scholarly journals Long-Term Management of Incidental Bladder Cancer Detected in Patients Undergoing Prostatectomy for Prostate Cancer

2019 ◽  
Vol 13 (3) ◽  
pp. 145-149
Author(s):  
Norihito Soga ◽  
Jun Furusawa ◽  
Yuji Ogura
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Routine Screening ◽  
Urinary Cytology ◽  
Urinary Sediment ◽  
Sediment Analysis ◽  
Observation Period

Introduction: At our institution, screening for incidental bladder cancer is routinely performed to avoid tumor cell dissemination caused by surgery in patients undergoing prostatectomy for prostate cancer (PCa). Here, we report the long-term clinical results in patients with incidental bladder cancer detected by routine screening prior to prostatectomy. Materials and Methods: Between January 2003 and December 2013, 430 patients undergoing prostatectomy for resection of PCa were enrolled in this cohort study. All patients underwent screening with cystoscopy, urinary sediment analysis, and urinary cytology to detect incidental bladder cancer. The clinical outcomes of cases with incidental bladder cancer were evaluated. Results: The incidence of incidental bladder cancer was 2.1% (9/430). All tumors were single papillary tumors located around the urinary orifice or lateral side and were diagnosed as urothelial cancer (UC). No significant findings were detected by urinary sediment analysis or urinary cytology. Pathological results of transurethral resections revealed 5 cases of pTa with Grade 1 UC and 4 cases of pTa with Grade 2 UC. Androgen-deprivation therapy was administered to 8/9 patients. During the observation period (average of 7.2 years), UC recurrence was detected in 2 cases (2 and 7.3 years). However, transurethral resection successfully removed the tumor completely. After an average of 19.6 months (12-25 months) without UC recurrence, 7 patients (77.8%) underwent prostatectomy, and 2 patients received radiation or androgen-deprivation therapy. Prostatectomy was carried out without dissemination of UC during the observation period. Conclusion: Incidental UC was detected in 2.1% of prostatectomy candidates. Preoperative routine screening with flexible cystoscopy was useful to detect early incidental UC.

Hormonal response recovery after long-term androgen deprivation therapy in patients with prostate cancer

2016 ◽  
Vol 50 (6) ◽  
pp. 425-428 ◽  
Author(s):  
Jacques Planas ◽  
Ana Celma ◽  
José Placer ◽  
Mercè Cuadras ◽  
Lucas Regis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Hormonal Response ◽  
Response Recovery

Androgen Deprivation Therapy for Prostate Cancer Does Not Increase Cardiovascular Mortality in the Long Term

Oncology ◽  
2012 ◽  
Vol 82 (1) ◽  
pp. 56-58 ◽  
Author(s):  
Chantelle Wilcox ◽  
Allison Kautto ◽  
Allison Steigler ◽  
James W. Denham
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Cardiovascular Mortality ◽  
Androgen Deprivation

Prevalence of overweight and prediabetes in men receiving systemic therapies for metastatic prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 289-289 ◽  
Author(s):  
Warner Finstad ◽  
Raimundas Galiauskas ◽  
James Cook ◽  
Kate Murphy ◽  
Derbrenn O'Connor ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Steroid Therapy ◽  
Metastatic Prostate Cancer ◽  
American Diabetes Association ◽  
Androgen Deprivation ◽  
Treatment Type ◽  
The Impact ◽  
Systemic Therapies

289 Background: Patients with metastatic prostate cancer receive several therapies which may be associated with a tendency to overweight and impaired glucose tolerance. These include androgen deprivation therapy and long term steroid therapy. We set out to assess the prevalence of overweight and diabetes/prediabetes in a cohort of patients attending an oncology day ward for a variety of systemic therapies. Methods: We performed a retrospective review of the medical records of men attending an oncology day ward for prostate cancer treatment. As part of their usual care, these men had regular height and weight checks and also had periodic hemoglobin A1C (HbA1C) measurements performed. The prevalence of prediabetes and diabetes in this patient population was assessed from the HbA1C results using the American Diabetes Association 2016 definitions. Information on patient steroid use (and type), and treatment type were also recorded. Results: Among 34 men with metastatic prostate cancer, the mean age was 74 (range 57-88). Therapies received included androgen deprivation therapy in all cases, with chemotherapy or novel androgen receptor pathway inhibitors such as abiraterone and enzalutamide. Only 12% had a pre-existing diagnosis of diabetes mellitus (all type 2). The majority (79%) are overweight or obese. 59% have pre-diabetes as per the American Diabetes Association 2016 Guidelines, while a further 24% meet criteria for diabetes. Only 18% have HbA1c in the normal range. 56% are on continuous long term steroid therapy, usually as part of their prostate cancer therapy. A further 23% receive intermittent steroids. Only 21% had received no steroids in the 6 months prior to first HbA1C check. 18% had castrate-sensitive disease and 82% had castrate resistant disease. Even among patients with castrate sensitive disease, 2/3 had abnormal HbA1c values. Conclusions: Overweight and prediabetes are very prevalent in men receiving systemic therapies for metastatic prostate cancer. A large percentage of men are on long-term steroid therapy which may be contributing to their risk of these conditions. Intervention is required for this group of patients to reduce the impact of therapy on cardiovascular and overall health.

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