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Oncogenesis and Metastasis
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Other examples of precursors include:Penile intraepithelial neoplasia (PeIN) in penile cancer.Atypical small acinar proliferation (ASAP) and high-grade prostatic intraepithelial neoplasia (HGPIN) in prostate cancer.Germ cell neoplasia in situ (GCNIS) in testicular cancer.
Prostate Cancer
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Which of the following information on molecular markers in prostate cancer is CORRECT?PCA3, a non-coding RNA, is under expressed in prostate cancer.Ki-67 antigen is detected by immunohistochemical staining and correlates with outcome after radical prostatectomy.Kallikrein 3 level is reduced in metastatic prostate cancer.High molecular weight cytokeratin binds to prostate cancer cells confirming the diagnosis of cancer over HGPIN.PSA doubling time is a useful tool that outperforms total PSA in the diagnosis of prostate cancer.
Prostate Cancer
Published in Mary J. Marian, Gerard E. Mullin, Integrating Nutrition Into Practice, 2017
Zyflamend is a unique herbal anti-inflammatory preparation containing 10 different extracts—rosemary, turmeric, ginger, holy basil, green tea, hu zhang, Chinese goldthread, barberry, oregano, and skullcap. Laboratory studies have shown it can inhibit the proliferation of human prostate cancer cells [90–92]. In one case report, a patient with high-grade prostatic intraepithelial neoplasm (HGPIN) was supplemented with Zyflamend for 18 months, at which time he did not show any evidence of PIN or cancer [93]. In a 2009 phase I study, patients (n = 23) with HGPIN took Zyflamend in addition to various other dietary supplements. At the conclusion of the study, 60% of the subjects had only benign tissue at biopsy [94]. Zyflamend was well tolerated and no serious adverse events were noted. This was a small study and the authors acknowledged the need for further trials.
Natural history of widespread high grade prostatic intraepithelial neoplasia and atypical small acinar proliferation: should we rebiopsy them all?
Published in Scandinavian Journal of Urology, 2021
Marco Oderda, Matteo Rosazza, Marco Agnello, Maurizio Barale, Giorgio Calleris, Lorenzo Daniele, Luisa Delsedime, Marco Falcone, Riccardo Faletti, Claudia Filippini, Andrea Giordano, Alessandro Marquis, Giancarlo Marra, Donatella Pacchioni, Paolo Gontero
HGPIN is defined as abnormal, proliferative change in pre-existing, architecturally normal prostatic ducts and acini with nuclear atypia similar to that seen in prostatic cancer. Recent studies have estimated that the risk of developing PCa after initial diagnosis of HGPIN is around 22–23%, not different from the same risk after a benign diagnosis [1]. A separate entity is represented by widespread HGPIN (wHGPIN), defined by Netto and Epstein as four or more cores involved by HGPIN, which has shown a higher likelihood of finding PCa on rebiopsy, up to 55% [2]. The situation is completely different for ASAP that indicates a situation of diagnostic uncertainty, highly predictive for concurrent or subsequent PCa. This pathological finding encompasses a variety of lesions including benign mimickers of cancer and small foci of adenocarcinoma which, for a several reasons, cannot be accurately diagnosed [3]. The risk of PCa detection on rebiopsy after ASAP is estimated around 40%, ranging from 17% to 60% [4–6]. A recent study showed that the combination of HGPIN and ASAP in the same biopsy is even more predictive of subsequent cancer (58%) than isolated ASAP (35%) [5]. Given that the natural history of HGPIN and ASAP is not thoroughly known, however, it is difficult to provide reliable estimates of association with PCa. Consequently, there is no consensus whether to repeat a prostate biopsy after such diagnoses, and which is the best timing to do it.
Impact of 18-Month Soy Protein Supplementation on Steroid Hormones and Serum Biomarkers of Angiogenesis, Apoptosis, and the Growth Hormone/IGF-1 Axis: Results of a Randomized, Placebo-Controlled Trial in Males Following Prostatectomy
Published in Nutrition and Cancer, 2022
Maarten C. Bosland, Jonathan Huang, Michael J. Schlicht, Erika Enk, Hui Xie, Ikuko Kato
Randomized clinical trials of the effect of soy consumption on cancer risk and mortality are needed, but only a few have been reported. Miyanaga et al. (16) randomized men without high-grade prostatic intraepithelial neoplasia (HGPIN) at biopsy to isolated soy isoflavones in tablets and found a decreased incidence of study biopsy-detected prostate cancer after 12 mo, compared to men on placebo tablets, but only in subjects ≤65 years old and only in men who did not produce equally. There was no difference in HGPIN incidence between the two groups in this study. It should be noted that the sample sizes in this study were quite small and the duration of intervention was relatively short. In another study, Quaas et al. (17) randomized postmenopausal women to soy protein isolate or milk protein for three years and found no difference between the study arms in the incidence of endometrial hyperplasia and cancer at end-of-study biopsy. Previously, we found no effect of soy protein isolate supplementation for two years on prostate cancer recurrence following radical prostatectomy compared to a milk protein placebo (18). Although there are no randomized trials of soy with breast cancer as endpoint, soy and soy isoflavones did not affect mammographic breast density, an established breast cancer risk factor, in randomized studies (19–23) and did not affect breast epithelial cell proliferation obtained by fine-needle aspiration (24) or biopsy (25), suggesting a lack of protective effect. Some studies with cancer as endpoint combined soy or isoflavones with other agents precluding evaluation of a specific soy or isoflavone effect on prostate cancer risk (26) or cancer in women (27).
Anorectal application of 5% lidocaine cream reduces pain prior to periprostatic nerve block during transrectal ultrasound guided prostate biopsy: Randomized, prospective controlled study
Published in Scandinavian Journal of Urology, 2021
Yishai H. Rappaport, Sergey Kravchick, Amos Neheman, Ilia Beberashvili, Kobi Stav, Shmuel Roizman, Amnon Zisman
Overall, 252 patients were enrolled and were randomized to one of the seven groups, comprising six study and one control group. Patient distribution, demographic and co-morbidity properties did not differ between study groups and are presented in Table 1. Mean age was 66.7 ± 7.0 years, being similar in all groups. Abnormal DRE had a high incidence in the control group with 21 patients (51%) having a suspicious prostate at palpation, while in the 5 min topical + rectal lidocaine exposure a low incidence was recorded, only two patients (9%) had a palpable abnormality. All together 80 patients (32%) had a suspicious palpable prostate. Palpable abnormality did not correlate directly to malignant pathology as can be seen in the intergroup distribution. Ninety-three patients (36%) were positive for malignancy, two with a neuroendocrine tumor and 91 with a Gleason score ≥6. Eight additional patients had high grade prostatic intraepithelial neoplasia (HGPIN), thus 101 patients (40%) had non-BPH histology. Low incidence of DM, hypothyroidism and prior history of cerebrovascular accident or transient ischemic attack were observed among all study groups. PSA and abnormal DRE were the only prominent potential confounders according to univariate analysis. Significant differences in VAS between all study groups and control were observed at all time frames. In a univariate analysis, significant differences were observed during probe insertion, during intrarectal probe manipulation and while performing PPNB. In a multivariate analysis adjusted for PSA, DM status, spinal disease, abnormal DRE and non-BPH histology, significance remained only for probe insertion and intrarectal manipulation (Table 2).