SYMPTOMS
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.
Some symptoms of prostate cancer are—
•Difficulty starting urination.
•Weak, or interrupted flow of urine.
•Frequent urination, especially at night.
•Difficulty emptying the bladder completely.
•Pain or burning during urination.
•Blood in the urine or semen.
•Pain in the back, hips, or pelvis that doesn't go away.
•Painful ejaculation.
If you have any symptoms that worry you, be sure to see your doctor right away. Keep in mind that these symptoms may be caused by conditions other than prostate cancer.
RISK FACTORS
Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include—
•Age: The older a man is, the greater his risk for getting prostate cancer.1
•Family history: Certain genes (the functional and physical units of heredity passed from parent to offspring) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.1
•Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why.
Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man's risk of developing the disease, either positively or negatively. Some of the factors under study include—1 2 3 4
•Vitamins, minerals, and herbal supplements.
•Diets high in animal fat, especially polyunsaturated fat.
•Men's hormone levels.
•Environmental agents (pesticide residues on foods, and industrial and occupational exposures).
References
1Bostwick DG, Burke HB, Djakiew D, Euling S, Ho SM, Landolph J, Morrison H, Sonawane B, Shifflett T, Waters DJ, Timms B. Human prostate cancer risk factors. Cancer 2004;101(10 Suppl):2371–2490.
2Vainio H, Bianchini F, eds. IARC Handbooks of Cancer Prevention, Vol 6: Weight Control and Physical Activity. Lyon, France: IARC Press; 2002.
3Curry S, Byers T, Hewitt M, eds. Fulfilling the Potential of Cancer Prevention and Early Detection.
4Platz EA, Giovannucci E. Prostate Cancer. In: Schottenfeld D, Fraumeni JF, eds. Cancer Epidemiology and Prevention, 3rd ed. New York, NY: Oxford University Press, 2006.
Prostate-specific antigen: An evolving role in diagnosis, monitoring, and treatment evaluation in prostate cancer.
Prostate specific antigen (PSA) was introduced as a prostate cancer screening tool more than 20 years ago. However, there is continuing debate regarding its utility in screening for prostate cancer. Mass screening is costly, may result in the diagnosis and treatment of prostate cancers that never become clinically significant, and the evidence of a subsequent reduction in mortality is inconclusive. In addition to its role in screening, PSA is also used to monitor the progression of the disease, both localized and metastatic.
Although the evidence is contradictory, PSA is still an important tool for monitoring patient progression following treatment of definitive localized prostate cancer. However, its use in monitoring castrate-resistant prostate cancer (CRPC) is more controversial, particularly in the context of novel targeted treatments, which may have little impact on PSA levels. These issues highlight the urgent need to identify prostate cancer biomarkers that will improve early disease detection, increase accuracy of diagnosis, determine the aggressiveness of disease, and monitor treatment efficacy, particularly in late-stage disease.
This review discusses the key issues associated with the use of PSA as an early screening tool for prostate cancer, as a prognostic marker to measure disease progression in both early- and late-stage prostate cancer, and as a surrogate endpoint in clinical trials with new agents. Copyright © 2009 Elsevier Inc. All rights reserved.
Payne H, Cornford P.
Department of Oncology, UCLH NHS Foundation Trust, London, United Kingdom.
Although the evidence is contradictory, PSA is still an important tool for monitoring patient progression following treatment of definitive localized prostate cancer. However, its use in monitoring castrate-resistant prostate cancer (CRPC) is more controversial, particularly in the context of novel targeted treatments, which may have little impact on PSA levels. These issues highlight the urgent need to identify prostate cancer biomarkers that will improve early disease detection, increase accuracy of diagnosis, determine the aggressiveness of disease, and monitor treatment efficacy, particularly in late-stage disease.
This review discusses the key issues associated with the use of PSA as an early screening tool for prostate cancer, as a prognostic marker to measure disease progression in both early- and late-stage prostate cancer, and as a surrogate endpoint in clinical trials with new agents. Copyright © 2009 Elsevier Inc. All rights reserved.
Payne H, Cornford P.
Department of Oncology, UCLH NHS Foundation Trust, London, United Kingdom.
Serum Prostate-Specific Antigen Hemodilution Among Obese Men Undergoing Screening in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Tria
(Cancer Epidemiol Biomarkers Prev 2009;18(3):748–51)
Background: Previous studies have shown an inverse relationship between prostate-specific antigen (PSA) concentration and body mass index (BMI). It has been recently proposed that this relationship may be explained by the larger plasma volume of obese men diluting a fixed amount of PSA (hemodilution effect). We examined this hypothesis in a cohort of men enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.
Methods: Of 38,349 men ages 55 to 74 years randomized in PLCO to receive annual PSA and digital rectal examination screening, 28,380 had a baseline PSA, complete demographic information, and no prostate cancer diagnosis within 6 years from baseline. Self-reported height and weight were used to calculate BMI and to estimate plasma volume. PSA mass was estimated as PSA concentration times plasma volume. Multivariable linear regression models were used to investigate the relationship between PSA concentration, plasma volume, PSA mass, and BMI.
Results: PSA concentration significantly decreased with increasing BMI (P < 0.001); mean PSA values were 1.27, 1.25, 1.18, and 1.07 ng/mL among normal (BMI, 18.5-25), overweight (BMI, 25-30), obese (BMI, 30-35), and morbidly obese (BMI, >35) men, respectively. However, plasma volume also increased with increasing BMI and PSA mass showed no association with BMI, with mean values of 3.78, 3.95, 3.97, and 3.82 μg across the four BMI categories (P = 0.10).
Conclusions: This study confirms earlier findings that the inverse relationship between PSA concentration and BMI may be explained by a hemodilution effect. These findings could have implications for prostate cancer screening in large men.
Background: Previous studies have shown an inverse relationship between prostate-specific antigen (PSA) concentration and body mass index (BMI). It has been recently proposed that this relationship may be explained by the larger plasma volume of obese men diluting a fixed amount of PSA (hemodilution effect). We examined this hypothesis in a cohort of men enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.
Methods: Of 38,349 men ages 55 to 74 years randomized in PLCO to receive annual PSA and digital rectal examination screening, 28,380 had a baseline PSA, complete demographic information, and no prostate cancer diagnosis within 6 years from baseline. Self-reported height and weight were used to calculate BMI and to estimate plasma volume. PSA mass was estimated as PSA concentration times plasma volume. Multivariable linear regression models were used to investigate the relationship between PSA concentration, plasma volume, PSA mass, and BMI.
Results: PSA concentration significantly decreased with increasing BMI (P < 0.001); mean PSA values were 1.27, 1.25, 1.18, and 1.07 ng/mL among normal (BMI, 18.5-25), overweight (BMI, 25-30), obese (BMI, 30-35), and morbidly obese (BMI, >35) men, respectively. However, plasma volume also increased with increasing BMI and PSA mass showed no association with BMI, with mean values of 3.78, 3.95, 3.97, and 3.82 μg across the four BMI categories (P = 0.10).
Conclusions: This study confirms earlier findings that the inverse relationship between PSA concentration and BMI may be explained by a hemodilution effect. These findings could have implications for prostate cancer screening in large men.
PSA Doubling Time as a Predictive Factor on Repeat Biopsy for Detection of Prostate Cancer
imbo M, Tomioka S, Sasaki M, Shima T, Suzuki N, Murakami S, Nakatsu H, Shimazaki J.
1Department of Urology, Asahi General Hospital, Asahi.
OBJECTIVE: Detection of prostate cancer needs a biopsy of the prostate. Suspecting cancer from an increase in Prostate Specific Antigen (PSA) has a high negative rate at an initial prostate biopsy. Cases with negative initial biopsy may be the candidates of subsequent biopsy. For lowering unnecessary repeat biopsy, the use of predictive factors before a repeat biopsy is applied for indication.
METHODS: Seventy-seven cases with negative initial prostate biopsy received a repeat biopsy and factors for the detection of cancer were examined.
RESULTS: Prostate Specific Antigen doubling time distinguished a part of cancer cases. Its sensitivity of 30, 50 and 70 months was 36.6%, 30.4% and 10%, respectively. Cancer case did not show PSA doubling time of >100 months in general. Values of PSA transition zone density, %Free/total PSA and PSA velocity were similar between cancer and no cancer cases.
CONCLUSIONS: Prostate Specific Antigen doubling time was one of the predictive factors for the detection of prostate cancer and was valuable for avoiding unnecessary repeat biopsy in some cases.
1Department of Urology, Asahi General Hospital, Asahi.
OBJECTIVE: Detection of prostate cancer needs a biopsy of the prostate. Suspecting cancer from an increase in Prostate Specific Antigen (PSA) has a high negative rate at an initial prostate biopsy. Cases with negative initial biopsy may be the candidates of subsequent biopsy. For lowering unnecessary repeat biopsy, the use of predictive factors before a repeat biopsy is applied for indication.
METHODS: Seventy-seven cases with negative initial prostate biopsy received a repeat biopsy and factors for the detection of cancer were examined.
RESULTS: Prostate Specific Antigen doubling time distinguished a part of cancer cases. Its sensitivity of 30, 50 and 70 months was 36.6%, 30.4% and 10%, respectively. Cancer case did not show PSA doubling time of >100 months in general. Values of PSA transition zone density, %Free/total PSA and PSA velocity were similar between cancer and no cancer cases.
CONCLUSIONS: Prostate Specific Antigen doubling time was one of the predictive factors for the detection of prostate cancer and was valuable for avoiding unnecessary repeat biopsy in some cases.
Prostate-specific antigen in vaginal fluid after exposure to known amounts of semen and after condom use: comparison of self-collected and nurse-colle
BACKGROUND: Prostate-specific antigen (PSA) in vaginal fluid indicates exposure to semen , and was used to assess condom effectiveness, although validity and reliability have not been fully evaluated. Our objective was to compare PSA in self-collected samples with samples collected by a nurse.
METHODS: We conducted two studies, each with 100 women aged 18-48 years. In the first, a nurse exposed each participant to her partner's semen (10, 100 and 1000 microl), and nurse and participant collected samples. In the second, each participant sampled before and after using two male condoms (MC) and two female condoms (FC); a nurse collected another sample afterwards.
RESULTS: PSA concentration increased with semen exposure, but was lower in nurse-collected samples. Both procedures were sensitive, almost 100% after exposure to 100-1000 microl of semen . PSA detection rates with MC and FC were 13% and 28% in self-collected samples, 8% and 9% in nurse-collected samples. Concordance between sample types was 93% with the MC (95% CI: 89%; 96%), 78% with the FC (95% CI: 72%; 84%). PSA decay between sampling times may explain higher values in self-collected samples.
CONCLUSIONS: PSA is a highly sensitive surrogate endpoint for condom effectiveness studies. Self-collected and nurse-collected samples are equivalent, but sample collection timing is critical
Bahamondes L, Diaz J, Marchi NM, Castro S, Villarroel M, Macaluso M.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
METHODS: We conducted two studies, each with 100 women aged 18-48 years. In the first, a nurse exposed each participant to her partner's semen (10, 100 and 1000 microl), and nurse and participant collected samples. In the second, each participant sampled before and after using two male condoms (MC) and two female condoms (FC); a nurse collected another sample afterwards.
RESULTS: PSA concentration increased with semen exposure, but was lower in nurse-collected samples. Both procedures were sensitive, almost 100% after exposure to 100-1000 microl of semen . PSA detection rates with MC and FC were 13% and 28% in self-collected samples, 8% and 9% in nurse-collected samples. Concordance between sample types was 93% with the MC (95% CI: 89%; 96%), 78% with the FC (95% CI: 72%; 84%). PSA decay between sampling times may explain higher values in self-collected samples.
CONCLUSIONS: PSA is a highly sensitive surrogate endpoint for condom effectiveness studies. Self-collected and nurse-collected samples are equivalent, but sample collection timing is critical
Bahamondes L, Diaz J, Marchi NM, Castro S, Villarroel M, Macaluso M.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
Subscribe to:
Posts (Atom)