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The PROFILE Feasibility Study: Targeted Screening of Men With a Family History of Prostate Cancer.

BACKGROUND: A better assessment of individualized prostate cancer (PrCa) risk is needed to improve screening. The use of the prostate-specific antigen (PSA) level for screening in the general population has limitations and is not currently advocated. Approximately 100 common single nucleotide polymorphisms (SNPs) have been identified that are associated with the risk of developing PrCa. The PROFILE pilot study explored the feasibility of using SNP profiling in men with a family history (FH) of PrCa to investigate the probability of detecting PrCa at prostate biopsy (PB). The primary aim of thi…

[The assessment of pathological PSA values by the general practitioner--observation or intervention?].

AIM: The aim of the present study was to evaluate the initiated consecutive diagnostic course after measurement of an elevated PSA value by the general practitioner. PATIENTS AND METHODS: 406 patients who underwent ultrasound-guided transrectal biopsy of the prostate were assessed retrospectively. Using a standardised questionnaire, we evaluated the examination findings detected by the general practitioners responsible for the patients' medical care. RESULTS: 88 patients revealed an elevated PSA-value of > or = 4 ng / mL. 60 of these patients showed an elevated PSA already in the first measu

The effect of race on the discriminatory accuracy of models to predict biochemical recurrence after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital and Duke Prostate Center databases.

To evaluate whether race modifies the accuracy of nomograms to predict biochemical recurrence (BCR) after radical prostatectomy among subjects from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Center (DPC) databases. Retrospective analysis of 1721 and 4511 subjects from the SEARCH and DPC cohorts, respectively. The discrimination accuracy for BCR of seven previously published predictive models was assessed using concordance index and compared between African-American men (AAM) and Caucasian men (CM). AAM represented 44% of SEARCH and 14% of DPC. In both cohorts,

Role of 18F-PSMA-1007 PET/CT-derived quantitative volumetric tumor parameters in cytoreductive radical prostatectomy selection for patients with low-volume metastatic hormone-sensitive prostate cancer: a retrospective study.

BACKGROUND: Cytoreductive radical prostatectomy (cRP) has emerged as a promising therapeutic approach for low-volume metastatic hormone-sens … 3 (41.28-157.41 cm3) and 78.57 cm3, respectively. Whole-body PSMA-TV was positively correlated with prostate-specific antigen (PSA), and patients with nonregional lymph node (NRLN) metastases had a greater whole-body PSMA-TV (P = 0.001). Cox regression analyses revealed that cRP, lower whole-body PSMA-TV and the absence of NRLN metastases were associated with better PFS (a …

Head-to-Head Comparison of 68Ga-PSMA-11 with 68Ga-P137 in Patients with Suspected Prostate Cancer.

P137 is a novel oxalyldiaminopropionic acid-urea-based prostate-specific membrane antigen (PSMA) targeting agent. This study compared the uptake patterns of 68Ga-P137 and the FDA-approved PET tracer 68Ga-PSMA-11 for diagnosing prostate cancer (PCa). Sixteen patients suspected of PCa were scanned by 68Ga-PSMA-11 and 68Ga-P137 PET/CT, respectively, followed by prospective analysis. The tumor-to-background ratio was calculated using normal prostate tissue, blood pool, muscle, and urine as backgrounds. Pathology or follow-up results were used to analyze uptake patterns of benign/malignant lesions

Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial.

Background The effects of regional histopathologic changes on prostate MRI scans have not been accurately quantified in men with an elevated prostate-specific antigen (PSA) level and no previous biopsy. Purpose To assess how Gleason grade, maximum cancer core length (MCCL), inflammation, prostatic intraepithelial neoplasia (PIN), or atypical small acinar proliferation within a Barzell zone affects the odds of MRI visibility. Materials and Methods In this secondary analysis of the Prostate MRI Imaging Study (PROMIS; May 2012 to November 2015), consecutive participants who underwent multiparamet…

Berberine Improves Benign Prostatic Hyperplasia via Suppression of 5 Alpha Reductase and Extracellular Signal-Regulated Kinase in Vivo and in Vitro.

Benign prostate hyperplasia (BPH) is a common disease in elderly men, characterized by proliferated prostate and urinary tract symptoms. The … the detrimental effects not only weight reduction and histological changes but also suppression of prostate-specific antigen (PSA), which is elevated during BPH. Additionally, BBR suppressed TP-associated increase of 5AR, androgen receptor (AR) and steroid coactivator-1 (SRC-1), the key factors in the pathogenesis of BPH. To evaluate the underlying molecular mechanisms re …

Men under the age of 55 years with screen detected prostate cancer do not have less significant disease compared to older men in a population of patients in Australia.

BACKGROUND: The American Urological Association (AUA) changed their Prostate-Specific Antigen (PSA) screening guidelines in 2013 to not recommend testing in men under 55 years of age without significant risk factors (such as a family history of prostate cancer or African ethnicity). The AUA argues that the rates of 'insignificant' prostate cancer (PC) in men under 55 are so high that the potential harms of PSA-testing in this population (over diagnosis and overtreatment) outweigh the benefits (early detection and treatment). Our study aims to identify and compare the rates of insignificant and…

Race as an independent predictor of outcome after treatment for localized prostate cancer.

PURPOSE: We analyze the outcome after prostatectomy or radiotherapy for localized prostate cancer with respect to race. MATERIALS AND METHODS: A total of 2,219 consecutive patients with prostate cancer were treated with radiotherapy (1,183) or radical prostatectomy (1,036) between June 1986 and June 1998. Initial prostate specific antigen (PSA) and biopsy Gleason scores were available in all cases. Androgen deprivation was used in 22% of men (492). Of the patients 86% (1,901) were white, including Hispanic and Asian, and 14% (318) were black. The outcomes of interest were biochemical relapse-

Single-cell analysis of multiple cancer types reveals differences in endothelial cells between tumors and normal tissues.

Endothelial cells (ECs) play an important role in tumor progression. Currently, the main target of anti-angiogenic therapy is the vascular endothelial growth factor (VEGF) pathway. Some patients do benefit from anti-VEGF/VEGFR therapy; however, a large number of patients do not have response or acquire drug resistance after treatment. Moreover, anti-VEGF/VEGFR therapy may lead to nephrotoxicity and cardiovascular-related side effects due to its action on normal ECs. Therefore, it is necessary to identify targets that are specific to tumor ECs and could be applied to various cancer types. We in

Biopsy-based diagnosis of prostate cancer in 1290 patients referred for prostate examination: results according to the PSA level, digital rectal examination and ultrasonography.

Authors present their retrospective study of 1290 patients referred for prostate evaluation. The risk of cancer was analysed according to PSA, rectal palpation and ultrasound examination. Among the 1290 patients, 54.8% had cancer. The risk of cancer was multiplied by 2.8 when the PSA was between the normal limit and 10 ng/ml, by 7.5 when it exceeded 10 ng/ml, by 4.0 when rectal palpation was abnormal and by 1.6 when a hypoechogenic zone was present. Although a hypoechogenic zone does not improve the detection of cancer compared to PSA and rectal palpation, an increased PSA level even lower tha

Improving Pharmacokinetics of PSMA/GRPR-Targeting Radiolabeled Heterodimer through Enhanced Albumin Binding.

Radiolabeled heterodimers targeting prostate-specific membrane antigen (PSMA) and gastrin-releasing peptide receptor (GRPR) have been extensively investigated to overcome heterogeneous target expression in prostate cancer. However, low tumor retention and high kidney uptake remain major challenges. In this study, we designed and synthesized a novel albumin binder (ALB)-modified PSMA/GRPR-targeting heterodimer, PADA, to improve tumor retention and tumor-to-kidney ratios. [111In]In-PADA exhibited marked binding ability to albumin, PSMA, and GRPR in vitro. In biodistribution studies, the tumor re

Pulmonary Metastases From Undiagnosed Prostate Cancer Mimicking Late Recurrence of Renal Cell Carcinoma: Diagnosis Confirmed by Thoracoscopic Biopsy.

This case report concerns a 68-year-old man who presented with enlarging pulmonary nodules 24 years after undergoing a right radical nephrectomy for renal cell carcinoma (RCC). Given the long disease-free interval and the characteristic late recurrence pattern of RCC, pulmonary metastasis of renal origin was initially suspected. Considering the potential bleeding risk associated with the hypervascular nature of metastatic RCC, video-assisted thoracoscopic surgery (VATS) was performed for a definitive diagnosis. Histopathological analysis revealed a cribriform architecture, and immunohistochemi

Overdiagnosis and Overtreatment in Prostate Cancer.

Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient's lifespan, while overtreatment refers to unnecessary interventions that can cause adverse effects such as urinary incontinence, erectile dysfunction, and a reduced quality of life. This review highlights contributing factors, including the limitations of PSA testing, advanc…

Internal migration seeking medical care for prostate cancer.

OBJECTIVE: To characterize the migratory flow of Mexican men affiliated to Seguro Popular (SP) seeking medical care for prostate cancer (PC). MATERIALS AND METHODS: The administrative base for the treatment of incident CP (5 526 men) funded by the SP (2012-2016) was used. Oncological risk at diagnosis (low, intermediate, high) was estimated based on prostate-specific antigen, Gleason score, and clinical stage. Spatial network analysis and centrality measures were used to identify the health migratory flow. RESULTS: 1 369 men sought treatment outside their state of residence, all of them with…

Treatment Patterns and Clinical Outcomes Among Patients With Metastatic Prostate Cancer Harboring Homologous Recombination Repair Mutations.

BACKGROUND: There is currently limited literature assessing the real-world treatment patterns and clinical outcomes of patients with metasta … ased for subsequent lines. Similarly, there was a trend of decreasing progression-free survival and prostate-specific antigen response from 1L to 4L+ therapy. CONCLUSIONS: Treatment patterns identified in this study were similar to those among patients with mCRPC regardless of tumor HRR mutation status in the literature.

Anogenital distance and the risk of Late-onset hypogonadism.

OBJECTIVE: to investigate the association between anogenital distance (AGD) and the risk of Late-onset Hypogonadism (LOH). METHODS: We prospectively recruited 145 consecutive patients referred for transrectal prostate biopsy due to prostate-specific antigen (PSA) elevation or abnormal digital rectal examination, between September 2019 and December 2021. Two variants of AGD, anus to scrotum base (AGDas) and anus to dorsal insertion of penis (AGDap) were measured. Serum total testosterone levels in fasting conditions between 07.00 and 11.00 h were determined. Patients filled out the Aging Males…

Roseomonas Species Bacteremia With Associated Endocarditis and Possible CNS Septic Embolic Phenomenon.

Rosemonas species has been associated with infections in both immunocompetent and immunocompromised hosts, manifesting as peritonitis, bacteremia, catheter-related bacteremia, endophthalmitis, spondylitis, and endocarditis. Here we present a man in his 60s who was brought to our institution for sudden onset of aphasia, right-sided paresthesia, and new onset tonic-clonic seizure episodes. At presentation, he was found to have severe lactic acidosis, acute kidney failure, bilateral hydronephrosis, elevated prostate-specific antigen (PSA), and an enlarged prostate. Blood cultures obtained on admi…

Use of imaging-based dosimetry for personalising radiopharmaceutical therapy of cancer.

Theranostics - i.e., the combination of molecular imaging and radiopharmaceutical therapy of cancer targeting a common biological feature - is a rapidly expanding field owing the recent successes of novel radiopharmaceutical therapies, such as 177Lu-based prostate-specific membrane antigen radioligand therapy of prostate cancer and peptide receptor radionuclide therapy of neuroendocrine tumours. Despite the ongoing technical developments in imaging-based dosimetry, the existence of tumour absorbed dose-efficacy and organ absorbed dose-toxicity relationships, as well as the high interpatient va

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… Among 30 patients treated with fixed-activity 177 Lu-PSMA-617, those who biochemically responded (i.e. prostate-specific antigen decline > 50%) received a median mean tumour absorbed dose of 14.1 Gy, as compared with 9.6 Gy for those who did not [ 36 ]. …

First case of 18F-choline uptake in acoustic schwannoma after stereotactic radiotherapy.

A 69-year-old male patient, with bilateral hypoacusia and tinnitus, had a diagnosis of left vestibular schwannoma with synchronous meningioma on the left frontal lobe. After partial surgical resection of the acoustic schwannoma, this was followed by stereotactic radiosurgery on the residual lesion. The patient had a metachronous prostate cancer treated with conformal radiotherapy associated to 6 months of hormone therapy with luteinizing hormone/releasing hormone analog. During follow-up, prostate-specific antigen value increased to 0.27 ng/mL and the patient underwent 18F-methylcholine positr…