רמות PSA וסרטן הערמונית

Source: Fox Chase Cancer Center Date: November 9, 2006 Rapidly Rising PSA Before Treatment Is Key Indicator Of Cancer Spread Results of a new Fox Chase Cancer Center study show that men with a rapidly rising PSA level before treatment have a high probability of metastatic disease AND should receive hormone therapy in addition to radiation. The findings were presented today at the 48th Annual Meeting of the American Society for Therapeutic Radiology AND Oncology in Philadelphia. ------------------------------------------------------------------------------- The rate of a rise in PSA level, known as PSA velocity (PSAV), can be used to determine when prostate cancer spread may have already occurred, even in men with clinically localized disease. PSA, OR prostate specific antigen, is measured by a blood test AND used to determine if prostate cancer is present. "We've known that men with a rapidly rising PSA are at greater risk of prostate cancer-related death AND this study suggests that undetected distant metastasis present prior to radiation therapy may be the cause," explained Mark K. Buyyounouski, M.D., M.S., an attending physician in the radiation oncology department at Fox Chase AND lead author of the study. The study looked at data collected between 1989 AND 1999 for 671 men with clinically localized prostate cancer who received 3-D conformal radiation therapy. Buyyounouski AND others demonstrated that when the PSAV was greater than 2 ng/ml per year, the PSA was likely to continue rising at the same rate despite radiation therapy to the prostate. What's more, this group of men was found to have a greater likelihood of distant spread of prostate cancer AND a greater risk of dying of the disease. This relationship was not seen for men with a slower PSAV of less than 2 ng/ml. "This study suggests that an initially high PSAV often represents previously undetected metastatic disease exists at the time of diagnosis," said Buyyounouski. "This disease has the opportunity to progress if radiation therapy to the prostate AND surrounding tissue is the only treatment," said Buyyounouski. "Therefore, it is recommended that the PSAV be used in addition to other high risk factors to determine if androgen deprivation therapy should be part of the treatment." Androgen deprivation therapy, OR hormone therapy, has been shown to improve survival when used in conjunction with radiation therapy for men at high risk of undetected spread of prostate cancer. Buyyounouski concluded that requiring a PSAV of less than 2 ng/ml will be important for selecting patients who are most likely to benefit from radiation therapy alone. This has important implications for studies designed to compare various radiation regimens such as hypofractionation.

Source: American Society for Therapeutic Radiology AND Oncology Date: November 9, 2006 Largest PSA Bounce Study Eases Worry Of Prostate Cancer Returning Prostate cancer patients who have a temporary rise in their prostate specific antigen (PSA) levels after radiation therapy - called a PSA bounce - are not at an increased risk of their cancer coming back any more than those who don't have a temporary rise, according to the largest study of its kind presented November 8, 2006, at the American Society for Therapeutic Radiology AND Oncology's 48th Annual Meeting in Philadelphia. -------------------------------------------------------------------------------- External beam radiation therapy AND radiation seed implants are two of the main treatments for prostate cancer. Since these treatments are minimally invasive, have short recovery periods AND often help men preserve their sexual AND urinary function, many men with prostate cancer prefer radiation over other treatments, including surgery. The PSA bounce is common in half of all men who have radiation treatment for prostate cancer. Increased levels of PSA, which is a protein produced by the prostate, may be a sign of prostate cancer. "I believe the results of our study should help reduce the stress AND uncertainty for men who experience a PSA bounce after radiation knowing that this doesn't represent a recurrence OR put them at increased risk for cancer coming back later on," said Eric Horwitz, M.D., lead author of the study AND clinical director of the radiation oncology department at Fox Chase Cancer Center in Philadelphia. "This study significantly impacts the clinical practice for both radiation oncologists AND urologists. Clinicians should consider additional PSA tests after the initial bounce to see if the PSA levels return to normal before concluding that cancer has recurred AND recommending additional treatment." The study involved more than 7,500 men in 19 institutions who were treated for prostate cancer with either external beam radiation therapy OR radiation seed implants. Findings show that over a 10-year period, there was no difference in cancer recurrence between those who had a PSA bounce AND those who did not.

N Engl J Med. 2006 Feb 9;354(6):557-66. Saw palmetto for benign prostatic hyperplasia. Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, San Francisco, USA. BACKGROUND: Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia AND is commonly recommended as an alternative to drugs approved by the Food AND Drug Administration. METHODS: In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) OR placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) AND the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, AND the rate of reported adverse effects. RESULTS: There was no significant difference between the saw palmetto AND placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38), prostate size, residual volume after voiding, quality of life, OR serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups. CONCLUSIONS: In this study, saw palmetto did not improve symptoms OR objective measures of benign prostatic hyperplasia. . --------------------------------------------------- Nutr Cancer. 2006;55(1):21-7. Saw palmetto supplement use AND prostate cancer risk. School of Nutrition AND Exercise Science, Bastyr University, Kenmore, WA 98028-4966, USA. Saw palmetto is an herb used to treat the symptoms of benign prostatic hyperplasia. In vitro studies have found that saw palmetto inhibits growth of prostatic cancer cells AND may induce apoptosis. To evaluate whether saw palmetto supplements are associated with a reduced risk of prostate cancer, we conducted a prospective cohort study of 35,171 men aged 50-76 yr in western Washington state. Subjects completed questionnaires between 2000 AND 2002 on frequency of use of saw palmetto supplements AND saw palmetto-containing multivitamins over the previous 10 yr in addition to other information on supplement intake, medical history, AND demographics. Men were followed through December 2003 (mean of 2.3 yr of follow-up) via the western Washington Surveillance, Epidemiology, AND End Results cancer registry, during which time 580 developed prostate cancer. Ten percent of the cohort used saw palmetto at least once per week for a year in the 10 yr before baseline. No association was found between this level of use of saw palmetto AND risk of prostate cancer development [hazard ratio (HR) = 0.95; 95% confidence interval = 0.74-1.23] OR with increasing frequency OR duration of use. In this free-living population, use of commercial saw palmetto, which varies widely in dose AND constituent ratios, was not associated with prostate cancer risk.

צריכת אנטיאוקסידנטים ע"י חולים בסרטן הערמונית המטופלים ברדיותרפיה אינה פוגעת ביעילות הטיפול. השאלה היא האם הם עוזרים. Antioxidants Complement Cancer Treatment 10.11.06 Antioxidants -- such as green tea extract, vitamins C AND E -- do not interfere with radiation treatment for cancer, says a U.S. study. This study provides evidence that antioxidants as a complementary therapy in cancer treatment do not interfere with external beam radiation therapy, said lead author Timothy Birdsall, vice president of integrative medicine for Cancer Treatment Centers of America. Antioxidants are one of many complementary AND alternative medicine therapies that are crucial in today's fight against cancer. Researchers at Cancer Treatment Centers of America reviewed PSA levels of prostate cancer patients after receiving radiation therapy. They found no difference between patients taking antioxidants AND those who did not. Antioxidants used in the study included green tea extract, melatonin, high-potency multivitamins, vitamin C AND vitamin E. The study addressed the concern that antioxidants might interfere with cancer cell oxidation levels that contribute to tumor killing by chemotherapy AND radiation therapy. The findings are scheduled to be presented at the Society of Integrative Oncology's Third International Conference in Boston.