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Diagnostic events for prostate cancer

admin — Tue, 03 May 2011 11:29:51 +0000

Diagnostic events (in squares) in the sequence of screening and follow-up for prostate cancer. The size and darkness of the curved arrows indicate the current knowledge regarding diagnostic tools. Block arrows indicate the function of diagnostic modalities regarding the outcome of events.

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Prostatitis Syndromes. Part 4: Diagnosis
Cultures. In acute cases, documentation of a significant infection of the bladder urine is all that is required for definitive diagnosis. However, a urine culture is insufficient to differentiate chronic bacterial prostatitis from non-bacterial prostatitis or prostatodynia, as specimens are usually sterile in all three disorders. Culture evidence of prostatic infection is necessary to accurately ...
Prostate cells in the absence of trophic factors
A is presented: BPH < NHP< LNCaP < PCA< PC3
Prostate Cancer: Screening
Controversy surrounds screening for prostate cancer with the main arguments being questionable cost-effectiveness and overdiagnosis when the disease can be indolent and may be at a point where it is medically irrelevant to intervene. Screening for prostate cancer is done by digital rectal exam (DRE) and prostate-specific antigen (PSA). DRE and PSA should be done ...
Blood Test Approved For Prostate Cancer
FDA Stops Short of Recommending Procedure The Food and Drug Administration yesterday approved the first blood test for detecting prostate cancer. The disease, although rarely fatal, is the second most common cancer in American men, affecting about 13 percent nationwide. The agency approved the test for use in conjunction with other conventional diagnostic procedures such ...
Prostatitis: Factors InfluencingPrognosis
Prostatitis is a poorly understood syndrome. This lack of understanding may adversely affect outcomes in patients with all forms of prostatitis. To improve on the prognosis of prostatitis, the clinician requires an excellent understanding of its epidemiology, evaluation, etiology, pathophysiology, and therapy. The goal of this chapter is to illustrate some common misconceptions concerning prostatitis ...

Comparison of the gross anatomy of the human and rat prostate

admin — Thu, 31 Dec 2009 06:31:33 +0000

Comparison of the gross anatomy of the human (left) and rat (right) prostate

PZ = peripheral zone; CZ = central zone; TZ = transition zone; fm = anterior fibromuscular stroma; UD = distal urethra; UP = proximal urethral segment; E = ejaculatory ducts; bn = bladder neck; s = preprostatic and distal striated urethral sphincters; C = coronal plane; OC = oblique coronal plane; BL = bladder; SV = seminal vesicles; CG = coagulating gland; V = ventral lobe of the prostate; L = lateral lobe of the prostate; D = distal lobe of the prostate; Bur G = bulbourethral gland; UR = urethra; PU = pubis; vas deferens; CE = cauda epididymis.

Reproduced from Price D. Comparative aspects of development and structure in the prostate. In: Vollmer EP, editor. Biology of the prostate and related tissues. Vol. XII. Bethesda (MD): Dept. of Health, Education, and Welfare (US); 1963.; and Jesik CJ, Holland JM, Lee C. An anatomic and his-tologic study of the rat prostate. Prostate 1982; 3.

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Prostatism: Pathology
Prostatism is the clinical syndrome consisting of the symptoms associated with outlet obstruction at the bladder neck. By far the commonest cause of this syndrome is benign prostatic hypertrophy, but other entities such as bladder neck stenosis and urethral strictures can produce these symptoms as well. Prostatic hypertrophy is in fact a hyperplasia of epithelial ...
Benign Prostatic Hyperplasia: Anatomy
Anatomy The prostate is approximately the size and shape of a walnut and is nestled under the bladder, anterior to the rectum. The primary function of the prostate is to secrete fluids that protect and sustain sperm while in the vagina after intercourse. Prostatic fluid is produced in the 30 to 50 secretory glands distributed ...
Benign prostatic hyperplasia. Part 1
Introduction This review is based on a Medline search, together with additional articles cited in a previous review and two recent texts. Benign prostatic hyperplasia (BPH) will be reviewed here with only a passing reference to cancer of the prostate. There is a major problem of terminology in considering this clinical area. Having changed the ...
Pharmacophysiologic Rationale for the use of Alpha-Blocker Drugs
The prostate gland is often referred to as being composed of five distinct lobes during fetal development — anterior, posterior, median, and two lateral lobes. In the adult prostate, this distinction is usually abolished and the prostate is considered to be composed of three concentric layers: the outer layer (the external prostate gland proper) and ...
Erectile Dysfunction following Radical Prostatectomy
Incidence Erectile dysfunction following radical prostatectomy is a common problem, with the incidence variously estimated at 43, 84, and 100%. The discussion of pelvic anatomy below is helpful in understanding the potential surgical pitfalls that can lead to erectile dysfunction. Modifications in the surgical approach may decrease the incidence of postoperative erectile dysfunction. Nerve-sparing prostatectomy ...

Aspartate transport and citrate production in prostate luminal epithelial cells

admin — Tue, 29 Dec 2009 06:43:39 +0000

Aspartate transport and citrate production in prostate luminal epithelial cells

The low affinity L-aspartate transporter Na⁺-K⁺ ATPase and a citrate transporter are represented at the apical membrane. The high affinity L-aspartate transporter and glucose transporters are represented in the basal membrane.

Reproduced from Lao L, Franklin R B, Costello L C. High-affinity L-aspartate transporter in prostate epithelial cells that is regulated by testosterone. Prostate 1993; 22.

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Benign Prostatic Hyperplasia: Etiology
The exact mechanisms that cause benign prostatic hyperplasia are unknown. Extensive research indicates that hormonal changes and increasing age are clear risk factors for benign prostatic hyperplasia development. Cell culture studies have determined that the androgen dihydrotestosterone has an important role in prostatic growth. These studies also suggest other effects of this hormone on benign ...
Prostate cells in the absence of trophic factors
A is presented: BPH < NHP< LNCaP < PCA< PC3
High-Grade Prostatic Intraepithelial Neoplasia
Loss of genome protective function in high-grade prostatic intraepithelial neoplasia (HGPIN) based on proliferation compartment infidelity. Reproduced from De Marzo A M, Nelson W G, Meeker A K, Coffey D S. Stem cell features of benign and malignant prostate epithelial cells. J Urol 1998; 160.
Effects of tissue localization of the androgen receptor on differentiation of the urogenital sinus
Epithelium and stroma from the urogenital sinuses of wild-type (androgen-receptor positive) or Tfm (androgen-receptor negative) mice were recombined and grafted under the renal capsule. Prostatic epithelium was obtained when wild-type or Tfm epithelium was recombined with wild-type stroma. Recombination of wild-type or Tfm epithelium with Tfm stroma resulted in development of a vaginal morphology. Reproduced ...
Growth Factors
The possible role of a nonandrogenic factor in the development of benign prostatic hyperplasia has been suggested by the observation that as the testosterone levels decrease in most aging men, the prostate continues to grow in size. Additionally, the exogenous addition of androgens increase the growth of the prostate in vivo but androgens do not ...

Prostate cells in the absence of trophic factors

admin — Sun, 27 Dec 2009 07:05:14 +0000

Various prostate cells in the absence of trophic factors

is presented: BPH < NHP< LNCaP < PCA< PC3upward arrowhead); decrease (downward arrowhead); little or no expression (little/no). Shown in the middle are the cell growth and apoptosis properties of various prostate cells in the absence of trophic factors, as deduced from preceding figures. (- = no growth;. + to +++ = different levels of apoptosis.) The BPH and NHP cells did not proliferate at all and demonstrated fast apoptotic kinetics. The LNCaP cells demonstrated a low level of proliferation and an intermediate level of apoptosis. The PC3 cells demonstrated very aggressive growth and intermediate levels of apoptosis. The PCA and DU 145 cells, in contrast, demonstrated a rapid cell proliferation as well as much delayed and decreased levels of apoptosis. B, Summary of molecular events leading to differential survivabilities of normal versus cancerous prostate epithelial cells in the absence of trophic factors. Note that there exist exceptions to this generalized scheme. For example, PCA cells possess wild-type P53 and express little/no bcl-2.

Reproduced from Tang D G, Li L, Chopra D P, Porter A T. Extended survivability of prostate cancer cells in the absence of trophic factors: increased proliferation, evasion of apoptosis, and the role of apoptosis proteins. Cancer Res 1998; 58.

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Benign Prostatic Hyperplasia: Etiology
The exact mechanisms that cause benign prostatic hyperplasia are unknown. Extensive research indicates that hormonal changes and increasing age are clear risk factors for benign prostatic hyperplasia development. Cell culture studies have determined that the androgen dihydrotestosterone has an important role in prostatic growth. These studies also suggest other effects of this hormone on benign ...
Endothelin-Receptor Antagonists
Overview. Endothelin-receptor antagonists represent a new generation of oral, targeted, cytostatic agents. They have huge commercial potential if they can successfully negotiate the obstacles to development: demonstration of efficacy in terms of an end point that regulatory agencies deem is sufficiently clinically relevant. Endothelins are part of a family of autocrine / paracrine peptides (ET-1, ...
Growth Factors
The possible role of a nonandrogenic factor in the development of benign prostatic hyperplasia has been suggested by the observation that as the testosterone levels decrease in most aging men, the prostate continues to grow in size. Additionally, the exogenous addition of androgens increase the growth of the prostate in vivo but androgens do not ...
Proteasome Inhibitors
Overview. The proteasome is a novel target for cancer drugs, and clinical studies in myeloma have generated intense excitement in this field. Because the proteasome interacts with many proteins (as described in the next section), research into the downstream consequences of drugs that inhibit this target is ongoing. Mechanism Of Action. Proteasomes are enzyme complexes ...
Etiology and pathophysiology
Typically, tumors of the prostate grow slowly. The vast majority arise in the subcapsular peripheral region of the posterior lobe—a region of the gland that is most sensitive to changes in androgen levels. Tumors generally originate as small, well-differentiated lesions and double in size every two to four years. As a tumor grows, the cells ...

High-Grade Prostatic Intraepithelial Neoplasia

admin — Fri, 25 Dec 2009 07:01:09 +0000

Loss of genome protective function in high-grade prostatic intraepithelial neoplasia (HGPIN) based on proliferation compartment infidelity.

Reproduced from De Marzo A M, Nelson W G, Meeker A K, Coffey D S. Stem cell features of benign and malignant prostate epithelial cells. J Urol 1998; 160.

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Chemoprevention of Cancer of the Prostate
With a dramatic increase in the number of prostate cancers detected as a result of prostate-specific antigen screening and the resulting public focus on the disease, a lot of attention has been placed on how to respond to this public health threat. While the focus of the 1970s and early 1980s was the optimal management ...
Prostate cells in the absence of trophic factors
A is presented: BPH < NHP< LNCaP < PCA< PC3
Aspartate transport and citrate production in prostate luminal epithelial cells
The low affinity L-aspartate transporter Na+-K+ ATPase and a citrate transporter are represented at the apical membrane. The high affinity L-aspartate transporter and glucose transporters are represented in the basal membrane. Reproduced from Lao L, Franklin R B, Costello L C. High-affinity L-aspartate transporter in prostate epithelial cells that is regulated by testosterone. Prostate 1993; ...
Hormonal Therapies
Overview. Several hormonal therapies are in development for CaP. Baxter Oncology's D-63153 and teverelix (Ardana's Antaralix) are decapeptide luteinizing hormone-releasing hormone (LHRH) antagonists in Phase II development. Lack of data precludes further discussion of them. Toremifene (GTx's Acapodene) is a nonsteroidal selective estrogen-receptor modulator (SERM) in Phase Ilb / III development. It is being tested ...
Hormonal and Cellular Aspects of Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is the most common neoplastic disease in men, seen histologically in more than 50% of those over 60 years of age; however, the basic hormonal and cellular processes which lead to its development are still unclear. In the last few decades, there has been a tremendous effort to understand these processes because ...

Diagram of the human androgen receptor gene

admin — Tue, 22 Dec 2009 06:47:19 +0000

Schematic diagram of the human androgen receptor gene

Black areas = trans-activation domains; P = proline directed phosphorylated Ser residues; HSP = heat shock protein; pKC = protein kinase C; pKA = protein kinase A; MAPK = mitogen-activated protein kinase; DNA-Dep Kin = DNA-dependent kinase; Ser-Pro = serine-proline directed kinase; Cas-Kin II = casein kinase II.

Adapted from Wiener et al., MacLean et al., Blok et al., and Zhou et al.

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Combined Androgen Blockade
Overview. Combined androgen blockade (CAB)—sometimes called androgen -deprivation therapy—is the simultaneous administration of an LHRH analogue and an antiandrogen. A huge number of randomized, controlled trials have been undertaken to assess the benefit of adding an antiandrogen to LHRH therapy. Mechanism Of Action. The individual components of this regimen contribute the following mechanisms to achieve ...
Epidermal Growth Factor Receptor Inhibitors
Overview. A vast amount of R&D has been committed to the study of epidermal growth factor receptor (EGFR) inhibition. Although several EGFR inhibitors have been launched for other solid tumor types, results for CaP have been very disappointing. The two main approaches researchers have investigated are the specific inhibition of EGFR tyrosine kinase (e.g., gefitinib ...
Future developments
Even with the latest developments in cytotoxic chemotherapy for bladder cancer, many patients die from muscle-invasive disease, despite aggressive therapy with curative intent. Durable long-term remissions due to chemotherapy in metastatic disease are the exception rather than the rule, and median survival is approximately 14 months after commencement of chemotherapy. There remains a need for ...
Etiology
The precise etiology of CaP is unknown, although studies suggest that CaP occurs as a result of complex interactions between exposure to environmental toxins and associated genetic changes and predisposition. CaP appears in the prostate epithelial cells, where precancerous histological changes are common in men in their 20s and 30s; however, CaP does not become ...
Effects of tissue localization of the androgen receptor on differentiation of the urogenital sinus
Epithelium and stroma from the urogenital sinuses of wild-type (androgen-receptor positive) or Tfm (androgen-receptor negative) mice were recombined and grafted under the renal capsule. Prostatic epithelium was obtained when wild-type or Tfm epithelium was recombined with wild-type stroma. Recombination of wild-type or Tfm epithelium with Tfm stroma resulted in development of a vaginal morphology. Reproduced ...

Effects of tissue localization of the androgen receptor on differentiation of the urogenital sinus

admin — Fri, 18 Dec 2009 06:21:00 +0000

Effects of tissue localization of the androgen receptor on differentiation of the urogenital sinus (UGS)

Epithelium and stroma from the urogenital sinuses of wild-type (androgen-receptor positive) or Tfm (androgen-receptor negative) mice were recombined and grafted under the renal capsule. Prostatic epithelium was obtained when wild-type or Tfm epithelium was recombined with wild-type stroma. Recombination of wild-type or Tfm epithelium with Tfm stroma resulted in development of a vaginal morphology.

Reproduced with permission from Cunha G R, Chung W K, Shannon J M, Reese B G. Stromal-epithelial interactions in sex differentiation. Biol Reprod 1980; 22.

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Hormonal and Cellular Aspects of Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is the most common neoplastic disease in men, seen histologically in more than 50% of those over 60 years of age; however, the basic hormonal and cellular processes which lead to its development are still unclear. In the last few decades, there has been a tremendous effort to understand these processes because ...
Treatments for Benign Prostatic Hyperplasia. Part 1
Benign Prostatic Hyperplasia (BPH) is the most common neoplasm affecting humans. More than 400 000 prostatectomies are performed annually in the United States, second only to cataract extractions in charges to Medicare. In an era of limited health care funds, the indications for and efficacy of traditional therapy must be reviewed. A variety of new ...
Diagram of the human androgen receptor gene
Black areas = trans-activation domains; P = proline directed phosphorylated Ser residues; HSP = heat shock protein; pKC = protein kinase C; pKA = protein kinase A; MAPK = mitogen-activated protein kinase; DNA-Dep Kin = DNA-dependent kinase; Ser-Pro = serine-proline directed kinase; Cas-Kin II = casein kinase II. Adapted from Wiener et al., MacLean et ...
Comparison of the gross anatomy of the human and rat prostate
PZ = peripheral zone; CZ = central zone; TZ = transition zone; fm = anterior fibromuscular stroma; UD = distal urethra; UP = proximal urethral segment; E = ejaculatory ducts; bn = bladder neck; s = preprostatic and distal striated urethral sphincters; C = coronal plane; OC = oblique coronal plane; BL = bladder; SV ...
Tamsulosin
Tamsulosin (Astellas/Boehringer Ingelheim/Abbott's Harnal/Flomax/Omnic), the leading alpha blocker, is a long-acting alpha blocker that is selective for alpha1A- and alpha1A-adrenoceptors found predominantly in the prostate. Astellas (formerly Yamanouchi) initially marketed tamsulosin in an immediate-release formulation (Harnal) in Japan and Europe. Boehringer Ingelheim also markets tamsulosin in the United States as a delayed-release formulation (Flomax) to ...

Estimated cancer deaths in 10 leading sites (United States)

admin — Tue, 15 Dec 2009 05:34:59 +0000

Excludes basal and squamous cell skin cancerand carcinoma in situ except bladder. From Landis S H, Murray T, Bolden S, Wingo P A. Cancer Statistics, 1998. CA Cancer J Clin 1998; 48.

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Prostate Cancer: Introduction
Prostate cancer is the second most common cancer in men. Pharmacists not only monitor drug side effects, interactions, and adherence but also prevent complications of chemotherapy and guide palliative care. Pharmacists have an important role in the treatment of patients who have prostate cancer. Monitoring patients for adverse effects of drug therapy, drug/disease interactions, adherence ...
The management of benign prostatic hyperplasia. Etiology of BPH
Complications due to an enlarged prostate can severely affect quality of life. Use of combination therapy has provided some dramatic results in managing associated symptoms. It is well documented that the prostate continues to grow during the lifetime of most men. This continued enlargement of the prostate does not cause problems until late in a ...
Aspartate transport and citrate production in prostate luminal epithelial cells
The low affinity L-aspartate transporter Na+-K+ ATPase and a citrate transporter are represented at the apical membrane. The high affinity L-aspartate transporter and glucose transporters are represented in the basal membrane. Reproduced from Lao L, Franklin R B, Costello L C. High-affinity L-aspartate transporter in prostate epithelial cells that is regulated by testosterone. Prostate 1993; ...
Prostate cells in the absence of trophic factors
A is presented: BPH < NHP< LNCaP < PCA< PC3
Studies in Metastatic Disease
For half a century, systemic therapy of prostate cancer has centered on suppressing androgenic stimuli by either surgical or medical gonadal suppression. The hypothesis that a tumor clone may be or will become sensitive to lower androgen levels fostered attempts to eliminate all sources of androgens, including the adrenals. Numerous studies conducted during the 1980s ...