SBRT for Localized Prostate Cancer: Is it Ready for Take-Off?

Healthcare systems are often compared with the aviation industry. Progress in both is highly desired but must always be achieved with safety in mind. Everyone wants to get from point A to point B faster and more comfortably, but how much risk of uncertainty is one ready to accept to achieve that extra speed? Both industries also share the aspect of competition for customers. In the field of localized prostate cancer, patients have an ever-increasing choice of options: radical surgery (open vs laparoscopic vs robot-assisted), external beam radiation therapy (EBRT) (with photons or protons), brachytherapy (low-dose rate or high-dose rate), focal ablative therapies (irreversible electroporation therapy vs laser ablation vs ultrasound ablation vs vascular targeted photodynamic therapy vs cryotherapy), and —perhaps the most important option, especially for patients with low-risk prostate cancer—active surveillance.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Clinical Investigation Source Type: research

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Abstract The classification of human cancers has traditionally relied on the tissue of origin, the histologic appearance and anatomical extent of disease, otherwise referred to as grade and stage. However, this system fails to explain the highly variable clinical behaviour seen for any one cancer. Molecular characterization through techniques such as next-generation sequencing (NGS) has led to an appreciation of the extreme genetic heterogeneity that underlies most human cancers. Because of the difficulties associated with fresh tissue biopsy, interest has increased in using circulating tumour material, such as ci...
Source: Cell Research - Category: Cytology Authors: Tags: Recent Results Cancer Res Source Type: research
This article reviews the major pathways by which adrenal steroids are converted to the potent male sex hormones, testosterone (T) and 5α-dihydrotestosterone (5α-DHT) and the discrete enzyme isoforms involved in castration resistant prostate cancer. Previous studies have mainly utilized radiotracers to investigate these pathways but have not used prevailing concentrations of precursors found in castrate male human serum. In addition, the full power of stable-isotope dilution liquid chromatography tandem mass spectrometry has not been applied routinely. Furthermore, it is clear that adaptive responses occur in th...
Source: The Journal of Steroid Biochemistry and Molecular Biology - Category: Biochemistry Source Type: research
Publication date: Available online 13 October 2019Source: European UrologyAuthor(s): Bruce Montgomery, Stephen Plymate
Source: European Urology - Category: Urology & Nephrology Source Type: research
AbstractPurposeTo assess the final pathology risk in MRI-positive grade group (GG) 2 prostate cancer (PCa) patients undergoing targeted (TB) and systematic (SB) biopsies, and thereby, the possibility of active surveillance (AS) in this population.Patients and methodsWe included 242 consecutive men diagnosed with GG2 PCa by a combination of SB and software-based fusion TB undergoing a radical prostatectomy (RP). The primary endpoints were the pathological findings in RP specimens, including favourable disease which was defined by a pT2 and GG1 –2 disease.ResultsThe rate of upgrading was 33% including 3% of GG 4 &ndash...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
AbstractObjectiveQualitative interpretation in bone scan is often complicated by the presence of degenerative joint disease (DJD), especially in the elderly patient. The aim of this study is to compare objectively99mTc-MDP tracer uptake between DJD and osseous metastases of the spine using semi-quantitative assessment with SPECT SUV.MethodsBone scan with SPECT/CT using99mTc-MDP was performed in 34 patients diagnosed with prostate carcinoma. SPECT/CT was performed based on our institutional standard guidelines. SUVmax based on body weight in 238 normal vertebrae visualized on SPECT/CT was quantified as baseline. A total of ...
Source: Annals of Nuclear Medicine - Category: Nuclear Medicine Source Type: research
AbstractPurposeTo evaluate biochemical recurrence (BCR) risk in men with localized prostate cancer (PC) of pathological Gleason score (pGS) 8 –10. Although such patients have low BCR-free survival (BCRFS) following radical prostatectomy (RP), they are not recommended for adjuvant radiation therapy (ART) as per current guidelines.MethodsAmong an adjuvant treatment-na ïve cohort between 1995 and 2015, 1272 men were identified and categorized into group 1 [pGS7 (3 + 4) and pT3;n  =  654], group 2 [pGS7 (4 + 3) and pT3;n  =  408], and group 3 (pGS 8–10 an...
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 12 October 2019Source: Journal of Molecular LiquidsAuthor(s): Nazanin Mokhtari, Somayeh Taymouri, Mina Mirian, Mohammad DinariAbstractIn the present study, a novel polyimine-based covalent triazine framework (PI-CTF) was introduced as a promising biocompatible carrier for sorafenib (SFN) delivery. High specific surface area and porosity allowed us to achieve drug loading and encapsulation efficiency as high as 83% and 98%, respectively. The in vitro drug release study of SFN-loaded PI-CTF showed a sustained and pH-dependent release behavior in which acidic pH accelerated drug release comp...
Source: Journal of Molecular Liquids - Category: Molecular Biology Source Type: research
Conclusion: Refraining from voiding prior to F-18-fluciclovine injection results in significantly lower urinary bladder radioactivity compared to purposeful voiding pre-injection. We have modified our practice accordingly, particularly as moderate and intense bladder activity may mask/mimic local prostate cancer recurrence. Mechanisms underlying this phenomenon should be further investigated. PMID: 31604898 [PubMed - as supplied by publisher]
Source: Journal of Nuclear Medicine Technology - Category: Nuclear Medicine Tags: J Nucl Med Technol Source Type: research
Conclusion: The study shows that the use of 213Bi-PSMA/DOTATOC for the therapy of CRPC and NET, respectively, has been convenient, safe and straightforward. The external radiation doses to the occupational workers involved in different procedures were far below the dose limits prescribed by the Regulatory Authority (20mSv/yr). The dose rates from the treated patients showed no detrimental effect on public and environment. PMID: 31604889 [PubMed - as supplied by publisher]
Source: Journal of Nuclear Medicine Technology - Category: Nuclear Medicine Tags: J Nucl Med Technol Source Type: research
(Natural News) Prostate cancer is among the leading cancers in men in the U.S., second only to skin cancer. The American Cancer Society estimates around 174,650 new cases of – and 31,620 deaths from – prostate cancer each year, in its latest report. Fortunately, new evidence suggests that eating certain foods could play a role in starving – or even preventing – cancer....
Source: - Category: Consumer Health News Source Type: news
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