scholarly journals Metastatic prostate cancer with malignant ascites: A case report and literature review

2013 ◽  
Vol 7 (3-4) ◽  
pp. e248-50 ◽  
Author(s):  
Ifeanyi Ani ◽  
Mark Costaldi ◽  
Robert Abouassaly
Keyword(s):  
Prostate Cancer ◽  
Renal Failure ◽  
African American Male ◽  
Voiding Dysfunction ◽  
Specific Antigen ◽  
Malignant Ascites ◽  
Metabolic Abnormalities ◽  
Prostatic Specific Antigen ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Malignant ascites from advanced prostate cancer is a rare entity with only few cases reported. It represents a poor prognosis. We report a case of a 57 year old African American male presenting with weight loss, lower urinary tract symptoms, and voiding dysfunction, found to be in renal failure with metabolic abnormalities associated with significant abdominal distention and pain.  CT imaging showed ascites which was pathologically confirmed by immunostaining and cytological identification of malignant cells. Prostate biopsy identified high grade prostate cancer which responded to hormonal therapy with a significant decrease in serum prostatic specific antigen (PSA). Ascites was managed with paracentesis and renal failure with hemodialysis as needed.

scholarly journals Biomarkers in the setting of benign prostatic hyperplasia-induced lower urinary tract symptoms: what an interventional radiologist needs to know

2020 ◽  
Vol 93 (1114) ◽  
pp. 20200484
Author(s):  
Shamar Young ◽  
Alessandro Gasparetto ◽  
Hamed Jalaeian ◽  
Jafar Golzarian
Keyword(s):  
Prostate Cancer ◽  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

With increasing evidence to support prostate artery embolization (PAE) in the treatment of benign prostatic hyperplasia (BPH)-induced lower urinary tract symptoms (LUTS), Interventional Radiologists have begun to play an important role in the management of these patients. One area of knowledge needed when developing a PAE practice is knowledge of prostate-specific antigen (PSA) and other biomarkers utilized to detect prostate cancer in this population and what role they should play in the work up and follow-up of patients presenting with presumed BPH-induced LUTS. Furthermore, understanding how to evaluate presumed BPH-induced LUTS and stratify the risk of prostate cancer is an important skill to develop. The goal of this review is to provide Interventional Radiologists who have begun or aim to begin a PAE practice with the information they need to know regarding PSA levels and prostate cancer risk stratification for this patient population.

scholarly journals Prevalence of Prostate Cancer at Serum PSA Level Between 2.5 and 4.0 NG/ML in Bangladeshi Men

2020 ◽  
Vol 19 (2) ◽  
pp. 85-89
Author(s):  
Md Latifur Rahman Miah ◽  
Md Shawkat Alam ◽  
Md Abdus Salam ◽  
Md Naushad Alam ◽  
Md Nazmul Islam ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Urinary Tract ◽  
Prostate Specific Antigen ◽  
Lower Urinary Tract ◽  
Specific Antigen ◽  
Malignant Lesion ◽  
Age Group ◽  
Urinary Tract Symptoms ◽  
Study Population ◽  
Lower Urinary

Background: Prostate cancer is the most common cancer in men. The most common prostate cancer test is the prostate-specific antigen (PSA) test. This is a simple blood test that measures the presence of prostate-specific antigen circulating in bloodstream. This test is usually the first step in any prostate cancer diagnosis. Objective: To detect the occurrence of prostate cancer at different level of serum PSA level between 2.5ng/ml and 4ng/ml. Method: This hospital based cross sectional analytical study was conducted between the periods of January 2012 to April 2013. A total of 30 patients with features of lower urinary tract symptoms with enlarged prostate attending to the Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Sher-E-Bangla Nagar, Dhaka were purposively selected as study population by taking the permission of ethical committee. Patients more than 50 years old with lower urinary tract symptoms at S. PSA level 2.5 - 4 ng/ml and enlarged prostate in DRE were selected as study population. Patients with bleeding disorder, anorectal pathology, active UTI or prostatitis or urethral stricture were excluded from this study. DRE was done to see the size, consistency and nodularity of prostate. Those who had enlarged prostate found on DRE, they were sent for biopsy multi parametric MRI (MPMRI) & Prostate Imaging Reporting and Data system (PIRAD) score may be applied. Result: The mean age of the patients was 66.87±10.13 years with a range of 52-90 years. Among 30 patients 10 (33.3%) were in the age group of 51-60 years, 10 (33.3%) were in the age group of 61 - 70 years, 5 (16.7%) were in the age group of 71 - 80 years and 5 (16.7%) were in the age group >80 years. Among 30 patients 4 (13.3%) had malignant lesion and 26 (86.7%) had benign lesion. Mean serum PSA level among the patients with histopathological findings benign and malignant were 3.34±0.51 and 3.47±0.43 ng/ml respectively. Out of 4 patients with malignant lesion, 1(25.0%) had serum PSA level within 2.50-2.99 ng/ml, another 1(25.0%) had 3.00-3.49 ng/ml and 2(50.0%) had serum PSA level within 3.50-4.00 ng/ml. There is no statistically significant difference observed in serum PSA level among the patients with histopathological findings benign and malignant (P>0.05). Conclusion: For early diagnosis of prostate cancer cut-off value of serum PSA of 2.5 ng/ ml may be used as an indication for prostate biopsy. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.85-89

scholarly journals The Advantages of Transurethral Resection of the Prostate in Patients with an Elevated or Rising Prostate Specific Antigen, Mild or Moderate Lower Urinary Tract Symptoms, Bladder Outlet Obstruction and Negative Prostate Cancer Imaging or Prostate Biopsies: A Prospective Analysis in 105 Consecutive Patients

2016 ◽  
Vol 10 (3) ◽  
pp. 140-144 ◽  
Author(s):  
Evert Baten ◽  
Koenraad van Renterghem
Keyword(s):  
Prostate Cancer ◽  
Urinary Tract ◽  
Transurethral Resection ◽  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Specific Antigen ◽  
Outlet Obstruction ◽  
Urinary Tract Symptoms ◽  
The Mean ◽  
Lower Urinary

Objective: To investigate elevated or rising prostate specific antigen (PSA) as a marker for bladder outlet obstruction (BOO) in patients with minor lower urinary tract symptoms (LUTS) and without prostate cancer. Materials and Methods: One hundred and five consecutive patients were prospectively analyzed between 2005 and 2013. All patients were referred to the principal investigator by their general practitioner as a result of an elevated and/or rising PSA. Only patients with minor LUTS [International Prostate Symptom Score (I-PSS) 0-19] and without suspicion for prostate cancer were included. All patients had BOO, shown by full urodynamics, and underwent transurethral resection of the prostate. The resected tissue was histologically examined and PSA and I-PSS were evaluated after 3, 6 and 12 months and later on yearly. Results: Mean pre-operative PSA and I-PSS values were 8.8 ng/ml and 11.1, respectively. The mean detrusor pressure at maximum flow was 93.6 cmH2O. The mean resected volume was 52 g and the mean prostate biopsy rate was 1.8. Eighty-three of 105 patients (79%) had no malignancy and were diagnosed with BOO due to benign prostate hyperplasia (subgroup 1). Their mean PSA decreased from 9.2 to 0.7 ng/ml and 0.9 ng/ml after 6 and 12 months post-operation, respectively. The mean I-PSS declined from 11 to 3 after 6 and 12 months. Sixteen of 105 patients (15%) were treated for prostate cancer (subgroup 2). Radical prostatectomy was performed in 11 patients, brachytherapy in 3 patients and external beam radiotherapy in 2 patients. Six of 105 patients (5.7%) had active surveillance (subgroup 3). Conclusion: BOO can cause an elevated or rising PSA in patients with minor LUTS and negative screening for prostate cancer. Transurethral resection of the prostate is an adequate treatment for these patients.

scholarly journals Triptorelin for the relief of lower urinary tract symptoms in men with advanced prostate cancer: results of a prospective, observational, grouped-analysis study

2017 ◽  
Vol 9 (7) ◽  
pp. 179-190 ◽  
Author(s):  
Thierry Gil ◽  
Fouad Aoun ◽  
Patrick Cabri ◽  
Valérie Perrot ◽  
Roland van Velthoven
Keyword(s):  
Prostate Cancer ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Specific Antigen ◽  
Urinary Symptoms ◽  
Release Formulation ◽  
Extended Release Formulation ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background: Lower urinary tract symptoms (LUTSs) may develop in men with prostate cancer (PCa) and can impact quality of life (QoL). Gonadotropin-releasing hormone (GnRH) agonists as androgen deprivation therapy are standard treatment for PCa, however, data are limited on their effects on LUTSs. A grouped analysis of national observational, non-interventional studies initiated in clinical practice was performed to assess the effectiveness of triptorelin in reducing moderate or severe LUTSs, measured using the International Prostate Symptom Score (IPSS) in men with advanced or metastatic PCa. Methods: Men with PCa and LUTSs scheduled to receive triptorelin (3-month or 1-month extended release formulation) were recruited into prospective, non-interventional studies at centres in Algeria, Australia, Belgium, China, Hungary, Romania and South Korea. The primary effectiveness endpoint was the proportion of patients with moderate or severe LUTSs, assessed by IPSS, after 48 weeks. Secondary endpoints included: total IPSS, QoL due to urinary symptoms (IPSS Question 8) and prostate-specific antigen (PSA) levels at 24 and 48 weeks. Results: A total of 2701 patients were recruited; 1851 patients with moderate or severe LUTSs at baseline (IPSS > 7), received triptorelin and had follow-up IPSS (efficacy population). The proportion of patients with moderate or severe LUTSs was reduced to 67.2% from baseline at week 48, following a reduction to 75.9% at week 24: the overall time effect was significant ( p < 0.001). QoL due to urinary symptoms significantly improved from a mean score of 3.7 at baseline, to adjusted means of 2.5 and 2.1, at weeks 24 and 48, respectively ( p < 0.001 versus baseline). Mean PSA levels were reduced from 158.8 ng/ml at baseline to 11.5 and 16.0 ng/ml at weeks 24 and 48, respectively. Conclusions: Within the limitations of these observational studies, improvements in LUTSs and QoL observed after 24 weeks and maintained at 48 weeks indicate that triptorelin-induced effects improve LUTSs in patients with advanced PCa.

scholarly journals Effects of Testosterone Level on Lower Urinary Tract Symptoms

2016 ◽  
Vol 10 (5) ◽  
pp. 440-442 ◽  
Author(s):  
E. David Crawford ◽  
Wendy Poage ◽  
Allen Nyhuis ◽  
David A. Price ◽  
Sherie A. Dowsett ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Urinary Tract ◽  
Prostate Specific Antigen ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Specific Antigen ◽  
Tissue Growth ◽  
Urinary Tract Symptoms ◽  
Prostate Size ◽  
Lower Urinary

Lower urinary tract symptoms (LUTS) are common in older men and are frequently associated with benign prostatic hyperplasia (BPH). The relationship between BPH and endogenous total testosterone (TT) levels has been widely studied. The aim of this post hoc analysis was to determine the association between LUTS and endogenous TT levels in a subset of men participating in the 2013 Prostate Cancer Awareness Week, a U.S. community-based prostate cancer screening program. Men completed the International Prostate Symptom Score (I-PSS) questionnaire, prostate size was estimated by a digital rectal examination, and serum TT and prostate-specific antigen levels were measured. Mean TT levels (ng/dl) did not significantly correlate with prostate size category ( r = +.03, p = .69): normal, 419.2 ( n = 106); enlarged, 394.7 ( n = 71); abnormal, 416.4 ( n = 7); and abnormal/suspicious, 515.2 ( n = 19). Mean TT levels (ng/dl) did not significantly correlate with I-PSS category ( r = −.06, p = .40): none, 468.5 ( n = 15); mild, 414.0 ( n = 138); moderate, 397.4 ( n = 66); and severe, 437.9 ( n = 7). Mean TT levels (ng/dl) did not significantly correlate with I-PSS quality of life rating ( r = −.13, p = .055): delighted, 474.5 ( n = 43); pleased, 424.6 ( n = 65); mostly satisfied, 361.2 ( n = 63); mixed, 448.2 ( n = 29); mostly dissatisfied, 337.2 ( n = 17); and unhappy, 435.8 ( n = 6). Adjustment for prostate size or prostate-specific antigen levels yielded similar findings. In conclusion, endogenous TT levels did not correlate with LUTS or prostate size, and these findings support the saturation theory in which TT is not able to induce further androgen-stimulated prostate tissue growth due to receptor saturation. Any worsening of LUTS following testosterone replacement therapy in hypogonadal men may be related to stimulation of prostatic cells previously deprived of testosterone.

scholarly journals An Improbable Case of Ascites

2020 ◽  
Author(s):  
Virginia Visconti ◽  
Andre Fernandes ◽  
Ismenia Oliveira
Keyword(s):  
Prostate Cancer ◽  
Cancer Metastasis ◽  
Specific Antigen ◽  
Abdominal Distension ◽  
Abdominal Ultrasound ◽  
Malignant Ascites ◽  
Prostatic Specific Antigen ◽  
Computerised Tomography ◽  
Peritoneal Implant ◽  
Prostate Cancer Metastasis

Prostate cancer is the most frequent malignancy seen in males, with about 15% of cases showing metastatic disease at diagnosis, most commonly in bones (vertebrae, ribs, long bones). However, peritoneal metastasis with malignant ascites is extremely rare and may be overlooked by physicians. We report the case of a 77-year-old man presenting with symptoms of abdominal distension, nausea and weight loss. Abdominal ultrasound and computerised tomography confirmed ascites, peritoneal carcinomatosis and an enlarged prostate. Serum and ascitic prostatic-specific antigen were both elevated. Prostate biopsy identified a prostate adenocarcinoma, while biopsy of a peritoneal implant identified a prostate cancer metastasis, which responded well to hormonal therapy.

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