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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.
Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Toremifene has also been evaluated under the brand name AcapodeneTM for use in prostate cancer by the pharmaceutical company GTx Inc who conducted two Phase 3 clinical trials. The first was to study amelioration of the significant side effects of androgen deprivation therapy (ADT) such as vertebral/spine fractures, hot flushes, lipid profile imbalance, and gynecomastia in advanced prostate cancer. The second studied its use for the prevention of prostate cancer in men with high-grade prostatic intraepithelial neoplasia (PIN). In 2008 the company reported that in the first trial, toremifene reduced the rate of osteoporotic fractures by half, and had a favorable impact on bone mineral density, lipid profile balance, and gynecomastia. An NDA for the relief of ADT side effects was submitted to the FDA in 2009, although this was rejected on the grounds that more clinical data were required.
MRI Imaging of Seminal Vesicle Invasion (SVI) in Prostate Adenocarcinoma
Published in Ayman El-Baz, Gyan Pareek, Jasjit S. Suri, Prostate Cancer Imaging, 2018
Samuel A. Gold, Graham R. Hale, Kareem N. Rayn, Vladimir Valera, Jonathan B. Bloom, Peter A. Pinto
SVI is reported in 3.1%–26% of radical prostatectomy specimens [13–17]. The mechanism of PCa invasion into the seminal vesicles is not uniform. Currently, SVI is categorized into three modes of cancerous invasion. Type I SVI describes spread via the IES/ejaculatory ducts into the seminal vesicles [15]. The precise route of spread is not totally understood. According to the 2009 International Society of Urological Pathology conference, SVI should only be diagnosed with cancerous invasion of the muscular wall of the extraprostatic part of the seminal vesicle, rather than possible extension into the seminal vesicle epithelium of IES, which is difficult to discern from ejaculatory duct epithelium [12,15,18–20]. Furthermore, seminal vesicle epithelium has also been shown to resemble prostatic intraepithelial neoplasia, atypical acinar proliferations, and prostatic adenocarcinoma [21]. Type II SVI describes invasion through the prostatic capsule and into the seminal vesicles. This is further subdivided into type IIa, which signifies invasion through the base of the prostate directly into the seminal vesicle, and type IIb, which signifies retrograde invasion into the seminal vesicles via involvement of the periprostatic nerves [15,19,20]. Type III SVI describes discontinuous or metastatic lesions in the seminal vesicles [15] (Table 19.2) (Figure 19.2).
Sulforaphane Bioavailability and Chemopreventive Activity in Men Presenting for Biopsy of the Prostate Gland: A Randomized Controlled Trial
Published in Nutrition and Cancer, 2020
Zhenzhen Zhang, Mark Garzotto, Edward W. Davis, Motomi Mori, Wesley A. Stoller, Paige E. Farris, Carmen P. Wong, Laura M. Beaver, George V. Thomas, David E. Williams, Roderick H. Dashwood, David A. Hendrix, Emily Ho, Jackilen Shannon
For blood samples, plasma was collected, and peripheral blood mononuclear cell (PBMC) was isolated using a Ficoll Histopaque gradient per manufacture’s protocol. Plasma and urine samples were acidified with 10% trifluoroacetic acid (TFA) immediately after collection and were used for SFN metabolite evaluation. PBMC was cryopreserved in freezing media containing 10% DMSO and was used to determine HDAC activity. Prostate biopsies were obtained per clinical evaluation protocol with 10–20 cores taken for diagnosis and an additional four cores (three flash frozen and one formalin fixed) obtained solely for research purposes. Should the subject have cancer/prostatic intraepithelial neoplasia (PIN), research cores were collected away from the lesion in healthy tissue to determine the effect of treatment on similar tissue types. The research cores were embedded in optimal cutting temperature (OCT) compound and then suspended in methylbutane cooled with dry-ice. These flash-frozen tissues were then placed in cryotubes and stored in –80 °C freezer. Frozen prostate biopsy cores were used for SFN metabolite analyses and transcriptome analyses. All other clinical prostate biopsy specimens were immediately placed in 10% neutral buffered formalin for clinical pathological diagnosis. Formalin-fixed research specimens were stored and available for immunohistochemical (IHC) studies.
The use of transrectal ultrasound-guided biopsy following the introduction of prostate-specific antigen testing in Denmark: a population-based analysis
Published in Scandinavian Journal of Urology, 2018
Nina Klemann, Martin Andreas Røder, John Thomas Helgstrand, Klaus Brasso, Birgitte G. Toft, Ben Vainer, Peter Iversen
A detailed description of the DaPCaR database has previously been published [6]. For this paper, data on all men who underwent TRUS-gb of the prostate during the period 1995–2011 were extracted. Biopsies of seminal vesicles and biopsies in cases of suspected recurrence after curative therapy were excluded, as were biopsies in combination with transurethral resection of the prostate (TURP). If a specimen had been revised by a tertiary referral pathologist, the revised evaluation was used for analysis. A diagnostic TRUS-gb was defined as the first TRUS-gb containing PCa not preceded by PCa in a TURP. The pathological evaluation terms ‘suspicious of adenocarcinoma’ and ‘dysplasia’ [or high-grade prostatic intraepithelial neoplasia (PIN)] were not considered malignant. The detection rate for each year of the study period was calculated as the total number of diagnostic TRUS-gb sets divided by the total number of initial TRUS-gb sets plus the rebiopsy sets that were preceded by a normal TRUS-gb. The percentage of men diagnosed on the initial TRUS-gb set in a specific year was calculated as the total number of individuals for whom the initial TRUS-gb was malignant divided by the total number of initial TRUS-gb sets performed.
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).