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Scientists Develop New Prostate Cancer Cell Line

Researchers at the Cancer Biology at Jefferson Medical College of Thomas Jefferson University have established a laboratory prostate cancer cell line they believe will become a valuable research tool in both understanding and treating prostate cancer.

According to study’s lead author, this cell line provides a new experimental model for studies on androgen-related growth of prostate cancer cells and for research on genetic changes and molecular pathways involved in growth of androgen-deprived prostate cancer cells.

This new prostate cancer cell line reflects how the cancer can initially be fueled by the male hormone androgen and how the cells can then morph into hormone-resistant, aggressive tumors. The majority of existing prostate cancer cell lines does one or the other, but not both.

Postprostatectomy incontinence

A research team has reviewed current data on the diagnosis and management of post-surgical stress incontinence in patients treated with radical prostatectomy for prostate cancer. Their summary notes that the European Association of Urology recommends a two-stage assessment for diagnosis of postprostatectomy incontinence.

Noninvasive therapy, pelvic floor-muscle training and biofeedback, is recommended in early postoperative and mild incontinence. They further note that treatment with duloxetine (Cymbalta) is especially effective in combination with physiotherapy, where it synergistically improves the continence rate.

For surgical treatment, the insertion of an artificial urinary sphincter is still the gold standard. They conclude that several minimal invasive treatment options have been introduced with different rates of success in recent years, but they have not yet surpassed the results of the artificial sphincter.

The Influence of Statin Medications on Prostate-Specific Antigen Levels

Dr. Robert J. Hamilton and associates report statin use lowers PSA levels, and as a result may confound the detection of prostate cancer (CaP) in these patients.

Nerve grafting at the time of radical prostatectomy: should we be doing it?

With increasing numbers of younger men being diagnosed with prostate cancer and subsequently undergoing radical prostatectomy, there is an increasing focus on quality of life postoperatively, especially potency. In patients with locally advanced disease, it has been suggested that use of nerve grafts at the time of radical prostatectomy may improve potency. The technique was first described in 1999 and several papers have been published about its utility.

However, there is still controversy over its use because of the lack of any large, blinded trials, the anatomy of the cavernous nerves and the necessity of excising the neurovascular bundles (especially bilaterally). In addition, the results achieved with nerve grafting, a procedure not without significant morbidity and mortality, do not exceed those produced by surgeons carrying out nerve-sparing procedures.

According to results of a recent work, erections sufficient to produce vaginal penetration following unilateral nerve grafting (with contralateral nerve sparing) were evident in 41.7-63.6% of patients. This is similar to the rates of 23-64% with unilateral nerve sparing alone. The rates of erectile function sufficient to produce vaginal penetration following bilateral nerve grafting were 34-72%, whereas it is widely accepted that very few men without nerve grafting would have any degree of potency.

CONCLUSIONS: Currently, there does not appear to be a widespread role for nerve grafting at the time of radical prostatectomy

Circulating Tumor Cells Predict Survival Benefit From Treatment In Metastatic Castration-Resistant Prostate Cancer

In the October 1, 2008 issue of Clinical Cancer Research, Dr. Johann de Bono and colleagues presented exciting data indicating that circulating tumor cells (CTC) predict overall survival (OS) in patients with castration-resistant prostate cancer (CRPC). CTC using the commercially available CellSearch is approved by the FDA as a prognostic indicator for patients with metastatic breast, prostate, and colorectal cancer. CTC have been reported to correlate with clinical outcomes in patients with CRPC.

Diet and prostate cancer

Clinical trial results revealed exclusively to ITV News show for the first time on this scale, that changing diet and lifestyle after cancer has been diagnosed, can significantly improve a patient’s outcome.

The trial, centred at Addenbrooke’s Hospital in Cambridge, involved men with advancing prostate cancer.

After a year of improving their diet and increasing exercise, nearly 40 per cent of them no longer required the expected surgery or radiotherapy.

Several studies show that eating certain foods may reduce the risk of developing prostate cancer, reduce the likelihood of prostate cancer coming back after treatment, or help slow down progression of the disease.

In recent years, the British diet has included less fruit and vegetables and more saturated fats and meat products. These changes may increase the risk of men developing prostate cancer over many years.

Tags: diet

The impact of statin therapy on PSA levels

A scientific team has reported data from a longitudinal study of 1,214 men receiving statin treatment with drugs like simvastatin or atorvastatin (Lipitor) between 1990 and 2006.

All patients were free of prostate cancer, had never had prostate surgery, had never taken drugs like finasteride that are known to alter androgen levels, and had had at least one PSA value taken within 2 years before and at least one PSA value taken within 1 year after starting a statin. The authors report that in these men, PSA levels declined significantly following the start of statin treatment.

The reduction was most pronounced among men with the largest decreases in low density lipoprotein (LDL) levels and among those with PSA levels that would make them candidates for prostate biopsy. It is clear that  statin therapy may be a complicating factor in detection the early detection of prostate cancer.

Meat, fish, and prostate cancer risk

A recent Canadian, prospective study evaluated the association between diet and risk for prostate cancer. All over 900 patients were scheduled to have a transrectal ultrasound-guided prostatic biopsy based on an elevated serum PSA level, a rising serum PSA level, or an abnormal digital rectal examination. Before receiving the results of their biopsy, all patients were asked to complete a self-administered food frequency questionnaire.

The authors concluded that, “Fish diets appear to be associated with less risk of prostate cancer detection, and meat diets appear to be associated with a 3-fold increased risk of prostate cancer. These observations add to the growing body of evidence suggesting a relationship between diet and prostate cancer risk.”

Post-operative surgical outcomes among African Americans

A recent study suggests that outcomes after surgical treatment of prostate cancer may not be as good for African Americans as they are for Caucasians, despite treatment by physicians and at hospitals with high prostate cancer surgery volumes.

This paper suggests that there may be “social and behavioral characteristics, and some aspects of access” that impact such an effect. It should be noted that other papers have previously  demonstrated differences in outcomes between African American and Caucasian men following surgery, even within equal access health systems such as the US military (see for example Moul et al.).

This was not the case, however, for those treated with radiation therapy.

da Vinci Surgery LIVE on the Web!

Surgeons at St. Mary’s Hospital will perform a live minimally invasive robot-assisted prostatectomy surgery for treating prostate cancer using a da Vinci(R) Surgical System. The da Vinci(R) is the most innovative surgical option available to treat prostate cancer.

Using the da Vinci(R) Surgical System, this prostate-removal procedure brings even more credibility to the term “minimally invasive surgery.” It requires five tiny incisions through which the surgeon operates, via remotely controlled robotic arms with tiny 8-millimeter instruments. Smaller incisions mean less trauma to the body and faster recovery. Use of the da Vinci system has also been shown to yield shorter hospital stays, less pain and superior clinical outcomes.

The prostatectomy will be performed by Dr. Brooke Johnson, Dean Health System urologist, and physician assistant Megan Kushner. Dr. Adam Tierney, Dean Health System urologist, will provide commentary. The webcast will be hosted by Steve Van Dinter, Regional Director of Media Relations & Public Affairs for SSM Health Care of Wisconsin.

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