Safety of testosterone therapy in men with prostate cancer.

Safety of testosterone therapy in men with prostate cancer. Expert Opin Drug Saf. 2019 Sep 07;: Authors: Morgentaler A, Caliber M Abstract Introduction: The use of testosterone therapy (TTh) in men with prostate cancer (PCa) is relatively new, and controversial, due to the longstanding maxim that TTh is contraindicated in men with PCa. Scientific advances have prompted a reevaluation of the potential role for TTh in men with PCa, particularly as TTh has been shown to provide important symptomatic and general health benefits to men with testosterone deficiency (TD), including many men with PCa who may expect to live 30-50 years after diagnosis. Areas covered: This review outlines the historical underpinnings of the historical belief that TTh "fuels" PCa and the experimental and clinical studies that have radically altered this view, including description of the saturation model. The authors review studies of TTh in men with PCa following radical prostatectomy and radiation therapy, in men on active surveillance, and in men with advanced or metastatic PCa. Expert opinion: TTh provides important symptomatic and overall health benefits for men with PCa who have TD. Although more safety studies are needed, TTh is a reasonable therapeutic option for men with low-risk PCa after surgery or radiation. Data in men on active surveillance are limited, but initial reports are reassuring. PMID: 31495240 [PubMed - as supplied by publisher]
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research

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Laser-excited gold nanoparticles safely destroyed prostate tumors in a recent pilot study involving 16 patients with low- to intermediate-risk prostate cancer. The highly targeted approach is being developed as an alternative to prostatectomy and radiation therapy, treatments associated with adverse urinary and sexual effects.
Source: JAMA - Category: General Medicine Source Type: research
Purpose of review During the last 15 years several updates in the Gleason grading have been made. With the help of pertinent research results pathologists have gained a better insight into the meanings of several prostate cancer (PCa) patterns and know better how to classify them in the Gleason grade system. Recent findings During the last years PCa with cribriform architecture has be given much attention. Many data have also been published about the meaning of comedonecrosis and its relationship with Gleason pattern 4 and 5. The correlationship between comedonecrosis and intraductal PCa has also been highlighted in t...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: CALCULATING PROSTATE CANCER RISK, AVOIDANCE OF OVERTREATMENT IN LOCALIZED PROSTATE CANCER: Edited by Matthew R. Cooperberg and Declan G. Murphy Source Type: research
Purpose of review The clinical course of localized prostate cancer varies widely, ranging from indolent disease unlikely to require treatment to aggressive cancers meriting intensive, multimodal therapy. Management recommendations have traditionally been determined based on clinical and pathologic factors, including serum prostate - specific antigen (PSA), clinical stage, and Gleason score. Unfortunately, these factors have limited ability to describe the underlying biology of a given tumor. Tissue-based genomic tests have emerged as a promising tool to more accurately characterize prostate cancer biology and projected c...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: CALCULATING PROSTATE CANCER RISK, AVOIDANCE OF OVERTREATMENT IN LOCALIZED PROSTATE CANCER: Edited by Matthew R. Cooperberg and Declan G. Murphy Source Type: research
Salvage radiation therapy (SRT) is recommended for men with biochemically recurrent prostate cancer post-radical prostatectomy. RTOG 9601 was a randomized phase 3 clinical trial that demonstrated an overall survival (OS) benefit from the addition of long-term anti-androgen therapy to SRT. However, hormone therapy has well documented side effects and has been shown to increase cardiac event rates, and there remains no evidence of an OS benefit from hormone therapy for men treated with early SRT. Herein, we aim to determine if pre-SRT PSA can serve as both a prognostic and predictive biomarker of benefit or harm from hormone therapy.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Source Type: research
CONCLUSIONS: Prostate cancer patients experience significant declines in HRQoL after primary therapy. Additional secondary therapy after RP, in the form of EBRT and/or ADT, appears to be responsible for further deterioration in HRQoL outcomes. PMID: 31469635 [PubMed - in process]
Source: Canadian Journal of Urology - Category: Urology & Nephrology Tags: Can J Urol Source Type: research
Medical device companies attempting to market a new treatment in the U.S. often make the erroneous assumption that winning FDA approval is the final destination, and success is theirs. In fact, going through the regulatory process is only the halfway point. The grueling path from FDA approval to reimbursement is like a treacherous walk through Death Valley and many companies don’t make it through. In this case study, I discuss the trials and triumphs of bringing robotic high intensity focused ultrasound (HIFU), a non-invasive procedure for localized prostate cancer, to the U.S.&Aci...
Source: MDDI - Category: Medical Devices Authors: Tags: Regulatory and Compliance Business Source Type: news
Studies show similar survival in men who used testosterone after radical prostatectomy or radiation therapy compared with those who did not.Medscape Urology
Source: Medscape Urology Headlines - Category: Urology & Nephrology Tags: Urology Commentary Source Type: news
Purpose of review Traditionally, local treatment was reserved for palliative control of symptoms in men with metastatic prostate cancer. In the past few years there have been many advances in the systemic options available. The aim of this review is to explore the evidence in support of treating the primary tumor despite the presence of metastatic disease. Recent findings There is a wealth of retrospective studies demonstrating advantages of local treatment [radical prostatectomy or radiation therapy (RT)] in metastatic disease. As these studies are prone to bias, treatment of the primary in the metastatic setting has...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: RENAL AND UROLOGICAL PROBLEMS: Edited by Fred Saad Source Type: research
Authors: Latorzeff I Abstract Prostate cancer is a sensitive adenocarcinoma, in more than 80 % of cases, to chemical castration, due to its hormone dependence. Locally advanced and/or high-risk cancer is defined based on clinical stage, initial PSA value or high Gleason score. Hormone therapy associated with radiation therapy is the standard of management and improves local control, reduces the risk of distant metastasis and improves specific and overall survival. Duration of hormone therapy, dose level of radiation therapy alone or associated with brachytherapy are controversial data in the literature. Radical pro...
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
In this study we evaluate the lesion detection efficacy of18F-DCFPyL PET/CT in patients with BCR and determine the detection efficacy as a function of their PSA value.MethodsA total of 248 consecutive patients were evaluated and underwent scanning with18F-DCFPyL PET/CT for BCR between November 2016 and 2018 in two hospitals in the Netherlands. Patients were examined after radical prostatectomy (52%), external-beam radiation therapy (42%) or brachytherapy (6%). Imaging was performed 120  min after injection of a median dose of 311 MBq18F-DCFPyL.ResultsIn 214 out of 248 PET/CT scans (86.3%), at least one lesion sug...
Source: European Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research
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