostate cancer awareness since its implementation as a screening tool almost 25 years ago, but, due to the largely indolent course of this disease and the unspecific nature of the PSA test, increased incidence has largely been associated with cancers that would not go on to cause death (clinically insignificant), leading to an overdiagnosis challenge and an ensuing overtreatment consequences. The overtreatment problem is exacerbated by the high risk of side effects that current treatment techniques have, putting patients’ quality of life at risk with little or no survival benefit. The goals of this paper are to evaluate the rise, prevalence, and impact of the overdiagnosis and ensuing overtreatment problems, as well as highlight potential solutions. In this effort, a review of major epidemiological and screening studies, cancer statistics from the advent of prostate-specific antigen screening to the present, and reports on patient concerns and treatment outcomes was conducted to present the dominant factors that underlie current challenges in prostate cancer treatment and illuminate potential solutions.

scholarly journals Role of miRNALet-7and Its Major Targets in Prostate Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Siegfried Wagner ◽  
Anaclet Ngezahayo ◽  
Hugo Murua Escobar ◽  
Ingo Nolte
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Target Genes ◽  
Prostate Cancer Screening ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Current Treatment ◽  
Diagnostic Potential ◽  
Major Interest ◽  
Hormone Refractory

Prostate cancer is worldwide the sixth leading cause of cancer related death in men thus early detection and successful treatment are still of major interest. The commonly performed screening of the prostate-specific antigen (PSA) is controversially discussed, as in many patients the prostate-specific antigen levels are chronically elevated in the absence of cancer. Due to the unsatisfying efficiency of available prostate cancer screening markers and the current treatment outcome of the aggressive hormone refractory prostate cancer, the evaluation of novel molecular markers and targets is considered an issue of high importance. MicroRNAs are relatively stable in body fluids orchestrating simultaneously the expression of many genes. These molecules are currently discussed to bear a greater diagnostic potential than protein-coding genes, being additionally promising therapeutic drugs and/or targets. Herein we review the potential impact of the microRNAlet-7family on prostate cancer and show how deregulation of several of its target genes could influence the cellular equilibrium in the prostate gland, promoting cancer development as they do in a variety of other human malignant neoplasias.

Lifestyle factors and prostate-specific antigen

2021 ◽  
pp. 205141582110277
Author(s):  
Daniel Wignall ◽  
Agapios Gkentzis
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Lifestyle Factors ◽  
Independent Effect ◽  
Reference List ◽  
Cancer Awareness ◽  
Level Of Evidence ◽  
Reductase Inhibitors ◽  
Psa Testing

Background: Increasing prostate cancer awareness has meant that more men are seeking out prostate-specific antigen (PSA) testing than ever before. Prostate cancer is now the most common malignancy in men, affecting one in eight. This article addresses lifestyle factors that may elevate PSA readings. Methods: A systematic review of the literature was performed using Medline for studies examining the association of PSA and lifestyle factors, including exercise, diet, sexual function as well as medication use. Further resources were identified from the reference list of retrieved articles. Results: Minimal level 1 evidence on the association of PSA with lifestyle factors was identified. Weak and generally inconsistent evidence was found on the effect of cycling and sexual activity. Diabetes and obesity did have inversely proportional effects on PSA values in large cohort studies. There was no evidence for an independent effect of different types of food to PSA. With regard to medications, the greatest impact is from 5-alpha reductase inhibitors, and these are used as a hair-loss treatment. Statins, non-steroidal anti-inflammatory drugs and thiazide diuretics can also have a clinically significant impact on PSA levels but unlikely to alter management. Discussion: For a small group of patients, cautious counselling on the factors summarised here before they have their blood tests may prevent undue stress and anxiety, particularly in those with borderline PSA results. Due to the inconsistency of results and lack of level 1a evidence, if there is reasonable suspicion for prostate cancer, a patient should still always be referred to a specialist. Level of evidence: Level 4.

scholarly journals Correlation between Prostate Specific Antigen and Prostate Biopsy Gleason Score

2019 ◽  
pp. 243-248
Author(s):  
PE Ngwu ◽  
GO Achor ◽  
VU Eziefule ◽  
JI Orji ◽  
FT Alozie
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Positive Correlation ◽  
Cancer Management ◽  
The Mean ◽  
High Level

Background: Prostate Specific Antigen (PSA) is a commonly used marker in prostate cancer management. Gleason grading is one of the most powerful predictors of prostatic biological behaviour. PSA, when combined with the Gleason score and clinical stage, improves the prediction of the pathological stage for prostate cancer. Objectives: To assess the degree of correlation between PSA level and Gleason score as well as determine the likelihood of aggressiveness of prostate cancer using Gleason score as a parameter. Methods: A cross-sectional prospective study was conducted among 234 consecutive consenting patients presenting to the Urology Out-Patient Clinic between April 2015 and March 2018. Serum PSA was done and patients with values above 4ng/ml and/or abnormal Digital Rectal Examination (DRE) were selected to have a prostate biopsy. The sample was histologically analysed with Gleason score recorded for those with prostate cancer. Gleason score was then correlated with PSA levels. Results: The mean age for prostate cancer patients was 71.3±8.7 years. The mean PSA for patients with prostate cancer was 52.3±37.5ng/ml (Confidence Interval = 46.1-58.6) with p<0.001. About 18.2% of histologically confirmed prostate cancer cases had Gleason score 8-10 implying a high level of tumour aggressiveness. There is a positive correlation between PSA and Gleason score with R-value 0.590 indicating a good degree of correlation. Conclusion: There is a good degree of a positive correlation between PSA level and Gleason score, as well as a high level of aggressiveness of prostate cancer in Umuahia.

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