The principal activity that a person does to earn money.
Definition: A group of organic food substances found in animals and plants in small quantities. They must be supplied in diet or dietary supplement and are essential for normal metabolism.|CRCH Definition: A class of micronutrients that regulate and support chemical reactions in the body. NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body's fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.
AKT; PKBRAC; CWS6; PRKBA; PKB-ALPHA; RAC-ALPHA
The serine-threonine protein kinase encoded by the AKT1 gene is catalytically inactive in serum-starved primary and immortalized fibroblasts. AKT1 and the related AKT2 are activated by platelet-derived growth factor. The activation is rapid and specific, and it is abrogated by mutations in the pleckstrin homology domain of AKT1. It was shown that the activation occurs through phosphatidylinositol 3-kinase. In the developing nervous system AKT is a critical mediator of growth factor-induced neuronal survival. Survival factors can suppress apoptosis in a transcription-independent manner by activating the serine/threonine kinase AKT1, which then phosphorylates and inactivates components of the apoptotic machinery. Mutations in this gene have been associated with the Proteus syndrome. Multiple alternatively spliced transcript variants have been found for this gene. [provided by RefSeq, Jul 2011]
Alkaline Phosphatase, Placental (Regan Isozyme) Gene/
Human ALPP wild-type allele is located in the vicinity of 2q37 and is approximately 4 kb in length. This allele, which encodes alkaline phosphatase, placental type protein, is involved in placental alkaline phosphatase activity.
Alkaline Phosphatase, Placental wt Allele/
Activity measured as a test of liver function, human Glutamic-Pyruvate Transaminases (Alanine Aminotransferase Family) are pyridoxal phosphate-dependent enzymes involved in cellular nitrogen metabolism, amino acid metabolism, and liver gluconeogenesis. Glutamic Pyruvic Transaminases mediate conversion of major intermediate metabolites, catalyzing reversible transamination between alanine and alpha-ketoglutarate to form pyruvate and glutamate. (NCI)
KD; AIS; AR8; TFM; DHTR; SBMA; HYSP1; NR3C4; SMAX1; HUMARA
The androgen receptor gene is more than 90 kb long and codes for a protein that has 3 major functional domains: the N-terminal domain, DNA-binding domain, and androgen-binding domain. The protein functions as a steroid-hormone activated transcription factor. Upon binding the hormone ligand, the receptor dissociates from accessory proteins, translocates into the nucleus, dimerizes, and then stimulates transcription of androgen responsive genes. This gene contains 2 polymorphic trinucleotide repeat segments that encode polyglutamine and polyglycine tracts in the N-terminal transactivation domain of its protein. Expansion of the polyglutamine tract from the normal 9-34 repeats to the pathogenic 38-62 repeats causes spinal bulbar muscular atrophy (SBMA, also known as Kennedy's disease). Mutations in this gene are also associated with complete androgen insensitivity (CAIS). Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Jan 2017]
Activity measured as a test of liver function, 46/47-kDa homodimeric human Aspartate Aminotransferases (Class-I Pyridoxal-Phosphate-Dependent Aminotransferase Family) are pyridoxal phosphate-dependent enzymes involved in amino acid metabolism and in the urea and tricarboxylic acid cycles. (NCI)
AT1; ATA; ATC; ATD; ATE; ATDC; TEL1; TELO1
The protein encoded by this gene belongs to the PI3/PI4-kinase family. This protein is an important cell cycle checkpoint kinase that phosphorylates; thus, it functions as a regulator of a wide variety of downstream proteins, including tumor suppressor proteins p53 and BRCA1, checkpoint kinase CHK2, checkpoint proteins RAD17 and RAD9, and DNA repair protein NBS1. This protein and the closely related kinase ATR are thought to be master controllers of cell cycle checkpoint signaling pathways that are required for cell response to DNA damage and for genome stability. Mutations in this gene are associated with ataxia telangiectasia, an autosomal recessive disorder. [provided by RefSeq, Aug 2010]
A synthetic decapeptide and antagonist of naturally occurring gonadotropin-releasing hormone (GnRH). Abarelix directly and competitively binds to and blocks the gonadotropin releasing hormone receptor in the anterior pituitary gland, thereby inhibiting the secretion and release of luteinizing hormone (LH) and follicle stimulating hormone (FSH). In males, the inhibition of LH secretion prevents the release of testosterone. As a result, this may relieve symptoms associated with prostate hypertrophy or prostate cancer, since testosterone is required to sustain prostate growth./NCI-GLOSS Definition: A drug used to reduce the amount of testosterone made in patients with advanced symptomatic prostate cancer for which no other treatment options are available. It belongs to the family of drugs called gonadotropin-releasing hormone (GnRH) antagonists.
A steroidal compound with antiandrogen activity. Abiraterone inhibits the enzymatic activity of steroid 17alpha-monooxygenase (17alpha-hydrolase/C17,20 lyase complex; CYP17A1), a member of the cytochrome p450 family that catalyzes the 17alpha-hydroxylation of steroid intermediates involved in testosterone synthesis. Administration of this agent may suppress testosterone production by both the testes and the adrenals to castrate-range levels.
Androsta-5,16-dien-3-ol, 17-(3-pyridinyl)-, acetate (ester), (3beta)-
An orally active acetate sester form of the steroidal compound abiraterone with antiandrogen activity. Abiraterone inhibits the enzymatic activity of steroid 17alpha-monooxygenase (17alpha-hydrolase/C17,20 lyase complex), a member of the cytochrome p450 family that catalyzes the 17alpha-hydroxylation of steroid intermediates involved in testosterone synthesis. Administration of this agent may suppress testosterone production by both the testes and the adrenals to castrate-range levels./NCI-GLOSS Definition: A substance being studied in the treatment of prostate cancer and breast cancer. It blocks tissues from making androgens (male hormones), such as testosterone. This may cause the death of cancer cells that need androgens to grow. It is a type of anti-androgen.
The ‘flare phenomenon’ might lead to detrimental effects such as increased bone pain, acute bladder outlet obstruction, obstructive renal failure, spinal cord compression, and cardiovascular death due to hypercoagulation status. Clinical flare needs to be distinguished from the biochemical flare and even from asymptomatic radiographic evidence of progression. Patients at risk are usually those with high-volume, symptomatic, bony disease. Concomitant therapy with an anti-androgen decreases the incidence of clinical flare, but does not completely suppress the risk.Some testosterone mini-flares have also been observed with the LHRH agonists. The clinical impact might be associated with a negative impact on OS (see Section 6.6.3.1).
An inflammatory process of the sebaceous glands which is characterized by comedones, nodules, papules and/or pustules on the skin. NCI-GLOSS Definition: A disorder of the skin in which oil glands and hair glands become inflamed. NICHD Definition: An inflammatory process of the sebaceous glands which is characterized by comedones, nodules, papules and/or pustules on the skin.
A colorless, odorless, crystalline amide that polymerizes rapidly and can form as a byproduct during the heating of starch-rich foods to high temperatures. Acrylamide is used in the production of polymers mainly in the water treatment industry, pulp and paper industry and textile treatment industry and is used as a laboratory reagent. The polymer is nontoxic, but exposure to the monomer can cause central and peripheral nervous system damage resulting in hallucinations, drowsiness and numbness in the hands and legs. Acrylamide is reasonably anticipated to be a human carcinogen. (NCI05)
Closely watching a patient's condition but not giving treatment unless there are changes in test results. Active surveillance avoids problems that may be caused by treatments such as radiation or surgery. It is used to find early signs that the condition is getting worse. During active surveillance, patients will be given certain exams and tests done on a regular schedule. It is sometimes used in prostate cancer.
Active surveillance and watchful waiting
"Although active surveillance (AS) and watchful waiting (WW) avoids treatment-related side effects, they carry an increased risk of psychological distress, which significantly affects HRQoL. Risk factors for not doing well on AS include: patient perception that the physician is making most of the decisions, poor physical health,high anxiety, high PSA, lack of a partner, mental impairment, recent diagnosis of PCa, and lower number of core samples taken at diagnostic biopsy. These factors are significantly associated with low HRQoL. Anxiety and distress remained low during the first 9 months of AS."
Role of food additives in cancer causation or prevention and in general health.
Adjuvant post-operative external irradiation after RP
9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,
droxy-8-(hydroxyacetyl)-1-methoxy-,hydrochloride, (8S-cis)-(9CI)
3b-glycol-1,2,3,4,6,11-hexahydro-3,5,12-trihydroxy-10-methoxy-6,11-dioxo-3-amino-2,3,6-trideoxy-alpha-, hydrochloride/ Rubex
3-Hydroxyacetyldaunorubicin Hydrochloride
The hydrochloride salt of doxorubicin, an anthracycline antibiotic with antineoplastic activity. Doxorubicin, isolated from the bacterium Streptomyces peucetius var. caesius, is the hydroxylated congener of daunorubicin. Doxorubicin intercalates between base pairs in the DNA helix, thereby preventing DNA replication and ultimately inhibiting protein synthesis. Additionally, doxorubicin inhibits topoisomerase II which results in an increased and stabilized cleavable enzyme-DNA linked complex during DNA replication and subsequently prevents the ligation of the nucleotide strand after double-strand breakage. Doxorubicin also forms oxygen free radicals resulting in cytotoxicity secondary to lipid peroxidation of cell membrane lipids; the formation of oxygen free radicals also contributes to the toxicity of the anthracycline antibiotics, namely the cardiac and cutaneous vascular effects./NCI-GLOSS Definition: A drug that is used to treat many types of cancer and is being studied in the treatment of other types of cancer. Adriamycin PFS comes from the bacterium Streptomyces peucetius. It damages DNA and may kill cancer cells. It is a type of anthracycline antitumor antibiotic.
How long something has existed; elapsed time since birth.
Prostate-specific antigen (PSA) level defined according to specific age groups or ranges, which takes into account the natural increase of PSA levels with increased age.
Age-Adjusted Prostate-Specific Antigen Measurement
Code name for a synthetic defoliant developed for military use. Agent Orange is a mixture of two chemicals, 2,4, dichlorophenoxyacetic acid (2,4-D) and 2,4,5 trichlorophenoxyacetic acid (2,4,5-T). The toxicity of Agent Orange is due to by-products from metabolic processes upon intake. The toxic by products are dioxin derivatives, which have been linked to the wasting syndrome, gastric ulcer, cancer, immunotoxicity, hepatotoxicity, vascular lesions, teratogenicity, and impaired reproductive performance. (NCI04)
Air pollution is defined as a phenomenon harmful to the ecological system and the normal conditions of human existence and development when some substances in the atmosphere exceed a certain concentration
A volatile liquid prepared by fermentation of certain carbohydrates. Alcohol acts as a central nervous system (CNS) depressant, a diuretic, and a disinfectant. Although the exact mechanism of CNS depression is unknown, alcohol may act by inhibiting the opening of calcium channels, mediated by the binding of the inhibitory neurotransmitter gamma-amino butyric acid (GABA) to GABA-A receptors, or through inhibitory actions at N-methyl-D-aspartate (NMDA)-type glutamate receptors. Alcohol inhibits the production of antidiuretic hormone, thereby producing diuresis that may lead to dehydration. This agent kills organisms by denaturing their proteins./NCI-GLOSS Definition: A chemical substance found in beer, wine, and liquor, and some medicines, mouthwashes, household products, and essential oils (scented liquid taken from plants). Alcohol contains a carbon atom attached to a hydroxyl group (a molecule made of an oxygen atom and a hydrogen atom).
An essential fatty acid belonging to the omega-3 fatty acids group. It is highly concentrated in certain plant oils and has been reported to inhibit the synthesis of prostaglandin resulting in reduced inflammation and prevention of certain chronic diseases. CRCH Definition: Polyunsaturated fatty acid with 18 carbons and 3 double bonds at the 3rd, 6th, and 9th carbons from the methyl end."
The orally bioavailable alpha form of the naturally-occurring fat-soluble vitamin E, with potent antioxidant and cytoprotective activities. Upon administration, alpha-tocopherol neutralizes free radicals, thereby protecting tissues and organs from oxidative damage. Alpha-tocopherol gets incorporated into biological membranes, prevents protein oxidation and inhibits lipid peroxidation, thereby maintaining cell membrane integrity and protecting the cell against damage. In addition, alpha-tocopherol inhibits the activity of protein kinase C (PKC) and PKC-mediated pathways. Alpha-tocopherol also modulates the expression of various genes, plays a key role in neurological function, inhibits platelet aggregation and enhances vasodilation. Compared with other forms of tocopherol, alpha-tocopherol is the most biologically active form and is the form that is preferentially absorbed and retained in the body. CRCH Definition: Tocopherol with three methyl groups on its chromanol ring."
A therapeutic regimen that utilizes pharmaceuticals to reduce serum levels of male sex hormones./NCI-GLOSS Definition: Treatment with drugs used to block production or interfere with the action of male sex hormones.
Definition: Androgen receptor (919 aa, ~99 kDa) is encoded by the human AR gene. This protein plays a role in the modulation of steroid-dependent gene transcription.
NR3C4;Nuclear Receptor Subfamily 3 Group C Member 4
These oral compounds are classified according to their chemical structure as:|• steroidal, e.g. cyproterone acetate (CPA), megestrol acetate and medroxyprogesterone acetate;|• non-steroidal or pure, e.g. nilutamide, flutamide and bicalutamide.Both classes compete with androgens at the receptor level. This is the sole action of non-steroidal antiandrogens that leads to an unchanged or slightly elevated testosterone level. Conversely, steroidal|antiandrogens have progestational properties leading to a central inhibition by crossing the blood-brain barrier
NCI-GLOSS Definition: Having to do with reducing inflammation.
Any agent capable of preventing blood clot formation. NCI-GLOSS Definition: A substance that is used to prevent and treat blood clots in blood vessels and the heart"
Any substance used to reduce hyperglycemia or treat disorders associated with diabetes. Based on their mechanism of action, this class of agents can be classified to the following groups: directly acting insulomimetics, which activates insulin receptors; indirectly acting insulinomimetics, which increase insulin release such as sulfonylureas or which potentiate the effect of insulin such as metformin; those act directly on the metabolism of glucose such as inhibitors of glucosidases and inhibitors of aldose reductase.
Any substance used in the treatment of acute or chronic hypertension regardless of pharmacological mechanism. Antihypertensive agents include diuretics, alpha-adrenergic and beta-adrenergic antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, ganglionic blockers, and vasodilator agents.
An element with atomic symbol As, atomic number 33, and atomic weight 74.92. NCI-GLOSS Definition: A poisonous chemical used to kill weeds and pests. Also used in cancer therapy.
some houses were insulated by blowing crushed, loose-fill asbestos (largely amosite with some crocidolite) into roof spaces. Over time, asbestos fibres migrated to other areas such as wall cavities, subfloor spaces, cupboards, heating and cooling ducts and vents, living areas, and bedrooms.
An orally administered non-steroidal antiinflammatory agent. Acetylsalicylic acid binds to and acetylates serine residues in cyclooxygenases, resulting in decreased synthesis of prostaglandin, platelet aggregation, and inflammation. This agent exhibits analgesic, antipyretic, and anticoagulant properties. NCI-GLOSS Definition: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention."
A genetic predisposition to form IgE antibodies in response to exposure to allergens and therefore, for the development of immediate (type I) hypersensitivity and atopic conditions, such as allergic rhinitis; bronchial asthma, atopic dermatitis, and food allergy. Mutations of specific alleles on the long arm of chromosome 5 have been associated with higher levels of IL-4 and IgE and are known as IL-4 promoter polymorphisms.
A class of nutrients that are in the water-soluble B-vitamin family. B vitamins include thiamine, riboflavin, niacin (nicotinic acid), niacinamide (nicotinamide), the vitamin B6 group (including pyridoxine, pyridoxal, pyridoxamine), biotin, pantothenic acid, folic acid, and possibly para-aminobenzoic.
This gene encodes a protein which interacts with the N-terminal region of BRCA1. In addition to its ability to bind BRCA1 in vivo and in vitro, it shares homology with the 2 most conserved regions of BRCA1: the N-terminal RING motif and the C-terminal BRCT domain. The RING motif is a cysteine-rich sequence found in a variety of proteins that regulate cell growth, including the products of tumor suppressor genes and dominant protooncogenes. This protein also contains 3 tandem ankyrin repeats. The BARD1/BRCA1 interaction is disrupted by tumorigenic amino acid substitutions in BRCA1, implying that the formation of a stable complex between these proteins may be an essential aspect of BRCA1 tumor suppression. This protein may be the target of oncogenic mutations in breast or ovarian cancer. Multiple alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Sep 2013]
A general indicator of the body fat an individual is carrying based upon the ratio of weight to height.
Inherited mutations in BRCA1 and this gene, BRCA2, confer increased lifetime risk of developing breast or ovarian cancer. Both BRCA1 and BRCA2 are involved in maintenance of genome stability, specifically the homologous recombination pathway for double-strand DNA repair. The BRCA2 protein contains several copies of a 70 aa motif called the BRC motif, and these motifs mediate binding to the RAD51 recombinase which functions in DNA repair. BRCA2 is considered a tumor suppressor gene, as tumors with BRCA2 mutations generally exhibit loss of heterozygosity (LOH) of the wild-type allele. [provided by RefSeq, Dec 2008]
FAD; FACD; FAD1; GLM3; BRCC2; FANCD; PNCA2; FANCD1; XRCC11; BROVCA2
BRIP1 BRCA1 interacting protein C-terminal helicase 1
The protein encoded by this gene is a member of the RecQ DEAH helicase family and interacts with the BRCT repeats of breast cancer, type 1 (BRCA1). The bound complex is important in the normal double-strand break repair function of breast cancer, type 1 (BRCA1). This gene may be a target of germline cancer-inducing mutations. [provided by RefSeq, Jul 2008]
A quantitative measurement of the amount of urea nitrogen present in a serum sample.
A hypotrichosis that is characterized by a loss of hair from the head or body. (|http://en.wikipedia.org/wiki/Alopecia, http://www.omim.org/entry/109200?search=109200&highlight=109200)
Baseline screening using the G8 screening tool
The International Society of Geriatric Oncology (SIOG) Prostate Cancer Working Group (PCWG) recommends that treatment for senior adults should be based on systematic evaluation of health status. The G8 (Geriatric 8) health status screening tool is described in Table 6.7.2, the Karnofsky and ECOG Scores in Table 6.7.3.
A file containing demographic, medical, and treatment information pertaining to an individual patient.
A naturally-occurring retinol (vitamin A) precursor obtained from certain fruits and vegetables with potential antineoplastic and chemopreventive activities. As an anti-oxidant, beta carotene inhibits free-radical damage to DNA. This agent also induces cell differentiation and apoptosis of some tumor cell types, particularly in early stages of tumorigenesis, and enhances immune system activity by stimulating the release of natural killer cells, lymphocytes, and monocytes. (NCI04) NCI-GLOSS Definition: A substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. The body can make vitamin A from beta carotene. Beta carotene is being studied in the prevention of some types of cancer. It is a type of antioxidant. CRCH Definition: Carotenoid consisting of a cyclic structure on each end with additional double bonds at the number 5 and 5' carbon atoms of the cyclic structures.
A synthetic, nonsteroidal antiandrogen. Bicalutamide competitively binds to cytosolic androgen receptors in target tissues, thereby inhibiting the receptor binding of androgens. This agent does not bind to most mutated forms of androgen receptors. (NCI04)/NCI-GLOSS Definition: An anticancer drug that belongs to the family of drugs called antiandrogens.
The event of being born GAIA Definition: The birth of an offspring, which breathes or shows evidence of life, or is born without signs of life at an estimated gestation of 24 weeks or more (as defined by Preterm Birth guidelines: http:www.brightoncollaboration.org)."
Birth weight is the body weight of a baby at its birth. The average birth weight in babies of European heritage is 3.5 kilograms (7.7 lb), though the range of normal is between 2.5 kilograms (5.5 lb) and 5 kilograms (11 lb) (all but 5% of newborns will fall into this range).
Compared with BWs between 3000 and 3500 g (reference), the fully adjusted odds ratios (OR, 95% CI) were 0.55 (0.33-0.91) for <3000 g, 0.86 (0.61-1.22) for 3500-4000 g and 0.98 (0.64-1.50) for >4000 g. Among men with aggressive tumours, the reduction in risk for those with BWs <3000 g (OR 0.26, 95% CI 0.09-0.72) was stronger than the rate of risk for PRCA overall.
Bisphenol A (BPA), 2,2-bis(4-hydroxyphenyl) propane, is one of the most utilized industrial chemicals worldwide, with the ability to interfere with/or mimic estrogenic hormones with associated biological responses.BPA is a synthetic phenol extensively used in the manufacture of polycarbonate plastics and epoxy resins.
Bisphosphonates have been used to inhibit osteoclast-mediated bone resorption in CRPC and have proven to be highly effective in reducing bone pain. 643 patients who had CRPC [862] with bone metastases were randomised to receive zoledronic acid, 4 or 8 mg every 3 weeks for 15 consecutive months, or placebo. At 15 and 24 months of follow-up, patients treated with 4 mg zoledronic acid had fewer skeletal-related events(SREs) compared to the placebo group (44% vs. 33%, P = 0.021) and fewer pathological fractures (13.1% vs.22.1%, P = 0.015). Furthermore, the time to first SRE was longer in the zoledronic acid group, thus improving|QoL.|Patients were initially randomised to 4 or 8 mg of zoledronic acid, but the 8 mg dosage|was later modified to 4 mg due to toxicity. The toxicity (e.g., jaw necrosis) of these drugs,especially aminobisphosphonate, must always be kept in mind. Patients should have a dental examination before starting bisphosphonate therapy. The risk of jaw necrosis is increased by a history of trauma, dental|surgery or dental infection, as well as long-term intravenous bisphosphonate administration.No survival benefit has been seen in any prospective trial with bisphosphonates.
Black tea is an infusion of dried leaves from plants of the Theaceae family. Due to the alkaloid caffeine, its main effect is stimulation. Black teas also contain other phytochemicals such as flavonoid and flavonoid-related compounds with strong antioxidant effects. They also attenuate atherosclerotic inflammation, reduce thrombosis, promote normal endothelial function, and block expression of cellular adhesion molecules. Black tea may reduce the risk of cancer, heart diseases, infectious diseases, and degenerative diseases. (NCI04)
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a hypodermic needle, or via fingerprick.
The pressure of the circulating blood against the walls of the blood vessels.
A general indicator of the body fat an individual is carrying based upon the ratio of weight to height. NCI-GLOSS Definition: A measure that relates body weight to height. BMI is sometimes used to measure total body fat and whether a person is a healthy weight. Excess body fat is linked to an increased risk of some diseases including heart disease and some cancers.
Bone pain (diffuse not joint pain or arthritis)
A nuclear imaging method used to evaluate pathological bone metabolism.
Bone scan and abdominopelvic computed tomography
骨扫描与腹腔骨盆计算机断层扫描
The standard workup to detect PCa metastases usually includes bone scan and abdominopelvic CT. However,because biochemical failure after RP or radiation therapy precedes clinical metastases by 7-8 years on average, the diagnostic yield of usual imaging techniques is poor in asymptomatic patients . In men with PSA-only relapse after RP, the probability of a positive bone scan is < 5%, when the PSA level is < 7 ng/mL. A PSA doubling time (PSA-DT) < 6 months or a PSA velocity > 0.5 ng/mL/month are predictors of positive bone scan.
Bone targeted therapies in metastatic CRPC
A type of radiation therapy in which radioactive material is placed inside the body, into a tumor or body cavity./NCI-GLOSS Definition: A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor./CDISC Definition: A type of radiation therapy in which radioactive material is placed inside the body, into a tumor or body cavity.
The Brugada electrocardiogram pattern is characterized by coved-type ST-elevation (>2 mm) in the right precordial leads. We report the case of a 62-year-old man, with bipolar disorder, admitted to the emergency department because of dyspnea and chest discomfort. The patient was on treatment with pregabalin and quetiapine. Unexpectedly, electrocardiogram at admission showed diffuse ST-elevation, more evident in inferior leads, where a Brugada-like pattern was present. The patient underwent coronary angiography with a diagnosis of suspected acute coronary syndrome. Coronary angiography, however, showed mild coronary artery disease not requiring coronary angioplasty. Echocardiography did not reveal left ventricular dysfunction or pericardial effusion. Troponin levels remained normal over serial controls. Eventually, chest radiography showed lung opacities and consolidation suggestive for pneumonia. To the best of our knowledge, this is one of the first cases showing a transient Brugada-like electrocardiogram pattern in inferior leads, probably amplified by the administration of pregabalin and quetiapine.
NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Vitamin C helps fight infections, heal wounds, and keep tissues healthy. It is an antioxidant that helps prevent cell damage caused by free radicals (highly reactive chemicals). Vitamin C is found in all fruits and vegetables, especially citrus fruits, strawberries, cantaloupe, green peppers, tomatoes, broccoli, leafy greens, and potatoes. It is water-soluble (can dissolve in water) and must be taken in every day. Vitamin C is being studied in the prevention and treatment of some types of cancer. CRCH Definition: Class of water-soluble antioxidant vitamins which are cofactors in the biosynthesis of collagen, carnitine, and neurotransmitters, and can quench a variety of reactive oxygen and nitrogen species. (DRI)
C peptide (31 aa, ~3 kDa) is encoded by the human INS gene. This protein is involved in both signal transduction and the modulation of blood flow. NCI-GLOSS Definition: A substance made by the pancreas. C-peptide and insulin are both part of a larger molecule that gets split apart before being released into the blood. Abnormal blood levels of C-peptide may occur in certain diseases, such as diabetes or cancer."
An element with atomic symbol Ca, atomic number 20, and atomic weight 40.08.
This gene encodes a member of the cysteine-aspartic acid protease (caspase) family. Sequential activation of caspases plays a central role in the execution-phase of cell apoptosis. Caspases exist as inactive proenzymes composed of a prodomain, a large protease subunit, and a small protease subunit. Activation of caspases requires proteolytic processing at conserved internal aspartic residues to generate a heterodimeric enzyme consisting of the large and small subunits. This protein is involved in the programmed cell death induced by Fas and various apoptotic stimuli. The N-terminal FADD-like death effector domain of this protein suggests that it may interact with Fas-interacting protein FADD. This protein was detected in the insoluble fraction of the affected brain region from Huntington disease patients but not in those from normal controls, which implicated the role in neurodegenerative diseases. Many alternatively spliced transcript variants encoding different isoforms have been described, although not all variants have had their full-length sequences determined. [provided by RefSeq, Jul 2008]
This metastasis suppressor gene product is a membrane glycoprotein that is a member of the transmembrane 4 superfamily. Expression of this gene has been shown to be downregulated in tumor progression of human cancers and can be activated by p53 through a consensus binding sequence in the promoter. Its expression and that of p53 are strongly correlated, and the loss of expression of these two proteins is associated with poor survival for prostate cancer patients. Two alternatively spliced transcript variants encoding distinct isoforms have been found for this gene. [provided by RefSeq, Jul 2008]
This gene encodes a classical cadherin of the cadherin superfamily. Alternative splicing results in multiple transcript variants, at least one of which encodes a preproprotein that is proteolytically processed to generate the mature glycoprotein. This calcium-dependent cell-cell adhesion protein is comprised of five extracellular cadherin repeats, a transmembrane region and a highly conserved cytoplasmic tail. Mutations in this gene are correlated with gastric, breast, colorectal, thyroid and ovarian cancer. Loss of function of this gene is thought to contribute to cancer progression by increasing proliferation, invasion, and/or metastasis. The ectodomain of this protein mediates bacterial adhesion to mammalian cells and the cytoplasmic domain is required for internalization. This gene is present in a gene cluster with other members of the cadherin family on chromosome 16. [provided by RefSeq, Nov 2015]
UVO; CDHE; ECAD; LCAM; Arc-1; BCDS1; CD324
In response to DNA damage and replication blocks, cell cycle progression is halted through the control of critical cell cycle regulators. The protein encoded by this gene is a cell cycle checkpoint regulator and putative tumor suppressor. It contains a forkhead-associated protein interaction domain essential for activation in response to DNA damage and is rapidly phosphorylated in response to replication blocks and DNA damage. When activated, the encoded protein is known to inhibit CDC25C phosphatase, preventing entry into mitosis, and has been shown to stabilize the tumor suppressor protein p53, leading to cell cycle arrest in G1. In addition, this protein interacts with and phosphorylates BRCA1, allowing BRCA1 to restore survival after DNA damage. Mutations in this gene have been linked with Li-Fraumeni syndrome, a highly penetrant familial cancer phenotype usually associated with inherited mutations in TP53. Also, mutations in this gene are thought to confer a predisposition to sarcomas, breast cancer, and brain tumors. This nuclear protein is a member of the CDS1 subfamily of serine/threonine protein kinases. Several transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Apr 2012]
CDS1; CHK2; LFS2; RAD53; hCds1; HuCds1; PP1425
The parental CHO cell line initiated from a biopsy of an ovary of an adult Chinese hamster.
Variation in the number of copies of a particular sequence within the genetic material of an individual. Large-scale copy number polymorphisms are common and widely distributed in the human genome
A promoter sequence which interacts with CRE binding proteins to modulate gene expression in response to the level of cAMP in the cell.
1-hydroxy-7beta,10beta-dimethoxy-9-oxo-5beta,20-epoxytax-11-ene-2alpha,4,13alpha-triyl 4-acetate 2-benzoate/
A semi-synthetic derivative of the natural taxoid 10-deacetylbaccatin III with potential antineoplastic activity. Cabazitaxel binds to and stabilizes tubulin, resulting in the inhibition of microtubule depolymerization and cell division, cell cycle arrest in the G2/M phase, and the inhibition of tumor cell proliferation. Unlike other taxane compounds, this agent is a poor substrate for the membrane-associated, multidrug resistance (MDR), P-glycoprotein (P-gp) efflux pump and may be useful for treating multidrug-resistant tumors. In addition, cabazitaxel penetrates the blood-brain barrier (BBB)./NCI-GLOSS Definition: A drug used with prednisone to treat hormone-resistant prostate cancer that has spread and that had been treated with docetaxel. It is also being studied in the treatment of other types of cancer. Cabazitaxel blocks cell growth by stopping cell division and may kill cancer cells. It is a type of antimitotic agent.
An element with atomic symbol Ca, atomic number 20, and atomic weight 40.08. NCI-GLOSS Definition: A mineral needed for healthy teeth, bones, and other body tissues. It is the most common mineral in the body. A deposit of calcium in body tissues, such as breast tissue, may be a sign of disease.
A class of hydrocarbons with an empirical formula of Cm(H20)n (where m and n may be equal) and includes monomers, polymers and derivatives of aldoses, ketoses, saccharides, and alditols. NCI-GLOSS Definition: A sugar molecule. Carbohydrates can be small and simple (for example, glucose) or they can be large and complex (for example, polysaccharides such as starch, chitin or cellulose)."
The ability of the heart and lungs to deliver blood and oxygen to the tissues during aerobic activity. It is a general measure of the relative conditioning of the heart and respiratory system.
Cardiovascular mortality is now the most common cause of death in PCa patients, even exceeding PCa mortality. Several studies showed that ADT, even after only 6 months, was associated with an increased risk of diabetes mellitus, cardiovascular disease, and myocardial infarction. The RTOG 92-02 and 94-08 confirmed an increased cardiovascular risk, unrelated to the duration of ADT and not accompanied by an overall increased cardiovascular mortality. No increase in cardiovascular mortality has been reported in a systematic meta-analysis of trials RTOG 8531, 8610, 9202, EORTC 30891 or EORTC 22863. However,an increase in cardiovascular mortality has been reported in patients suffering from previous congestiveheart failure or myocardial infarction in a retrospective database analysis or presenting with a metabolic syndrome.
A class of hydrocarbons (carotenes) and their oxygenated derivatives which exhibit chemopreventive properties. Carotenoids are pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. CRCH Definition: Class of compounds usually consisting of a hydrocarbon chain of 40 carbons, nine conjugated double bonds, and one or two cyclic structures at the ends of the conjugated chain. NCI-GLOSS Definition: A yellow, red, or orange substance found mostly in plants, including carrots, sweet potatoes, dark green leafy vegetables, and many fruits, grains, and oils. Some carotenoids are changed into vitamin A in the body and some are being studied in the prevention of cancer. A carotenoid is a type of antioxidant and a type of provitamin."
Surgical removal of the ovaries or testes./NCI-GLOSS Definition: Surgical removal of the testicles (orchiectomy) or ovaries (oophorectomy) to stop the production of sex hormones. Decreasing the levels of hormones may stop the growth of certain cancers.
A finding of low concentrations of testosterone in a subject's serum that results from the use of surgical or chemical castration procedures.
The use of synthetic or naturally-occurring chemicals for the treatment of diseases./NCI-GLOSS Definition: Treatment with anticancer drugs./CTEP Definition: Non-systemic chemotherapy treatment (e.g., intra-peritoneal, intra-cavitary, intra-thecal), or chemotherapy not described by Chemotherapy Single Agent Systemic or Multi-Agent Systemic.
A very stable, colorless, odorless, synthetic chlorinated polycyclic hydrocarbon that is a degradation product of Mirex. Chlordecone has been used as an insecticide on bananas, non-bearing citrus trees, tobacco, lawns and flowers. Exposure to this substance causes neurological symptoms, such as tremors and slurred speech. Chlordecone is reasonably anticipated to be a human carcinogen based on evidence of carcinogenicity in experimental animals. (NCI05)
An animal sterol found in the body tissues (and blood plasma) of vertebrates. It can be found in large concentrations within the liver, spinal cord, and brain. Cholesterol is an important component of the membranes of cells, providing stability. It is the major precursor for the synthesis of vitamin D, of the various steroid hormones, including cortisol, cortisone, and aldosterone in the adrenal glands, and of the sex hormones progesterone, estrogen, and testosterone. Cholesterol also has an important role for the brain synapses as well as in the immune system. In conditions featuring elevated low density lipoproteins (LDL), cholesterol often forms plaque deposits in the walls of arteries, a condition known as atherosclerosis, which is a major contributor to coronary heart disease and other forms of cardiovascular disease. CRCH Definition: Lipid composed of 27 carbon atoms which form three fused cycloheane (6-carbon) rings, a cyclopentane (5-carbon ring) and a side chain of 8 carbon atoms. (Ensminger et al). NCI-GLOSS Definition: A waxy, fat-like substance made in the liver, and found in the blood and in all cells of the body. Cholesterol is important for good health and is needed for making cell walls, tissues, hormones, vitamin D, and bile acid. Cholesterol also comes from eating foods taken from animals such as egg yolks, meat, and whole-milk dairy products. Too much cholesterol in the blood may build up in blood vessel walls, block blood flow to tissues and organs, and increase the risk of developing heart disease and stroke."
CRCH Definition: Water-soluble vitamin that is a precursor for acetylcholine, phospholipids, and the methyl donor betaine. (DRI) NCI-GLOSS Definition: A nutrient in the vitamin B complex that the body needs in small amounts to function and stay healthy. Choline helps cells make membranes, make a neurotransmitter (a chemical that helps nerve cells communicate with other cells), and remove fat from the liver. It is found in whole milk, beef liver, eggs, soy foods, and peanuts. Choline is water-soluble (can dissolve in water) and must be taken in every day. Not enough choline can cause diseases of the heart and blood vessels and damage to the liver. A form of choline is being studied in the treatment of some types of cancer and to reduce pain and fever. Choline is also being studied together with vitamin B12 in the prevention and treatment of cancer.
A histamine H(2)-receptor antagonist. Enhancing anti-tumor cell-mediated responses, cimetidine blocks histamine's ability to stimulate suppressor T lymphocyte activity and to inhibit natural killer (NK) cell activity and interleukin-2 production. Cimetidine also may inhibit tumor growth by suppressing histamine's growth-factor activity and blocking histamine-induced stimulation of vascular endothelial growth factor (VEGF), a pro-angiogenic growth factor. (NCI04) NCI-GLOSS Definition: A drug usually used to treat stomach ulcers and heartburn. It is also commonly used in a regimen to prevent allergic reactions."
Guanidine, N''-Cyano-N-Methyl-N'-(2-(((5-Methyl-1H-Imidazol-4-yl)Methyl)Thio)Ethyl)-
An alkylating-like inorganic platinum agent (cis-diamminedichloroplatinum) with antineoplastic activity. Cisplatin forms highly reactive, charged, platinum complexes which bind to nucleophilic groups such as GC-rich sites in DNA inducing intrastrand and interstrand DNA cross-links, as well as DNA-protein cross-links. These cross-links result in apoptosis and cell growth inhibition./NCI-GLOSS Definition: A drug used to treat many types of cancer. Cisplatin contains the metal platinum. It kills cancer cells by damaging their DNA and stopping them from dividing. Cisplatin is a type of alkylating agent.
A diagnosis made from a study of the signs and symptoms of a disease.
A characteristic of a medicinal product, specifying that its most predominant agreeable savor detected by the unified sensation of taste and olfactory receptors resembles coffee.
Diminished mental function./NICHD Definition: Diminished mental function.
Common complications due to bone metastases
Common complications due to bone metastases include bone pain, vertebral collapse or deformity, pathological fractures and spinal cord compression. Cementation is an effective treatment for painful spinal fracture, whatever its origin, clearly improving both pain and QoL. However, it is still important to offer standard palliative surgery, which can be effective for managing osteoblastic metastases. Impending spinal cord compression is an emergency. It must be recognised early and patients should be educated to recognise the warning signs. Once suspected, high-dose corticosteroids must be given and MRI performed as soon as possible. A systematic neurosurgery consultation should be planned to discuss a possible decompression, followed by external beam irradiation. Otherwise, external beam radiotherapy, with or without systemic therapy, is the treatment of choice.
The coexistence of two or more disease processes./NCI-GLOSS Definition: The condition of having two or more diseases at the same time.
The determination of the number of red blood cells, white blood cells, and platelets in a blood sample.
Complications of cryosurgery for primary treatment of PCa
Erectile dysfunction occurs in about 80% of patients and this remains a consistent complication of the CSAP procedure, independent of the generation of the system used. The complication rates described in third-generation cryosurgery include tissue sloughing in about 3%, incontinence in 4.4%, pelvic pain in 1.4% and urinary retention in about 2%. The development of fistula is usually rare, being < 0.2% in modern series. About 5% of all patients require transurethral resection of the prostate (TURP) for subvesical obstruction.
Complications of high-intensity focused ultrasound
Urinary retention appears to be one of the most common side-effects of HIFU, developing in almost allpatients, with the mean interval of catheterization via a suprapubic tube varying between 12 and 35 days. Grade I and II urinary stress incontinence occurs in about 12% of patients. Subsequent TURP or bladder neck incision to treat subvesical obstruction is common, and is sometimes even performed at the time of HIFU. Post-operative impotence occurs in 55-70% of patients.Elterman et al. have treated 95 patients with clinically organ-confined PCa using the Sonablate 500 device(SonaCare Medical, Charlotte, NC, USA) and have evaluated the type and frequency of treatment-associated complications. With a minimum follow-up of six months, 17% (7/41) of the men had significant incontinence,and 2%developed significant erectile dysfunction. Early and late subvesical obstruction necessitating surgical treatment occurred in 17 (17.9%) and 20 (21.1%) patients, respectively.Moderate to severe stress urinary incontinence was rare, occurring in fewer than 6.4% of men, and decreased in more recent treatment to 3.1% . Acute urinary retention was seen in 7.6% of men. Even in more recent treatment, the rate of urethral-rectal fistula was 0.7%.
Contrast-enhanced ultrasound-guided prostate biopsy
A radiologic technique that employs contrast agents to enable a more precise needle placement during a biopsy of the prostate.
The removal of a tissue sample using a needle with a relatively large diameter, for microscopic examination.
Narrowing of the coronary arteries due to fatty deposits inside the arterial walls. The diagnostic criteria may include documented history of any of the following: documented coronary artery stenosis greater than or equal to 50% (by cardiac catheterization or other modality of direct imaging of the coronary arteries); previous coronary artery bypass surgery (CABG); previous percutaneous coronary intervention (PCI); previous myocardial infarction. (ACC)
Narrowing of the coronary arteries due to fatty deposits inside the arterial walls.
The use of extreme cold to damage or destroy a body part, pathway, or function. The procedure is performed using small cryogenic probes during surgery, and has recently been applied to solitary sporadic renal tumor lesions./NCI-GLOSS Definition: A procedure in which tissue is frozen to destroy abnormal cells. Liquid nitrogen or liquid carbon dioxide is used to freeze the tissue./CDISC Definition: Removal, separation, detachment, extirpation or eradication of a body part, pathway or function by freezing. (NCI)
The therapeutic use of cold or refrigeration in medicine.
The identification and quantitation of all of the cytokines expressed in a biological sample.
A family of lipo-soluble steroids important to the absorption, metabolism, and function of calcium and phosphorus and the growth and development of bone and tooth enamel. Found naturally in animal tissues, cholecalciferol (vitamin D3) is formed in the skin when ultraviolet light activates cholesterol conversion into vitamin D3. Ultraviolet irradiation of ergosterol (plant vitamin D) forms ergocalciferol (vitamin D2). (NCI04) CRCH Definition: A class of fat-soluble vitamins that are seco-sterol precursors to the active hormone, 1,25-dihydroxy vitamin D. NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Vitamin D helps the body use calcium and phosphorus to make strong bones and teeth. It is fat-soluble (can dissolve in fats and oils) and is found in fatty fish, egg yolks, and dairy products. Skin exposed to sunshine can also make vitamin D. Not enough vitamin D can cause a bone disease called rickets. It is being studied in the prevention and treatment of some types of cancer."
The minimum pressure exerted into the systemic arterial circulation during cardiac ventricular relaxation and filling.
Many men with localised PCa will not benefit from definitive treatment, and ~45% of men with PSAdetected|PCa are candidates for deferred management. In men with comorbidity and limited life|expectancy, treatment of localised PCa may be deferred to avoid loss of quality of life (QoL). There are two|distinct strategies for conservative management that aim to reduce overtreatment: active surveillance and|watchful waiting.
Deficient nucleotide excision repair capacity
A long-acting, synthetic peptide with gonadotrophin-releasing hormone (GnRH) antagonistic properties. Degarelix targets and blocks GnRH receptors located on the surfaces of gonadotroph cells in the anterior pituitary, thereby reducing secretion of luteinizing hormone (LH) by pituitary gonadotroph cells and so decreasing testosterone production by interstitial (Leydig) cells in the testes./NCI-GLOSS Definition: A drug that is used to treat advanced prostate cancer and is also being studied in the treatment of benign prostatic hyperplasia. Degarelix binds to gonadotropin-releasing hormone (GnRH) receptors in the pituitary gland. This causes the body to stop making testosterone, which prostate cancer needs to grow. Degarelix is a type of GnRH antagonist.
The statistical characterization of human populations or segments of human populations (e.g., characterization by age, sex, race, or income).
A metabolic disorder characterized by abnormally high blood sugar levels due to diminished production of insulin or insulin resistance/desensitization. NCI-GLOSS Definition: A disease in which the body does not control the amount of glucose (a type of sugar) in the blood and the kidneys make a large amount of urine. This disease occurs when the body does not make enough insulin or does not use it the way it should. NICHD Definition: A metabolic condition, characterized by hyperglycemia, caused by insufficient secretion of insulin by the pancreas and/or decreased insulin action in target tissues."
A metabolic disorder characterized by abnormally high blood sugar levels due to diminished production of insulin or insulin resistance/desensitization.
Characteristic or indicative of a condition.
Diagnostic transurethral resection of the prostate
A job-exposure matrix was used for assigning exposure. For the calculation of dose-years, the duration of contact with specific substances was weighted by the intensity and probability of exposure according to a job-exposure matrix. The analysis of dose-years yielded a statistically significant association between occupational exposure to diesel fuel or fumes and prostate cancer (odds ratio 3.7, 95% confidence interval 1.4-9.8, for subjects exposed to more than 25 dose-years in a comparison with subjects never exposed).
The Western-style diet is characterized by its highly processed and refined foods and high contents of sugars, salt, and fat and protein from red meat. It has been recognized as the major contributor to metabolic disturbances and the development of obesity-related diseases including type 2 diabetes, hypertension, and cardiovascular disease.
The centered percentile score for each food parameter for each individual was then multiplied by the respective food parameter effect score (inflammatory potential for each food parameter), which was derived through a review of the literature, in order to obtain a food parameter-specific DII score for an individual. The overall DII score was calculated, for each participant, as a linear combination of all of the food parameter-specific DII scores,12 as follows: DII=b1×n1 + b2×n2……….b31×n31, where b refers to the literature-derived inflammatory effects score for each of the evaluable food parameters and n refers to the food parameter-specific centered percentiles, which were derived from the current case–control study dietary data. A description of the validation work, including both dietary recalls and a structured questionnaire similar to a FFQ, also is available.11 The methodology is depicted in Supporting Information Appendix.
Any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. The term is often used broadly to include injuries, disabilities, syndromes, symptoms, deviant behaviors, and atypical variations of structure and function.|CDISC-GLOSS Definition: Any deviation from or interruption of the normal structure or function of a part, organ, or system of the body as manifested by characteristic symptoms and signs. [Dorland's Medical Dictionary]|NCI-GLOSS Definition: In medicine, a health problem with certain characteristics or symptoms.
[2aR-[2a alphaa,4beta,4a beta,6beta,9alpha,(alphaR*,betaS*),-11alpha,12alpha,12a alpha,12b alpha]]-beta-[[(1,1-dimethylethoxy)carbonyl]-amino]-alpha-hydroxybenzemepropanoic Acid 12b-(Acetyloxy)-12(benzyloxy)-2a,3,4,4a,5,6,8,10,11,12,12a,12b-dodecahydeo-4,-6,11-trihydroxy-4a,8,13,13-tetramethyl-5-oxo-7,11-methano-1H-cyclodeca[3,4]benz[1,2-b]oxet-9-yl Ester
A semi-synthetic, second-generation taxane derived from a compound found in the European yew tree, Taxus baccata. Docetaxel displays potent and broad antineoplastic properties; it binds to and stabilizes tubulin, thereby inhibiting microtubule disassembly which results in cell- cycle arrest at the G2/M phase and cell death. This agent also inhibits pro-angiogenic factors such as vascular endothelial growth factor (VEGF) and displays immunomodulatory and pro-inflammatory properties by inducing various mediators of the inflammatory response. Docetaxel has been studied for use as a radiation-sensitizing agent. (NCI04)/NCI-GLOSS Definition: A drug used together with other drugs to treat certain types of breast cancer, stomach cancer, prostate cancer, and certain types of head and neck cancer. It is also being studied in the treatment of other types of cancer. Docetaxel is a type of mitotic inhibitor.
A significant improvement in median survival of 2-2.5 months occurred with docetaxel-based chemotherapy|compared to mitoxantrone + prednisone therapy. The standard for first-line cytotoxic chemotherapy|is docetaxel using the same regimen as in the TAX 327 trial, that is, 75 mg/m2 3 weekly combined with|prednisone 5 mg BID, up to 10 cycles, and palliation is the main target.|The patients considered for docetaxel represent a heterogeneous population. Several poor|prognostic factors have been described, such as a PSA level > 114 ng/mL, PSA-DT < 55 days, or the presence|of visceral metastases. A better risk group definition has recently been presented, based on the TAX|327 study cohort. The predictive factors were visceral metastases, pain, anaemia (Hb < 13 g/dL), bone scan|progression, and prior estramustine before docetaxel. Patients were categorised into three risk groups: low risk|(0 or 1 factor), intermediate (2 factors) and high risk (3 or 4 factors), leading to three different lengths of median|OS: 25.7, 18.7 and 12.8 months, respectively. In addition, two independent studies have suggested that|improved survival can be predicted by C-reactive protein (CRP) levels < 8 mg/L (HR, 2.96). Age by|itself is not a contraindication to docetaxel.
A stepwise increase in the amount of a therapeutic or investigational agent given to an individual.
A drug product that contains one or more active and/or inactive ingredients; it is intended to treat, prevent or alleviate the symptoms of disease. This term does not refer to the individual ingredients that make up the product.
A natural fat-soluble antioxidant with potential chemopreventive activity. Also known as tocopherol, vitamin E ameliorates free-radical damage to biological membranes, protecting polyunsaturated fatty acids (PUFA) within membrane phospholipids and within circulating lipoproteins. Peroxyl radicals react 1000-fold faster with vitamin E than with PUFA. In the case of oxygen free radical-mediated tumorigenesis, vitamin E may be chemopreventive. (NCI04) CRCH Definition: A fat-soluble vitamin which is primarily a chain-breaking antioxidant that prevents the propagation of lipid peroxidation. NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Vitamin E helps prevent cell damage caused by free radicals (highly reactive chemicals). It is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy vegetables, and vegetable oils. Not enough vitamin E can result in infertility (the inability to produce children). It is being studied in the prevention and treatment of some types of cancer. Vitamin E is a type of antioxidant."
This gene encodes an Eps15 homology domain binding protein. The encoded protein may play a role in endocytic trafficking. A single nucleotide polymorphism in this gene is associated with an aggressive form of prostate cancer. Alternate splicing results in multiple transcript variants. [provided by RefSeq, Feb 2010]
The protein encoded by this gene has a C-terminal domain with tRNA 3′ processing endoribonuclease activity, which catalyzes the removal of the 3' trailer from precursor tRNAs. The protein also interacts with activated Smad family member 2 (Smad2) and its nuclear partner forkhead box H1 (also known as FAST-1), and reduced expression can suppress transforming growth factor-beta induced growth arrest. Mutations in this gene result in an increased risk of prostate cancer. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Sep 2009]
DRT; EK5; ERK; CAPB; Hek5; PCBC; EPHT3; Tyro5
This gene encodes a member of the Eph receptor family of receptor tyrosine kinase transmembrane glycoproteins. These receptors are composed of an N-terminal glycosylated ligand-binding domain, a transmembrane region and an intracellular kinase domain. They bind ligands called ephrins and are involved in diverse cellular processes including motility, division, and differentiation. A distinguishing characteristic of Eph-ephrin signaling is that both receptors and ligands are competent to transduce a signaling cascade, resulting in bidirectional signaling. This protein belongs to a subgroup of the Eph receptors called EphB. Proteins of this subgroup are distinguished from other members of the family by sequence homology and preferential binding affinity for membrane-bound ephrin-B ligands. Allelic variants are associated with prostate and brain cancer susceptibility. Alternative splicing results in multiple transcript variants. [provided by RefSeq, May 2015]
This gene encodes an estrogen receptor, a ligand-activated transcription factor composed of several domains important for hormone binding, DNA binding, and activation of transcription. The protein localizes to the nucleus where it may form a homodimer or a heterodimer with estrogen receptor 2. Estrogen and its receptors are essential for sexual development and reproductive function, but also play a role in other tissues such as bone. Estrogen receptors are also involved in pathological processes including breast cancer, endometrial cancer, and osteoporosis. Alternative promoter usage and alternative splicing result in dozens of transcript variants, but the full-length nature of many of these variants has not been determined. [provided by RefSeq, Mar 2014]
The activities of educating or instructing or teaching; activities that impart knowledge or skill.
An indication of the years of schooling completed in graded public, private, or parochial schools, and in colleges, universities, or professional schools.
Collective designation for those tissues capable of secreting hormones. NCI-GLOSS Definition: Refers to tissue that makes and releases hormones that travel in the bloodstream and control the actions of other cells or organs. Some examples of endocrine tissues are the pituitary, thyroid, and adrenal glands."
Exposure to potentially harmful chemical, physical or biological agents via the environment.
An orally bioavailable, organic, non-steroidal small molecule targeting the androgen receptor (AR) with potential antineoplastic activity. Through a mechanism that is reported to be different from other approved AR antagonists, enzalutamide inhibits the activity of prostate cancer cell ARs, which may result in a reduction in prostate cancer cell proliferation and, correspondingly, a reduction in the serum prostate specific antigen (PSA) level. AR over-expression in prostate cancer represents a key mechanism associated with prostate cancer hormone resistance.
Benzamide, 4-(3-(4-cyano-3-(trifluoromethyl)phenyl)-5,5-dimethyl-4-oxo-2-thioxo-1-imidazolidinyl)-2-fluoro-N-methyl-
Epidemiological aspects of prostate cancer
The study of the causes, incidence and distribution of disease in the population and its application for prevention or control.
Persistent or recurrent inability to achieve or to maintain an erection during sexual activity. NCI-GLOSS Definition: An inability to have an erection of the penis adequate for sexual intercourse. CTCAE Definition: A disorder characterized by the persistent or recurrent inability to achieve or to maintain an erection during sexual activity."
estra-1,3,5(10)triene-317beta-diol 3-[N,N-bis-(2-chloroethyl)carbamate]
Estradiol 3-[bis(2-chloroethyl)carbamate]
A synthetic molecule combining estradiol and nornitrogen mustard through a carbamate link. Estramustine and its major metabolite estramustine bind to microtubule-associated proteins (MAPs) and tubulin, thereby inhibiting microtubule dynamics and leading to anaphase arrest in a dose-dependent fashion. This agent also exhibits anti-androgenic effects. (NCI04)/NCI-GLOSS Definition: A combination of the hormone estradiol (an estrogen) and nitrogen mustard (an anticancer drug). Used in the palliative therapy of prostate cancer.
17beta-(estra-1,3,5(10)-triene-3,17-diol 3-(bis(2-chloroethyl)carbamate))
Evaluating health status in senior adults
With a median age at diagnosis of 68 years, PCa is generally a disease of men aged > 70 years. In the USA, the increase in men aged > 65 years will result in an estimated 70% increase in annual diagnosis of PCa by 2030. A similar increase is expected in Europe. The Surveillance, Epidemiology and End Results (SEER) database shows that 71% of PCa-related deaths occur in men aged > 75 years, probably due to the higher incidence of advanced/metastatic disease. Despite the high incidence and mortality rates in senior adults, they may be undertreated in the USA and Europe. In the USA, only 41% of patients aged > 75 years with intermediate- and high-risk disease receive curative treatment compared to 88% aged 65-74. Two large studies showed that PCa-specific mortality was low for localised low- and intermediate-risk PCa, irrespective of age. In contrast, cancer-related mortality of up to 64% was found for high-risk PCa.
Biopsy of the prostate that extends beyond the standard 10 to 12 cores.
External-beam radiotherapy and low-dose rate brachytherapy
EBRT and I-125 low-dose rate (LDR) brachytherapy may cause urinary, sexual- and bowel dysfunction. Both methods can result in irritative voiding symptoms, such as urgency, frequency, and urge incontinence, that negatively affect overall urinary function and HRQoL [639]. In the radiotherapy group, urinary incontinence was reported to be at its worst by 2 months after surgery, but the effects of EBRT on urinary symptoms had resolved at 12 months and improved over baseline at 24 months [639]. Patients in the LDR brachytherapy group reported significant detriments in urinary irritation or obstruction and incontinence. At 1-2 years after LDR brachytherapy, incontinence was reported by 4-6% of patients. Eighteen percent of the LDR brachytherapy group and 11% of the EBRT group reported distress from overall urinary symptoms at 1 year.
体外放射治疗与低剂量率近距离放射治疗
Radiation therapy in which high-energy beams are delivered to the tumor from outside of the body. NCI-GLOSS Definition: A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body./CDISC Definition: A type of radiation therapy in which high-energy beams are delivered to the tumor from outside of the body.
Radiation therapy in which high-energy beams are delivered to the tumor from outside of the body./NCI-GLOSS Definition: A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body./CDISC Definition: A type of radiation therapy in which high-energy beams are delivered to the tumor from outside of the body.
NCI-GLOSS Definition: A record of the relationships among family members along with their medical histories. This includes current and past illnesses. A family history may show a pattern of certain diseases in a family.
Farming, Fishing, and Forestry Occupations
A class of professional or vocational positions of employment that involve farming, fishing or forestry.
Monobasic, aliphatic acids with varying chain lengths between 6 and 30. Fatty acids are a major constituent in all fats and can be either saturated, monounsaturated, or polyunsaturated. Saturated and monounsaturated fatty acids are synthesized by the body, whereas polyunsaturated fatty acids are not and must be obtained in the diet. (NCI) NCI-GLOSS Definition: A major component of fats that are used by the body for energy and tissue development."
ost-diagnostic fat intake was assessed using a validated food frequency questionnaire (FFQ) administered between 1997 and 2001 (11). Men were asked to report their usual intake of 61 foods and beverages over the previous year in nine frequency categories ranging from never or <1/month to 6+/day. A common portion size was specified for each food item (e.g. 1 ounce of nuts). Nutrient data came from the US Department of Agriculture. Intakes of each of the fats of interest were calculated by multiplying the amount of each type of fat in the specified portion size of a food item by the frequency of intake of that food item and summing across all foods. To calculate animal fat, total fat in the specified portion size of each food item from animal sources was multiplied by the frequency of intake for each item and summed across all food items. To calculate vegetable fat, total fat in the specified portion size of food items from vegetable sources was multipled by the frequency of intake of each item and summed across all food items. For food items with both animal and vegetable components (e.g., mashed potatoes, pizza, etc.), the fat content from animal and vegetable sources was determined based on a standard recipe. We multiplied intake of each of the fats (g/d) by 9 kcal and divided by total calories per day to calculate the percent of daily calories from each of the fats of interest.
Overall tiredness and lack of energy./CTCAE Definition: A disorder characterized by a state of generalized weakness with a pronounced inability to summon sufficient energy to accomplish daily activities./NICHD Definition: Overall tiredness and lack of energy./NCI-GLOSS Definition: A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic./CDISC Definition: Unusual tiredness and inability to perform usual activities.
FDA Definition: An elongated, tapering, generally thick-walled sclerenchyma cell of vascular plants; its walls may or may not be lignified
The removal of tissue specimens or fluid from the living body with a thin needle.
Primary ADT is the standard of care. There is no level 1 evidence to choose between an LHRH analogueor antagonist, except in patients with an impending spinal cord compression. In these patients, the choice forfirst-line treatment is between bilateral orchidectomy and an LHRH antagonist.
A grouping of jawed and jawless vertebrate animals usually having fins and a covering of scales or plates, breathing by means of gills, and living almost entirely in the water. CDISC Definition: Any jawed or jawless organisms in the phylum Chordata including the jawless fish, armored fish, cartilaginous fish, ray-finned fish and lobe-finned fish"
Chronic exposure to LHRH agonists results in the down-regulation of LHRH-receptors, suppressing LH and FSH secretion and therefore testosterone production. The castration level is usually obtained within 2-4 weeks. However, about 10% of treated patients fail to achieve castration levels, which rise to 15% if the castration threshold is defined as 1 nmol/l. Although there is no formal direct comparison between the various compounds, they are considered to be equally active [548] and comparable to orchiectomy.
Propanamide, 2-Methyl-N-(4-nitro-3-(trifluoromethyl)phenyl)-
A toluidine derivative and a nonsteroidal antiandrogen that is structurally related to bicalutamide and nilutamide. Flutamide and its more potent active metabolite 2-hydroxyflutamide competitively block dihydrotestosterone binding at androgen receptors, forming inactive complexes which cannot translocate into the cell nucleus. Formation of inactive receptors inhibits androgen-dependent DNA and protein synthesis, resulting in tumor cell growth arrest or transient tumor regression. (NCI04)/NCI-GLOSS Definition: An anticancer drug that is a type of antiandrogen.
During the past two decades, there has been a trend towards earlier diagnosis of PCa as a result of greater public and professional awareness, leading to the adoption of both formal and informal screening strategies. The effect of this has been to identify men at an earlier stage with smaller tumours that occupy only 5-10% of the prostate volume, with a greater propensity for unifocal or unilateral disease. Most focal therapies to date have been achieved with ablative technologies: cryotherapy, HIFU or photodynamic therapy, electroporation, focal radiotherapy by brachytherapy, or CyberKnife Robotic Radiosurgery System technology (Accuray Inc., Sunnyvale, CA, USA). The main purpose of focal therapy is to limit treatment toxicity in patients that could benefit from local disease control.
2-[4-[(2-amino-4-oxo-1H-pteridin-6-yl)methylamino]benzoyl]aminopentanedioic acid;
A cofactor for 1-carbon transfer involved with DNA synthesis. CRCH Definition: Class of water-soluble vitamins that are coenzymes in single-carbon transfers in the metabolism of nucleic and amino acids. (DRI)"
Any nutritious substance that people or animals eat or drink or that plants absorb in order to maintain life and growth.
The determination of the ratio of free prostate specific antigen as compared to the total prostate specific antigen present in a sample. The measurement may be expressed as a ratio or percentage.
Free prostate specific antigen measurement
The determination of the amount of free prostate specific antigen in a biological sample.
Urination at short intervals; it may result from increased urine formation, decreased bladder capacity, or lower urinary tract irritation.
A structure consisting of the fertilized and mature ovules ("seeds") and the ovary wall, which may be fleshy (as in the apple) or dry and hard (as in a maple fruit.
In biology, a gene is a sequence of DNA or RNA that codes for a molecule that has a function. During gene expression, the DNA is first copied into RNA. The RNA can be directly functional or be the intermediate template for a protein that performs a function. The transmission of genes to an organism's offspring is the basis of the inheritance of phenotypic traits. These genes make up different DNA sequences called genotypes. Genotypes along with environmental and developmental factors determine what the phenotypes will be. Most biological traits are under the influence of polygenes (many different genes) as well as gene–environment interactions. Some genetic traits are instantly visible, such as eye color or number of limbs, and some are not, such as blood type, risk for specific diseases, or the thousands of basic biochemical processes that constitute life.
Genetic and epigenetic of prostate cancer
Cancer epigenetics is the study of epigenetic modifications to the DNA of cancer cells that do not involve a change in the nucleotide sequence.
The score derived from universally embraced prostate cancer grading system developed by Dr. Donald F. Gleason in 1977. The system provides a reproducible description of the glandular architecture of prostate tissue to which a pathologist assigns a score depending primarily on the microscopic patterns of cancerous glands and cell morphology. The system correlates well with behavior at the extremes: Gleason 1+1 tumors are the most well differentiated, slowly growing and rarely spread; Gleason 4+5 tumors are the most poorly differentiated, often widely metastatic at the time of diagnosis. In the commoner intermediate grade tumors, however, behavior is extremely variable.
A class of organic compounds that are derived from a glucose that has been modified by an amino acid. These compounds are anionic sulfur-containing glucosides, produced as secondary metabolites by plants of the order Brassicales, which includes cruciferous vegetables. Glucosinolates can be toxic if ingested at high doses but lower doses are under investigation as potential tumor inhibitors.
6-[O-(1,1-Dimethylethyl)-D-serine]-10-deglycinamide Luteinizing Hormone-Releasing Factor (Pig) 2-(aminocarbonyl)hydrazide
A synthetic decapeptide analog of luteinizing hormone-releasing hormone (LHRH) with antineoplastic activity. Goserelin binds to and activates pituitary gonadotropin releasing hormone (GnRH) receptors. Prolonged administration of goserelin inhibits the secretion of pituitary gonadotropin, thereby decreasing levels of testosterone (in males) and estradiol (in females). Administration of this agent in a depot formulation may result in the regression of sex hormone-sensitive tumors and a reduction in sex organ size and function. (NCI04)/NCI-GLOSS Definition: A drug that belongs to the family of drugs called gonadotropin-releasing hormone analogues. Goserelin is used to block hormone production in the ovaries or testicles.
Tea derived from the dried leaves of the plant Camellia sinensis with potential antioxidant, chemopreventive, and lipid-lowering activities. Green tea contains polyphenols that are believed to be responsible for its chemopreventive effect. The polyphenol fraction contains mainly Epigallocatechin-3-gallate (EGCG) and other catechins, such as epicatechin (EC), gallocatechin gallate (GCG), epigallocatechin (EGC), and epicatechin gallate (ECG). Green tea polyphenols act as antioxidants and free radical scavengers and may affect enzymes involved in cellular replication and tumor angiogenesis by modulating angiogenic factors, such as vascular endothelial growth factor (VEGF).
The fact of being environmentally or ecologically conscious; commitment to environmental conservation.
The product of this gene is a membrane-associated protein that functions in clathrin-mediated endocytosis and protein trafficking within the cell. The encoded protein binds to the huntingtin protein in the brain; this interaction is lost in Huntington's disease. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Jul 2013]
The protein encoded by this gene is involved in cell motility. It is expressed in breast tissue and together with other proteins, it forms a complex with BRCA1 and BRCA2, thus is potentially associated with higher risk of breast cancer. Alternatively spliced transcript variants encoding different isoforms have been noted for this gene. [provided by RefSeq, Dec 2008]
HMMR hyaluronan mediated motility receptor
Genome-wide association and replication studies identify four variants associated with prostate cancer susceptibility.|Genome-wide association study identifies a second prostate cancer susceptibility variant at 8q24.
Genome-wide association and replication studies identify four variants associated with prostate cancer susceptibility.|Multiple loci identified in a genome-wide association study of prostate cancer.|Multiple newly identified loci associated with prostate cancer susceptibility.
Evidence for a prostate cancer-susceptibility locus on chromosome 20.|Predicting prostate cancer risk through incorporation of prostate cancer gene 3.|Utility of incorporating genetic variants for the early detection of prostate cancer.
Identification of a prostate cancer susceptibility locus on chromosome 7q11-21 in Jewish families.
Hereditary prostate cancer in Finland: fine-mapping validates 3p26 as a major predisposition locus.
HPCQTL19 Prostate cancer aggressiveness quantitative trait locus on chromosome 19
Confirmation of linkage of prostate cancer aggressiveness with chromosome 19q.
HPCX hereditary prostate cancer, X-linked
A haplotype at chromosome Xq27.2 confers susceptibility to prostate cancer.|Genetic linkage analysis of prostate cancer families to Xq27-28.|Evidence for a prostate cancer susceptibility locus on the X chromosome.|Contribution of HPC1 (RNASEL) and HPCX variants to prostate cancer in a founder population.
HPCX2 Prostate cancer, hereditary, X-linked 2
The determination of the breaking point and structural integrity of a material.
The red respiratory protein of erythrocytes, consisting of approximately 3.8% heme and 96.2% globin (64.5 KD), which as oxyhemoglobin (HbO2) transports oxygen from the lungs to the tissues where the oxygen is readily released and HbO2 becomes Hb.
The vertical measurement or distance from the base to the top of an object; the vertical dimension of extension. DICOM Definition: Vertical measurement value. CDISC Definition: The vertical measurement or distance from the base to the top of an object; the vertical dimension of extension. (NCI)"
Exhibiting a cyclic structure containing at least one amino (NH2) group, some Heterocyclic Amines are carcinogenic chemicals formed from cooking meat such as beef, pork, fowl, and fish when amino acids and creatine (found in muscle) react at high temperatures. About 17 identified heterocyclic amines that result from cooking meat may increase human cancer risk. Because of the high temperatures used, frying, broiling, and barbecuing produce the largest amounts of heterocyclic amines. (NCI04) NCI-GLOSS Definition: A chemical that is formed when meat, poultry, or fish is cooked at high temperatures, such as frying, broiling, and barbecuing. Heterocyclic amines are carcinogens (substances that may cause cancer)."
Internal radiation treatment that targets a cancerous tissue with accurate, high doses of radiation through the use of inserted temporary implants./CDISC Definition: A type of brachytherapy that targets a cancerous tissue with high doses of radiation through the use of inserted temporary implants.
Histopathology of radical prostatectomy specimens
根治性前列腺切除标本的病理检查
Hormonal drugs targeting the endocrine pathways in the pre-docetaxel space
激素类药物在前多西他赛空间靶向内分泌通路
Various treatment modalities that produce the desired therapeutic effect by means of change of hormone/hormones level./CTEP Definition: Cancer therapy, which incorporates hormonal manipulation (e.g., tamoxifen, androgen deprivation)./NCI-GLOSS Definition: Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body's natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone.
Hormonal treatment combined with chemotherapy
"Two large RCT were conducted, one is fully published, the second one just presented recently, but representing a cohort twice as large. They both compared ADT alone as standard with AT combined with upfront Docetaxel. They came to different findings regarding survival benefit and it is not possible to make a clear recommendation at the present time."
ADT is the first-line treatment in hormone-sensitive metastatic PCa. The SIOG PCWG recommends evaluation of baseline bone mineral density and prevention of osteoporosis by calcium and vitamin D supplements. Routine bisphosphonates or denosumab to prevent skeletal complications in ADT is not recommended, unlessthere is a risk of fracture, or castration-resistant PCa (CRPC) with skeletal metastasis.
Hyperfunction of the parathyroid glands resulting in the overproduction of parathyroid hormone. It may be primary or secondary; primary hyperparathyroidism is caused by parathyroid adenoma, parathyroid hyperplasia, parathyroid carcinoma, and multiple endocrine neoplasia. It is associated with hypercalcemia and hypophosphatemia. Signs and symptoms include weakness, fatigue, nausea, vomiting, constipation, depression, bone pain, osteoporosis, cystic bone lesions, and kidney stones. Secondary hyperparathyroidism is caused by the chronic stimulation of the parathyroid glands in patients with chronic renal failure, rickets, and malabsorption syndromes. NCI-GLOSS Definition: A condition in which the parathyroid gland (one of four pea-sized organs found on the thyroid) makes too much parathyroid hormone. This causes a loss of calcium from the bones and an increased level of calcium in the blood. Symptoms include bone pain and kidney problems. CTCAE Definition: A disorder characterized by an increase in production of parathyroid hormone by the parathyroid glands. This results in hypercalcemia (abnormally high levels of calcium in the blood). NICHD Definition: Elevated concentration of parathyroid hormone. Causes include conditions originating within the parathyroid glands (primary), in response to hypocalcemia and hyperphosphatemia (secondary), and renal disease (tertiary). Characteristics may include polyuria, polydipsia, constipation, lethargy, cognitive dysfunction, hypercalciuria, nephrolithiasis, and bone demineralization or reduced bone mineral density."
This gene is involved in cellular communication, growth and proliferation. It also plays a role in the regulation of muscular and skeletal development.
Insulin-Like Growth Factor 1 (Somatomedin C) Gene
An immunoglobulin isotype (subclass). This isotype has the unique ability to bind with high affinity to IgE receptors (FceRI) on mast cells and basophils and induce degranulation and cytokine production by these cells when they are crosslinked by antigen. In addition to a central role in atopy and allergic responses, it has been speculated that IgE-mediated mast cell degranulation, by its release of mediators that increase vascular permeability, has an important role in the initiation of immune response in general.
Any of a number of technologies that permits the visualization and acquisition of images into a physical or electronic record.
Immediate post-operative external irradiation after RP
Immediate versus deferred androgen deprivation therapy
There is no discussion regarding the introduction of IAD in symptomatic patients. However, there is still controversy concerning the best time to introduce hormonal therapy in asymptomatic metastatic patients due to the lack of properly conducted RCTs. These are underpowered trials with heterogeneous patient enrolment(i.e. locally advanced, M1a, M1b status) and variations in ADT modalities and follow-up schedules.ADT was shown to be the most cost-effective therapy if started at the time the patient developed symptomatic metastases. The Cochrane Library review extracted four good-quality RCTs: VACURG I and II trials, the MRC trial, and the ECOG 7887 study. These studies were all conducted in the pre-PSA era and included patientswith advanced PCa, who had received early vs. deferred ADT, either as primary therapy or adjuvant to radical prostatectomy. The Cochrane review found that the M1a/b population showed no improvement in OS,although early ADT significantly reduced disease progression and complication rates due to progression. Based on a systematic review of the literature, the ASCO guidelines on initial hormonal treatment for androgen-sensitive, metastatic, recurrent or progressive PCa concluded it was not possible to makea recommendation on when to start hormonal therapy in advanced asymptomatic PCa. The ESMOguidelines do not make any statement .
The level of dependence in daily activities influences survival in senior adults. The Activities of Daily Living (ADL) scale rates accomplishment of basic activities of daily living, while the Instrumental Activities of Daily Living (IADL) scale rates activities requiring higher cognition and judgement.
Infectious complications following prostate biopsy can range from those confined to the genitourinary tract (urinary tract infection [UTI], epididymitis, prostatitis) to sepsis.Escherichia coli is the most common organism isolated from patients presenting with post-TRUS biopsy sepsis, causing 75% to 90% of associated infections
Inability to conceive for at least one year after trying and having unprotected sex. Causes of female infertility include endometriosis, fallopian tubes obstruction, and polycystic ovary syndrome. Causes of male infertility include abnormal sperm production or function, blockage of the epididymis, blockage of the ejaculatory ducts, hypospadias, exposure to pesticides, and health related issues.
An element with atomic symbol Fe, atomic number 26, and atomic weight 55.85. NCI-GLOSS Definition: An important mineral the body needs to make hemoglobin, a substance in the blood that carries oxygen from the lungs to tissues throughout the body. Iron is also an important part of many other proteins and enzymes needed by the body for normal growth and development. It is found in red meat, fish, poultry, lentils, beans, and foods with iron added, such as cereal."
A class of polyphenolic compounds derived from the Fabaceae family with potential phytoestrogenic, cholesterol-reducing, chemotherapeutic and antioxidant activity. In isoflavones the phenyl group on the benzopyran ring is in position 3 relative to the oxygen of the ring. Most isoflavones for human consumption and that are currently studied are derived from soy beans. NCI-GLOSS Definition: An estrogen-like substance made by some plants, including the soy plant. Soy isoflavones are being studied in the prevention of cancer, hot flashes that occur with menopause, and osteoporosis (loss of bone density)."
The principal activity that a person does to earn money. CDISC Definition: A code specifying the job performed by the employee for the employer. For example, accountant, programmer analyst, patient care associate, staff nurse, etc.
The term ""vitamin K"" refers to a group of chemically similar fat-soluble compounds called naphthoquinones: vitamin K1 (phytonadione) is found in plants and is the primary source of vitamin K for humans through dietary consumption, vitamin K2 compounds (menaquinones) are made by bacteria in the human gut, and vitamin K3 (menadione) is a water-soluble preparation available for adults only. Vitamin K is necessary for the liver to produce the coagulation factors II, VII, IX, and X, as well as the clotting factors protein C, protein S, and protein Z; vitamin K deficiency can result in deficiencies of these coagulation factors and excess bleeding. An injection of vitamin K is routinely given to newborn infants to prevent vitamin K deficiency bleeding, also known as hemorrhagic disease of the newborn. Vitamin K deficiency is rare in adults but may result from chronic malnutrition or an inability to absorb dietary vitamins. CRCH Definition: Fat soluble vitamin that is a coenzyme during the synthesis of the biologically active form of a number of proteins involved in blood coagulation and bone metabolism. Vitamin K's structure typically consists of a methylated naphthoquinone ring from which one or more unsaturated aliphatic side chains are attached at the 3-position of the ring. NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Vitamin K helps to form blood clots (a mass that forms when blood platelets, proteins, and cells stick together) and maintain strong bones. It is fat-soluble (can dissolve in fats and oils) and is found in green leafy vegetables, broccoli, liver, and vegetable oils. Vitamin K is also made by bacteria that live in the large intestine. Not enough vitamin K can lead to bleeding and bruising."
This gene encodes a member of the Kruppel-like family of transcription factors. The zinc finger protein is a transcriptional activator, and functions as a tumor suppressor. Multiple transcript variants encoding different isoforms have been found for this gene, some of which are implicated in carcinogenesis. [provided by RefSeq, May 2009]
GBF; ZF9; BCD1; CBA1; CPBP; PAC1; ST12; COPEB
This gene, a Kirsten ras oncogene homolog from the mammalian ras gene family, encodes a protein that is a member of the small GTPase superfamily. A single amino acid substitution is responsible for an activating mutation. The transforming protein that results is implicated in various malignancies, including lung adenocarcinoma, mucinous adenoma, ductal carcinoma of the pancreas and colorectal carcinoma. Alternative splicing leads to variants encoding two isoforms that differ in the C-terminal region. [provided by RefSeq, Jul 2008]
NS; NS3; CFC2; RALD; K-Ras; KRAS1; KRAS2; RASK2; KI-RAS; C-K-RAS; K-RAS2A; K-RAS2B; K-RAS4A; K-RAS4B; c-Ki-ras2
A family of homotetrameric cytoplasmic enzymes involved in the conversion of L-lactate and NAD to pyruvate and NADH in the final step of anaerobic glycolysis. In vertebrates, genes for three different subunits (LDH-A, LDH-B and LDH-C) exist.
A procedure, usually conducted in a laboratory, that is intended to detect, identify, or quantify one or more significant substances, evaluate organ functions, or establish the nature of a condition or disease. Laboratory tests range from quite simple to extremely sophisticated. In modern medical practice they are commonly used to help establish or confirm a diagnosis and often aid in the management of disease.
Inability to fully digest and absorb lactose due to limited or no lactase activity in the small intestine. Congenital intolerance is inherited following an autosomal recessive pattern but is rare. It is more often due to a gradual decline of lactase production in adulthood following the ingestion of fewer lactose-containing foods or secondary to an intestinal mucosal brush-border injury. Prevalence is highest among Asians, Native Americans and Africans. Clinical signs include abdominal cramping, bloating, flatulence and diarrhea following the dietary intake of lactose. NCI-GLOSS Definition: The inability to digest or absorb lactose, a type of sugar found in milk and other dairy products."
Death of a fetus at 16 weeks, 0 days to 19 weeks, 6 days of gestation.
An element with atomic symbol Pb, atomic number 82, and atomic weight 207.2.
Leptin (167 aa, ~16 kDa) is encoded by the human LEP gene. This protein is secreted by adipocytes and plays a role in the regulation of both appetite and body fat stores.
A synthetic nonapeptide analogue of gonadotropin-releasing hormone. Leuprolide binds to and activates gonadotropin-releasing hormone (GnRH) receptors. Continuous, prolonged administration of leuprolide in males results in pituitary GnRH receptor desensitization and inhibition of pituitary secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH), leading to a significant decline in testosterone production; in females, prolonged administration results in a decrease in estradiol production. This agent reduces testosterone production to castration levels and may inhibit androgen receptor-positive tumor progression./NCI-GLOSS Definition: The active ingredient in a drug used to treat symptoms of advanced prostate cancer. It is also used to treat early puberty in children and certain gynecologic conditions. It is being studied in the treatment of other conditions and types of cancer. Leuprolide blocks the body from making testosterone (a male hormone) and estradiol (a female hormone). It may stop the growth of prostate cancer cells that need testosterone to grow. It is a type of gonadotropin-releasing hormone analog.
Local recurrence after radiation therapy
In patients with biochemical failure after radiation therapy, the biopsy status is a major predictor of outcome,provided the biopsies are obtained 18-24 months after treatment. Given the morbidity of local salvage options,it is thus necessary to obtain histological proof of the local recurrence before treating the patient .TRUS is not reliable in depicting local recurrences after radiation therapy. In contrast, mpMRI has yielded excellent results and can be used for biopsy targeting and guiding local salvage treatment.Detection of recurrent cancer is also feasible with Choline and Acetate PET/CT, but PET/CT has poorer spatial resolution than MRI.
Local recurrence after radical prostatectomy
The precise localisation of the local recurrence by imaging techniques is needed only if histological proof of the recurrence is mandatory before salvage treatment and/or if this localisation could change treatment planning. Transrectal ultrasound is neither sensitive nor specific in detecting local recurrences after RP. Even with TRUS guidance, the sensitivity of anastomotic biopsies remains low: 40-71% for PSA levels > 1 ng/mL and 14-45% for PSA levels < 1 ng/mL. As a consequence, salvage radiation therapy is usually decided on the basis of the BCR, without histological proof of the local recurrence. The dose delivered to the prostatic bed also tends to be uniform as it has not been demonstrated that a focal dose escalation at the site of recurrence improves the outcome. Thus, most patients undergo salvage radiation therapy without local imaging. Nonetheless, several studies have reported promising results in the detection of local recurrences using MRI, particularly dynamic contrast-enhanced MRI which showed sensitivities and specificities of 84-88% and 89-100%, respectively. However, the mean PSA level in these studies was 0.8-1.9 ng/mL, which is higher than the 0.5 ng/mL threshold usually used for salvage therapy. Recently, two studies evaluated mpMRI in patients with PSA level < 0.5 ng/mL. One found a sensitivity of only 13% in men with PSA level < 0.3 ng/mL , while the other reported a sensitivity of 86% in patients with PSA level < 0.4 ng/mL. Thus, it remains to be defined whether MRI is able to correctly detect local recurrences in patients with PSA level < 0.5 ng/mL in order to allow a stereotaxic boost to the recurrence site during salvage radiation therapy. Choline or Acetate PET/CT can also detect local recurrences, but are less sensitive than MRI.
Long-term complications after radiotherapy
Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Working ⩾55 h per week was associated with 1.60-fold (95% confidence interval 1.12–2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity.
Internal radiation treatment that targets a cancerous tissue with low doses of radiation through the use of inserted temporary or permanent implants./CDISC Definition: A type of brachytherapy that targets a cancerous tissue with low doses of radiation through the use of inserted temporary or permanent implants.
Luteinising-hormone-releasing hormone agonists
Long-acting LHRH agonists are currently the main forms of ADT. These synthetic analogues of LHRH, are delivered as depot injections on a 1-, 2-, 3-, 6-monthly, or yearly basis. After the first injection, they stimulate pituitary LHRH receptors, inducing a transient rise in LH and FSH leading to the ‘testosterone surge’ or ‘flareup’ phenomenon, which begins 2-3 days later and lasts for about 1 week. The different products have practical differences that need to be considered in everyday practice, including the storage temperature, whether a drug is ready for immediate use or requires reconstitution, and whether a drug is given by subcutaneous or intramuscular injection.
Luteinising-hormone-releasing hormone antagonists
LHRH antagonists bind immediately and competitively to LHRH receptors in the pituitary gland. The effect is a rapid decrease in LH, FSH and testosterone levels without any flare. The practical shortcoming of these compounds is the lack of a long-acting depot formulation.
A linear, unsaturated hydrocarbon carotenoid, the major red pigment in fruits such as tomatoes, pink grapefruit, apricots, red oranges, watermelon, rosehips, and guava. As a class, carotenoids are pigment compounds found in photosynthetic organisms (plants, algae, and some types of fungus), and are chemically characterized by a large polyene chain containing 35-40 carbon atoms; some carotenoid polyene chains are terminated by two 6-carbon rings. In animals, carotenoids such as lycopene may possess antioxidant properties which may retard aging and many degenerative diseases. As an essential nutrient, lycopene is required in the animal diet. (NCI04) CRCH Definition: Carotenoid which is a terpene assembled from 8 isoprene units. NCI-GLOSS Definition: A red pigment found in tomatoes and some fruits. It is an antioxidant and may help prevent some types of cancer."
A system for clinicopathologic evaluation of tumors based on the extent of tumor involvement at the primary site (T, followed by a number indicating size and depth of invasion), and lymph node involvement (N) and metastasis (M) each followed by a number starting at 0 for no evident metastasis; numbers used depend on the organ involved and influence the prognosis and choice of treatment.
A distant metastasis TNM finding indicating that there is no evidence of distant metastasis.
A clinical and/or pathologic distant metastasis TNM finding indicating the spread of cancer to distant anatomic sites.
A TNM finding indicating the spread of cancer to distant anatomic sites. The definition of M1a TNM finding depends on the specific type of cancer that it refers to; for example, for colorectal cancer it refers to metastasis confined to one organ or site (e.g., liver, lung, ovary, nonregional node); for prostate cancer it refers to metastasis to non-regional lymph node(s); for bone cancer it refers to metastasis to the lung.
A TNM finding indicating the spread of cancer to distant anatomic sites. The definition of M1b TNM finding depends on the specific type of cancer that it refers to; for example, for colorectal cancer it refers to metastases in more than one organ/site or the peritoneum; for prostate cancer it refers to metastasis to bone(s); for bone cancer it refers to metastasis to distant sites other than lung.
A TNM finding indicating the spread of cancer to distant anatomic sites. The definition of M1c TNM finding depends on the specific type of cancer that it refers to; for example, for prostate cancer it refers to metastasis to anatomic site(s) other than bone, with or without bone disease; for retinoblastoma it refers to central nervous system metastasis; for melanoma of the uvea it refers to distant metastasis, with the largest diameter of the largest metastasis measuring 8.0 cm or more.
MAD1L1 is a component of the mitotic spindle-assembly checkpoint that prevents the onset of anaphase until all chromosome are properly aligned at the metaphase plate. MAD1L1 functions as a homodimer and interacts with MAD2L1. MAD1L1 may play a role in cell cycle control and tumor suppression. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Jan 2015]
MAD1L1 mitotic arrest deficient 1 like 1
MSP; PSP; IGBF; MSPB; PN44; PRPS; HPC13; PSP57; PSP94; PSP-94
The protein encoded by this gene is a member of the immunoglobulin binding factor family. It is synthesized by the epithelial cells of the prostate gland and secreted into the seminal plasma. This protein has inhibin-like activity. It may have a role as an autocrine paracrine factor in uterine, breast and other female reproductive tissues. The expression of the encoded protein is found to be decreased in prostate cancer. Two alternatively spliced transcript variants encoding different isoforms are described for this gene. The use of alternate polyadenylation sites has been found for this gene. [provided by RefSeq, Jul 2008]
This gene encodes the class A macrophage scavenger receptors, which include three different types (1, 2, 3) generated by alternative splicing of this gene. These receptors or isoforms are macrophage-specific trimeric integral membrane glycoproteins and have been implicated in many macrophage-associated physiological and pathological processes including atherosclerosis, Alzheimer's disease, and host defense. The isoforms type 1 and type 2 are functional receptors and are able to mediate the endocytosis of modified low density lipoproteins (LDLs). The isoform type 3 does not internalize modified LDL (acetyl-LDL) despite having the domain shown to mediate this function in the types 1 and 2 isoforms. It has an altered intracellular processing and is trapped within the endoplasmic reticulum, making it unable to perform endocytosis. The isoform type 3 can inhibit the function of isoforms type 1 and type 2 when co-expressed, indicating a dominant negative effect and suggesting a mechanism for regulation of scavenger receptor activity in macrophages. [provided by RefSeq, Jul 2008]
SRA; SR-A; CD204; SR-AI; phSR1; phSR2; SCARA1; SR-AII; SR-AIII
MXI1 MAX interactor 1, dimerization protein
Expression of the c-myc gene, which produces an oncogenic transcription factor, is tightly regulated in normal cells but is frequently deregulated in human cancers. The protein encoded by this gene is a transcriptional repressor thought to negatively regulate MYC function, and is therefore a potential tumor suppressor. This protein inhibits the transcriptional activity of MYC by competing for MAX, another basic helix-loop-helix protein that binds to MYC and is required for its function. Defects in this gene are frequently found in patients with prostate tumors. Three alternatively spliced transcripts encoding different isoforms have been described. Additional alternatively spliced transcripts may exist but the products of these transcripts have not been verified experimentally. [provided by RefSeq, Jul 2008]
Inadequate nutrition resulting from poor diet, malabsorption, or abnormal nutrient distribution./NCI-GLOSS Definition: A condition caused by not getting enough calories or the right amount of key nutrients, such as vitamins and minerals, that are needed for health. Malnutrition may occur when there is a lack of nutrients in the diet or when the body cannot absorb nutrients from food. Cancer and cancer treatment may cause malnutrition.
Management of PSA failures after radiation therapy
Therapeutic options in these patients are ADT or local procedures such as SRP, cryotherapy, interstitial brachytherapy and high-intensity focused US . As a general rule, strong recommendations regarding the choice of any of these techniques cannot be made as the available evidence for these treatment options is of (very) low quality.
Management of prostate cancer in older men
A demographic parameter indicating a person's current conjugal status.
Refers to the use of drugs to suppress the function of the ovaries or testicles.
6-Dehydro-6-methyl-17 alpha-acetoxyprogesterone
The acetate salt form of megestrol, a synthetic derivative of the naturally occurring female sex hormone progesterone with potential anti-estrogenic and antineoplastic activity. Mimicking the action of progesterone, megestrol acetate binds to and activates nuclear progesterone receptors in the reproductive system, and causes the ligand-receptor complex to be translocated to the nucleus where it binds to and promotes expression of target genes. This leads to an alteration in protein synthesis, which modulates cell growth of reproductive tissues. Due to the negative feedback mechanism seen with progesterone, megestrol also blocks luteinizing hormone (LH) release from the pituitary gland, thereby leading to an inhibition of ovulation and an alteration in the cervical mucus and endometrium. Furthermore, without stimulation of LH, estrogen release from the ovaries is stopped, hence impedes the growth of estrogen-sensitive tumor cells./NCI-GLOSS Definition: A drug used to block estrogen and suppress the effects of estrogen and androgens. It is used to treat breast and endometrial cancer, and is being studied in the treatment of other types of cancer. It is also used to improve appetite in patients with cancer. Megace belongs to the group of hormones called progestins.
dione acetate17-Hydroxy-6-methylpregna-4,6-diene-3,20-dione Acetate
6-Methyl-delta-4,6-pregnadien-17 alpha-ol-3,20-dione Acetate
Lipid alterations are common and may occur as early as the first 3 months of treatment. ADT also decreases insulin sensitivity and increases fasting plasma insulin levels, which is a marker of insulin resistance.Once again, exercise is strongly recommended for its protective effect. In diabetic patients, metformin appears to be an attractive option for protection against metabolic effects, but there is insufficient data to recommend its use in non-diabetic patients.
A combination of medical conditions that, when present, increase the risk of heart attack, stroke, and diabetes mellitus. It includes the following medical conditions: increased blood pressure, central obesity, abnormal cholesterol levels, and elevated fasting glucose. NCI-GLOSS Definition: A condition is marked by extra fat around the abdomen, high levels of blood glucose (sugar) when not eating, high levels of triglycerides (a type of fat) in the blood, low levels of high-density lipoproteins (a type of protein that carries fats) in the blood, and high blood pressure. People with metabolic syndrome are at increased risk of diabetes mellitus and diseases of the heart and blood vessels."
In metastatic CRPC, docetaxel is standard in fit and vulnerable older men, with comparable response and tolerance to younger patients. Tolerability has not been specifically studied in frail older men. In elderly and frail patients, granulocyte colony-stimulating factor prophylaxis should be considered. Cabazitaxel, abiraterone acetate, enzalutamide, and sipuleucel-T increase survival in chemotherapytreated and chemotherapy-naïve senior adults. Palliative treatment includes surgery, radiopharmaceuticals, EBRT, and medical treatment for pain and symptoms.
A carcinoma that arises from the prostate gland and has spread to other anatomic sites.
An agent belonging to the biguanide class of antidiabetics with antihyperglycemic activity. Metformin is associated with a very low incidence of lactic acidosis. This agent helps reduce LDL cholesterol and triglyceride levels, and is not associated with weight gain, and prevents the cardiovascular complications of diabetes. Metformin is not metabolized and is excreted unchanged by the kidneys. NCI-GLOSS Definition: The active ingredient in a drug used to treat diabetes mellitus (a condition in which the body cannot control the level of sugar in the blood). It is also being studied in the treatment of cancer. It decreases the amount of glucose (a type of sugar) released into the bloodstream from the liver and increases the body's use of the glucose. Metformin is a type of antidiabetic agent."
N,N-Dimethylimidodicarbonimidic Diamide"
Role of trace elements in cancer causation or prevention and in general health
The discharge of urine from the bladder; urine from the kidneys is passed in spurts every few seconds along the ureters to the bladder, where it collects and later is passed to the outside via the urethra.
A worker who travels from place to place as an agricultural worker, ususally moving to participate in harvest activities.
A body substance containing proteins, fats, lactose, and various vitamins and minerals produced by the mammary glands of mature female bovines.
A solid, homogeneous, inorganic substance occurring in nature and having a definite chemical composition. NCI-GLOSS Definition: In medicine, a mineral is a nutrient that is needed in small amounts to keep the body healthy. Mineral nutrients include the elements calcium, magnesium, and iron."
Minimally invasive energy-ablative therapies are being developed rapidly, but there is still a lack of evidence to support their use.
An anthracenedione antibiotic with antineoplastic activity. Mitoxantrone intercalates into and crosslinks DNA, thereby disrupting DNA and RNA replication. This agent also binds to topoisomerase II, resulting in DNA strand breaks and inhibition of DNA repair. Mitoxantrone is less cardiotoxic compared to doxorubicin./NCI-GLOSS Definition: A drug used to treat advanced prostate cancer that does not respond to hormones, adult acute nonlymphocytic leukemia, and advanced or chronic multiple sclerosis. It is also being studied in the treatment of other cancers. It belongs to the family of drugs called antitumor antibiotics.
1,4-Dihydroxy-5,8-bis[[2-[(2-hydroxyethyl)amino]ethyl]amino]-9, 10-anthroquinone
1,3-Dihydroxy-5,8-bis[[2-[(2-hydroxyethyl)amino]ethyl]amino]-9, 10-anthracenedione
Most Common Complication After Radiotherapy for Prostate Cancer
After radiotherapy, the most common complication is
A question about an individual's knowledge of the most common complication after radiotherapy for prostate cancer.
A dietary supplement containing all or most of the vitamins that may not be readily available in the diet. Vitamins may be classified according to their solubility either in lipids (vitamins A, D, E, K, F) or in water (vitamins C, B-complex). Present in minute amounts in various foods, vitamins are essential to maintaining normal metabolism and biochemical functions. (NCI04)
A distant metastasis TNM finding indicating that the status of distant metastasis cannot be assessed.
A regional lymph node TNM finding indicating that there is no evidence of regional lymph node metastasis.
A general term that refers to a TNM finding of cancer metastases usually in a limited number of regional lymph nodes. The definition of N1 TNM finding depends on the specific type of cancer that it refers to; for example, for breast cancer it refers to micrometastases or metastases in 1-3 axillary lymph nodes; for cutaneous melanoma it refers to metastasis in 1 regional lymph node; for colorectal cancer it refers to metastases in 1-3 regional lymph nodes; and for bladder cancer it refers to metastasis in 1 regional lymph node in the true pelvis.
NQO2 N-ribosyldihydronicotinamide:quinone reductase 2
This gene encodes a member of the thioredoxin family of enzymes. It is a cytosolic and ubiquitously expressed flavoprotein that catalyzes the two-electron reduction of quinone substrates and uses dihydronicotinamide riboside as a reducing coenzyme. Mutations in this gene have been associated with neurodegenerative diseases and several cancers. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Mar 2014]
Nationality is a legal relationship between an individual person and a state.
Once a PSA relapse has been diagnosed, it is important to determine whether the recurrence has developed at local or distant sites. The risk of subsequent metastases and PCSM may be predicted by the initial clinical factors (e.g. T-category, PSA, biopsy Gleason score). If the patient has undergone RP, the pathological outcomes of the surgery (e.g. pathologic T-category and prostatectomy Gleason score, nodal and margin status) may provide further information. Beyond pre- and posttreatment clinico-pathological factors, PSA kinetics (PSA doubling-time (PSA-DT) and interval to PSA failure) may be used to estimate the risk of metastases and subsequent PCSM.
Removal of tissue from the prostate for microscopic examination, using a needle.
Neoadjuvant and adjuvant hormonal therapy and radical prostatectomy
Neoadjuvant hormonal therapy (NHT) is defined as therapy given before definitive local curative treatment.|Since PCa is an androgen-dependent tumour, NHT is an appealing concept. A recent review and meta-analysis|studied the role of NHT and prostatectomy. NHT significantly reduced positive margin rates (RR = 0.49|p < 0.00001), extra-prostatic extension (RR = 1.63; p < 0.0001) and lymph node invasion (RR = 0.49; 0.42-0.56;|p < 0.02). However, this was not associated with improved OS or disease-free survival (DFS).|Regarding adjuvant HT, a Cochrane review has been published: the pooled data showed a|non-significant 5-year OS benefit (OR: 1.50 [95% CI: 0.79-2.84]) and no 10-year OS benefit (with again a trend|favouring the adjuvant approach). The pooled data for DFS gave an overall OR of 3.73 (95% CI: 2.3-6.03). The|overall effect estimate was highly significant (p < 0.00001) in favour of the HT arm. The Early Prostate Cancer|Trialists’ Group (EPC) trial using bicalutamide 150 mg daily could not be included in the Cochrane review|due to missing information. After a median follow-up of 7.2 years, there was a significant improvement in|objective PFS that was only significant in the locally advanced disease group (HR: 0.75; 95% CI: 0.61-0.91).|There was an OS decrease trend in the localised disease group (HR: 1.16; 95% CI: 0.99-1.37). No OS benefit|was observed in both localised and locally advanced groups.|The main limitations of the above data are the mixing of pN0 and pN1 populations. For pN+ patients, 2 RCT are|available and drive the main conclusion of the Cochrane review, even if non RCT suggest that the benefit might|not be so large in all patients. Regarding pN0 / N0 stages, the only RCT is the EPC project. Using|more conventional HT, a large retrospective data base with a median follow up of 10 years suggests that|adjuvant HT might be linked to an increased specific, but not OS benefit.
Neoadjuvant chemotherapy plus radiotherapy
The GETUG 12 trial investigated the impact of neoadjuvant chemotherapy with docetaxel on the PFS in a|cohort of 413 high-risk patients, defined as having one or more of the following criteria: T3-4, Gleason score|> 8, PSA > 20 ng/mL, pN+. Patients were randomly assigned to either goserelin 10.8 mg every 3 months for 3|years, + four cycles of docetaxel, 70 mg/m2 every 3 weeks, + estramustine 10 mg/kg/dL on days 1-5 (arm 1) or|to goserelin alone (arm 2). Local therapy was administered at 3 months and consisted of radiotherapy in 358|patients (87%). Toxicity included grade 3-4 neutropenia (27%) with neutropenic fever in 2%, but no toxicityrelated|death and no secondary leukaemia. A PSA response (PSA < 0.2 ng/mL after 3 months of treatment)|was obtained in 34% in the ADT+DE arm and 15% in the ADT arm. With a median follow-up period of 4.6|years, the 4-year PFS was 85% in arm 1 vs. 81% in arm 2 (p = 0.26), but the data need to mature.
Neoadjuvant or adjuvant hormone therapy plus radiotherapy
The combination of radiotherapy with LHRH ADT has definitively proven its superiority compared with|radiotherapy alone followed by deferred ADT on relapse, as shown by phase III randomised trials (Table 7.3.3). These trials included high risk prostate cancer patients, mostly by virtue of locally advanced (T3-T4 N0-X)disease, though with a wide range of clinical risk factors, such as PSA level or Gleason grade (high risk localised, T1-2, N0-X prostate cancer). The most powerful conclusion from these studies comes from the EORTC 22863 trial, which is the basis for the combination of radiotherapy and ADT in patients with locally advanced prostate cancer as standard practice today.
Any surgery that attempts to preserve nerve function near the surgery site.
Neutering, from the Latin neuter, is the removal of an animal's reproductive organ, either all of it or a considerably large part. "Neutering" is often used incorrectly to refer only to male animals, but the term actually applies to both sexes. The male-specific term is castration, while spaying is usually reserved for female animals. Colloquially, both terms are often referred to as fixing. In male horses, castrating is referred to as gelding. Modern veterinary practice tends to use the term de-sexing.
A group of workers who work a shift during the night in an industry or occupation where a day shift or a back shift is also worked.
A synthetic, nonsteroidal agent with antiandrogenic properties. Nilutamide preferentially binds to androgen receptors and blocks androgen receptor activation by testosterone and other androgens; this agent may inhibit androgen-dependent growth of normal and neoplastic prostate cells. (NCI04)/NCI-GLOSS Definition: A drug that blocks the effects of male hormones in the body. It is a type of antiandrogen.
Frequent episodes of urination during the night.
Due to increased bone turnover and decreased BMD in a time-dependent manner, ADT use is linked to an increased risk of fracture (up to 45% relative risk with long-term ADT). Hip fractures in men are associated with a significant risk of death. A precise evaluation of BMD should be performed by dual emission X-ray absorptiometry (DEXA) before starting long-term ADT. An initial low BMD (T-score < -2.5 or < -1, with other risk factors) indicates a high risk of subsequent non-metastatic fracture. The WHO FRAX tool (http://www.shef.ac.uk/FRAX) should be used to evaluate individual risk. Obesity (increase in body fat mass by up to 10%) and sarcopenia (decrease in lean tissue mass by up to 3%) are common and occur during the first year of ADT. Both changes increase the fracture risk.
Non-steroidal anti-androgens monotherapy have been promoted on the basis of improved quality of life (QoL) and compliance compared to castration. They do not suppress testosterone secretion and it is claimed that libido, overall physical performance and bone mineral density (BMD) are preserved. Non-androgen pharmacological side-effects differ, with bicalutamide showing a more favourable safety and tolerability profile than nilutamide and flutamide. All three agents share a common liver toxicity (occasionally fatal) and liver enzymes must be monitored regularly.
A regional lymph node TNM finding indicating that the status of regional lymph nodes cannot be assessed.
Having a high amount of body fat (body mass index [BMI] of 30 or more). CTCAE Definition: A disorder characterized by having a high amount of body fat. NCI-GLOSS Definition: A condition marked by an abnormally high, unhealthy amount of body fat.
Watching something and taking note of what happens./CDISC Definition: Watching something and taking note of what happens.
A class of natural or synthetic hormones that binds to a cytoplasmic receptor and initiates translocation of the hormone-receptor complex to the nucleus of target cells of tissues rich in estrogen receptors, including the endometrium, myometrium, oviduct, vagina, fallopian tube, cervix, brain, liver, placenta, ovarian cells, Leydigs cells, kidney, prostate, pancreas, heart, and skin. (NCI)
An operation to remove part or all of the prostate gland through an incision in the lower abdomen or perineum (the area between the anus and scrotum). An open prostatectomy may be done to remove an enlarged prostate gland in benign prostatic hyperplasia (BPH) or as a treatment for prostate cancer.
Options other than surgery and radiotherapy for the primary treatment of localised prostate cancer
局部前列腺癌除手术和放疗以外的其他初级治疗选择
Besides radical prostatectomy (RP), external-beam radiation and brachytherapy, other modalities have emerged as therapeutic options in patients with clinically localised PCa. In this chapter, we will consider both whole gland and focal treatment, looking particularly at high-intensity focused ultrasound (HIFU) and cryosurgery (CSAP) as sufficient data are available to form the basis of some initial judgements on these latest additions to the management of PCa. Other options - such as photodynamic therapy, radiofrequency ablation and electroporation, among others - are considered to be in the early phases of evaluation and will therefore not be discussed in this edition of the guidelines. Both HIFU and CSAP have been developed as minimally invasive procedures with the aim of equivalent oncological safety with reduced toxicity.
A condition of reduced bone mass, with decreased cortical thickness and a decrease in the number and size of the trabeculae of cancellous bone (but normal chemical composition), resulting in increased fracture incidence.
"A 111In-capromab pendetide scan (ProstaScint™) yielded disappointing results in patients with biochemical failure after RP or radiation therapy. Its use is therefore not recommended.18F-Fluoride PET and PET/CT have a higher sensitivity than bone scan in detecting bone metastases. However, 18F-Fluoride is limited by a relative lack of specificity and by the fact that it does not assess soft-tissue metastases."
A question about whether an individual has or had other symptoms.
Other systemic side-effects of androgen-deprivation therapy
They are frequent and may lead to significantly increased morbidity or even mortality.
雄激素阻断治疗的其他系统性副作用
A group of organic food substances found in animals and plants in small quantities. They must be supplied in diet or dietary supplement and are essential for normal metabolism. CRCH Definition: A class of micronutrients that regulate and support chemical reactions in the body. NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body's fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.
A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products. The damage to biological tissues is caused by superoxide and other free radicals generated by many factors, including exposure to alcohol, medications, trauma, cold, toxins, and radiation or by antimicrobial cellular immunity, metabolic abnormality, or ""normal"" aging; not synonymous with hypoxia or hyperoxia. Oxidative stress promotes a range of degenerative disorders, including cancer, diabetes, premature aging, Alzheimer's, and many others. NCI-GLOSS Definition: A condition in which antioxidant levels are lower than normal. Antioxidant levels are usually measured in blood plasma."
This gene encodes a protein that may function in tumor suppression. This protein binds to and colocalizes with the breast cancer 2 early onset protein (BRCA2) in nuclear foci and likely permits the stable intranuclear localization and accumulation of BRCA2. [provided by RefSeq, Jul 2008]
PCAP is the major known prostate cancer predisposing locus in families from south and west Europe.|Predisposing gene for early-onset prostate cancer, localized on chromosome 1q42.2-43.|CGI-55 interacts with nuclear proteins and co-localizes to p80-coilin positive-coiled bodies in the nucleus.
This gene is evolutionarily conserved, and its product is proposed to play a role in human cellular senescence and tumor suppression. Antiproliferative activity is reported to be localized to the 3' UTR, which is proposed to function as a trans-acting regulatory RNA. Several pseudogenes of this gene have been identified. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Jul 2013]
PIK3CA phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha
MCM; CWS5; MCAP; PI3K; CLOVE; MCMTC; PI3K-alpha; p110-alpha
Phosphatidylinositol 3-kinase is composed of an 85 kDa regulatory subunit and a 110 kDa catalytic subunit. The protein encoded by this gene represents the catalytic subunit, which uses ATP to phosphorylate PtdIns, PtdIns4P and PtdIns(4,5)P2. This gene has been found to be oncogenic and has been implicated in cervical cancers. A pseudogene of this gene has been defined on chromosome 22. [provided by RefSeq, Apr 2016]
An irregular, disc-shaped element in the blood that assists in blood clotting. Platelets are not blood cells, they are fragments of large bone marrow cells called megakaryocytes.
PPM1D protein phosphatase, Mg2+/Mn2+ dependent 1D
The protein encoded by this gene is a member of the PP2C family of Ser/Thr protein phosphatases. PP2C family members are known to be negative regulators of cell stress response pathways. The expression of this gene is induced in a p53-dependent manner in response to various environmental stresses. While being induced by tumor suppressor protein TP53/p53, this phosphatase negatively regulates the activity of p38 MAP kinase, MAPK/p38, through which it reduces the phosphorylation of p53, and in turn suppresses p53-mediated transcription and apoptosis. This phosphatase thus mediates a feedback regulation of p38-p53 signaling that contributes to growth inhibition and the suppression of stress induced apoptosis. This gene is located in a chromosomal region known to be amplified in breast cancer. The amplification of this gene has been detected in both breast cancer cell line and primary breast tumors, which suggests a role of this gene in cancer development. [provided by RefSeq, Jul 2008]
A measurement of how fast PSA levels in the blood increase over time. A high PSA velocity may be a sign of prostate cancer and may help find fast-growing prostate cancers.
The number of months observed or calculated for PSA to increase two-fold.
This gene was identified as a tumor suppressor that is mutated in a large number of cancers at high frequency. The protein encoded by this gene is a phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase. It contains a tensin like domain as well as a catalytic domain similar to that of the dual specificity protein tyrosine phosphatases. Unlike most of the protein tyrosine phosphatases, this protein preferentially dephosphorylates phosphoinositide substrates. It negatively regulates intracellular levels of phosphatidylinositol-3,4,5-trisphosphate in cells and functions as a tumor suppressor by negatively regulating AKT/PKB signaling pathway. The use of a non-canonical (CUG) upstream initiation site produces a longer isoform that initiates translation with a leucine, and is thought to be preferentially associated with the mitochondrial inner membrane. This longer isoform may help regulate energy metabolism in the mitochondria. A pseudogene of this gene is found on chromosome 9. Alternative splicing and the use of multiple translation start codons results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Feb 2015]
BZS; DEC; CWS1; GLM2; MHAM; TEP1; MMAC1; PTEN1; 10q23del; PTENbeta
Most patients with CRPC have painful bone metastases. External beam radiotherapy is highly effective ,even as a single fraction.
The primary objective of treatment must be the eradication of measurable and biologically aggressive disease with minimal toxicity. However, although treatment is usually intended to be a single session, patients should know that further treatment might be necessary in the future. Standardised follow-up schedules and retreatment indications are currently non-existent.
Surgical removal of one or more pelvic lymph nodes.
PSA circulates in the blood in two forms: free or attached to a protein molecule. With benign prostate conditions, there is more free PSA, while cancer produces more of the attached form. A more accurate predictor of cancer than either a patient's age or his total PSA level. (from Cancer Information Service)
A record of a patient's background regarding health and the occurrence of disease events of the individual. In addition, personal medical history may be a variable in epidemiologic studies.
Any agent used to control, repel, or kill unwanted organisms./NCI-GLOSS Definition: Any substance that is used to kill insects and other pests.
Use of light activated drugs (photosensitizing agents) to kill cancer cells./NCI-GLOSS Definition: Treatment with drugs that become active when exposed to light. These activated drugs may kill cancer cells.
Any form of exercise or movement. Physical activity may include planned activity such as walking, running, basketball, or other sports. Physical activity may also include other daily activities such as household chores, yard work, walking the dog, etc.
A systemic evaluation of the body and its functions using visual inspection, palpation, percussion and auscultation. The purpose is to determine the presence or absence of physical signs of disease or abnormality for an individual's health assessment.
Hytoestrogens are plant‐derived dietary compounds, found in a wide variety of foods, especially in soy. They represent a diverse group of naturally occurring chemicals with structural similarity to 17‐β‐oestradiol (E2), the primary female sex hormone
Pizza is a traditional Italian dish consisting of a yeasted flatbread typically topped with tomato sauce and cheese and baked in an oven. It can also be topped with additional vegetables, meats, and condiments, and can be made without cheese.
Any living organism that typically synthesizes its food from inorganic substances, possesses cellulose cell walls, responds slowly and often permanently to a stimulus, lacks specialized sense organs and nervous system, and has no powers of locomotion. (EPA Terminology Reference System)
Enterolactone (ENL) is an enterolignan, which in humans is formed in the gut from various dietary lignans through the action of colonic bacteria, and is later detectable in the circulation， Lignans constitutes, besides isoflavones (e.g., genistein and daidzein, which are mainly found in soy products) and coumestans (mainly found in sprouts), one of the three main classes of phytoestrogens (PE), non-steroidal plant-based substances with estrogenic properties
A defined, decaffeinated green tea polyphenol mixture isolated from Camellia sinensis, a plant native to Asia, with antiviral and antioxidant activities and potential chemopreventive activity. Green tea extract contains antioxidant compounds, including flavonoids, vitamins and polyphenols such as epigallocatechin-3-gallate (EGCG), which may have antineoplastic properties. Consumption of green tea extract may confer chemopreventive protection against various cancers including those of the prostate, stomach, and esophagus./NCI-GLOSS Definition: A substance that is being studied in the prevention of cancer. It is made from decaffeinated green tea, and contains chemicals called catechins, which are antioxidants.
NCI-GLOSS Definition: A subtropical shrub or tree. Juice from the fruit may contain substances that decrease or slow the rise of prostate-specific antigen (PSA) levels. It is being studied for its ability to delay or prevent recurrent prostate cancer. The scientific name is Punica granatum.
Post-radical prostatectomy biochemical recurrence
According to Pound et al., not all patients with BCF after RP develop clinical recurrence. The authors evaluated the follow-up data for 1,997 patients after RP, and only 34% of those with BCF subsequently had a clinical recurrence. These data were confirmed by Boorjian et al. in a study including approximately 2,400 patients; only a minority of those with BCF after RP developed a clinically evident recurrence (22.9%) and only a few died of PCa (5.8%) . Overall, these studies demonstrated a general trend among men with PSA-only recurrence after RP (i.e. 7-40% of relapsing men): for every 100 men treated with RP, approximately 15-30 will develop BCR and 2-6 of those will die of PCa.
Post-radiotherapy biochemical recurrence
Similar to patients experiencing PSA-recurrence after RP, patients with a PSA-rise following RT can be subdivided into prognostic categories. A high-risk subgroup with elevated risk of metastases and PCSM are those patients with a PSA-DT < 3 months, time to biochemical progression < 3 years, biopsy Gleason score 8-10 and clinical stage cT3b-T4. Conversely, patients at low risk of metastases and PCSM are those with a PSA-DT > 15 months, biopsy Gleason score < 7, clinical stage < cT3a and time to biochemical progression> 3 years. Zumsteg et al. have designed a risk score to further subdivide patients who develop PSA recurrence following RT. Those with either 0, 1 or > 2 high-risk factors (PSA-DT < 3 months, time to biochemical progression < 3 years, biopsy Gleason score 8-10 and clinical stage cT3b-T4) have an increased risk of developing metastases and PCSM.Again, the choice of local salvage treatment (salvage RP, salvage cryo, salvage HIFU, salvage brachytherapy)should be guided by the life expectancy and oncological risk profile of each patient, together with the patient’s expectations.
Post-treatment quality of life in patients with localised prostate cancer
Increased life expectancy in PCa makes post-treatment QoL a key issue. Health-related QoL (HRQoL) refers to the impact of disease and treatment on well-being and physical, emotional and social functioning, including daily functioning. HRQoL is rated by patients, and is important because physicians often underestimate the impact of disease and treatment on patients. PCa-specific HRQoL refers to the disease-specific outcome of PCa, including urinary, bowel and sexual functioning. General HRQoL refers to well-being, vitality, fatigue, pain, general health status, global QoL, and life satisfaction. HRQoL is measured using standardised questionnaires, which provide an objective assessment of general and disease-specific domains. Comparison of the most common contemporary therapies for localised PCa is necessary to inform patients about treatment options and address patient preferences for the various possible outcomes. There is still limited objective data about HRQoL in PCa treatment.
局部前列腺癌患者的治疗后生活质量
Potential other benefits of intermittent androgen deprivation
The optimal thresholds at which ADT must be stopped or resumed are empirical. Nevertheless, several points are clear. • IAD is based on intermittent castration. Therefore, only drugs leading to castration are suitable for use in IAD. • Most published experiences are based on CAB, which is considered as standard treatment. An LHRH antagonist might be a valid alternative, without any significant benefits. • The induction cycle must last 9 months at the most, otherwise testosterone recovery is unlikely. • The treatment is stopped only if patients have fulfilled all the following criteria: - well-informed and compliant patient; - no clinical progression; - clear PSA response, empirically defined as a PSA < 4 ng/mL in metastatic disease. • Strict follow-up is mandatory, with clinical examination every 3-6 months. The more advanced the disease, the closer the follow-up. The same laboratory should be used to measure the PSA level. • Treatment is resumed when the patient reaches either a clinical progression, or a PSA above a predetermined, empirically fixed, threshold: usually 10-20 ng/mL in metastatic cases. • The same treatment is used for at least 3-6 months. • Subsequent cycles of treatment are based on the same rules until the first sign is seen of a castrateresistant status. • The best population for IAD has still to be fully characterised. However, the most important factor seems to be the patient’s response to the first cycle of IAD, e.g. the PSA level response.IAD might be an option in metastatic situations after a standardised induction period, even if the benefits are fewer compared to those with less advanced situations.
间歇性雄激素阻断治疗的潜在其他益处
Practical aspects for intermittent androgen deprivation
The high number of random and systematic errors associated with TRUS-guided random biopsy regimens means that this procedure is not sufficiently accurate for selecting candidates for focal therapy. Perineal biopsy or magnetic resonance imaging (MRI) may be useful tools. For characterizing men considering focal therapy, transperineal prostate biopsy using a template-guided approach is recommended. When used with a 5 mm sampling frame, this approach can rule in or out PCa foci with volumes of 0.5 mL and 0.2 mL with 90% certainty. Thus, the exact anatomical localization of the index lesion - defined as the biologically most aggressive - can be accurately determined.
A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, prednisone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations./NCI-GLOSS Definition: A drug used to lessen inflammation and lower the body's immune response. It is used with other drugs to treat leukemia and lymphoma and other types of cancer. It is also used alone or with other drugs to prevent or treat many other conditions. These include conditions related to cancer, such as anemia (a low level of red blood cells), allergic reactions, and loss of appetite. Prednisone is a type of therapeutic glucocorticoid.
Preserved foods have been found in some studies to be associated with increased cancer risks. The total amount of preserved food consumed was positively associated with cancer risk, the adjusted odds ratio being 7.05 (95% CI: 3.12-15.90) for the highest relative to the lowest quartile of intake. In particular, the consumption of pickled vegetables, fermented soy products, salted fish and preserved meats was associated with a significant increase in prostate cancer risk, all with a significant dose-response relationship.
The most prevalent Gleason pattern in a prostate biopsy or prostatectomy specimen. The Gleason score is defined by adding the most prevalent (primary) and second most prevalent (secondary) patterns.
A group of complex organic macromolecules composed of one or more chains (linear polymers) of alpha-L-amino acids linked by peptide bonds and ranging in size from a few thousand to over 1 million Daltons. Proteins are fundamental genetically encoded components of living cells with specific structures and functions dictated by amino acid sequence.
Processing of radical prostatectomy specimens
Prostate-specific antigen (261 aa, ~29 kDa) is encoded by the human KLK3 gene. This protein plays a role in both proteolysis and seminal fluid liquefaction.
A term that refers to the staging of prostate carcinoma according to the American Joint Committee on Cancer, 6th edition.
A term that refers to the staging of prostate cancer according to the American Joint Committee on Cancer, 8th edition. This staging system applies to adenocarcinomas and squamous cell carcinomas of the prostate gland. It does not apply to sarcomas, urothelial cell carcinomas, and urothelial carcinoma of bladder involving prostate. (from AJCC 8th Ed.)
Transperineal Template-Guided Stereotactic Saturation Prostate Biopsy
Transperineal prostate biopsy that removes more than 20 cores. This is typically reserved for high-risk patients.
The ratio of serum prostate specific antigen to prostate volume.
Prostate specific antigen mRNA measurement
The determination of the amount of prostate specific antigen mRNA in a biological sample.
Removal of tissue from the prostate for microscopic examination.
One of the most common malignant tumors afflicting men. The majority of carcinomas arise in the peripheral zone and a minority occur in the central or the transitional zone of the prostate gland. Grossly, prostatic carcinomas appear as ill-defined yellow areas of discoloration in the prostate gland lobes. Adenocarcinomas represent the overwhelming majority of prostatic carcinomas. Prostatic-specific antigen (PSA) serum test is widely used as a screening test for the early detection of prostatic carcinoma. Treatment options include radical prostatectomy, radiation therapy, androgen ablation and cryotherapy. Watchful waiting or surveillance alone is an option for older patients with low-grade or low-stage disease. -- 2002
A neoplastic proliferation of the epithelial cells that line the acini and the ducts of the prostate gland. The neoplastic epithelial cells are confined within the acini and the ducts and they do not invade the surrounding prostatic stroma. Morphologically, it is classified as low or high grade. NCI-GLOSS Definition: Noncancerous growth of cells lining the internal and external surfaces of the prostate gland. Having high-grade PIN may increase the risk of developing prostate cancer."
PIN - Prostatic Intraepithelial Neoplasia
Prostate intraepithelial neoplasia (PIN)
An infectious or non-infectious inflammatory process affecting the prostate gland. NICHD Definition: An inflammatory process affecting the prostate gland. NCI-GLOSS Definition: Inflammation of the prostate gland."
In theory, proton beams are an attractive alternative to photon-beam radiotherapy for PCa, as they|deposit almost all their radiation dose at the end of the particle’s path in tissue (the Bragg peak), in contrast to|photons, which deposit radiation along their path. There is also a very sharp fall-off for proton beams beyond|their deposition depth, meaning that critical normal tissues beyond this depth could be effectively spared. In|contrast, photon beams continue to deposit energy until they leave the body, including an exit dose.|Two recent planning studies comparing conformal proton therapy with IMRT have yielded|conflicting results; one study suggested that the two are equivalent in terms of rectal dose sparing, but that|IMRT is actually superior in terms of bladder sparing; the other study suggested a clearer advantage for|protons.|One randomised trial on dose escalation (70.2 vs. 79.2 Gy) has incorporated protons for the boost|doses of either 19.8 or 28.8 Gy. This trial shows improved outcome with the higher dose, but it cannot be used|as evidence for the superiority of proton therapy per se. Thus, unequivocal information that shows an|advantage of protons over IMRT photon therapy is still not available.|Studies from the SEER database, and from Harvard, describing toxicity and patient|reported outcomes, respectively, do not point to an inherent superiority for protons - indeed, in terms of longer|term GI toxicity, proton therapy might even be inferior to IMRT.|A retrospective 2:1 matched-control analysis of 27,647 US Medicare patients compared 314|men receiving proton therapy with 628 men who had IMRT. Despite the considerably higher costs for proton|therapy, there was some improvement in GU-tract toxicity after 6 months, but not after 12 months, and not at|the GI tract.|A randomised trial comparing equivalent doses of proton-beam therapy with IMRT is needed|to compare the efficacy of protons vs. photons; a study of this type is under consideration by the RTOG.|Meanwhile, proton therapy must be regarded as a promising, but experimental, alternative to photon-beam|therapy.
A disorder characterized by two or more episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). Repeated episodes of hypomania or mania only are classified as bipolar. http://apps.who.int/classifications/icd10/browse/2016/en#/F30.8
RECA; BRCC5; FANCR; MRMV2; HRAD51; RAD51A; HsRad51; HsT16930
The protein encoded by this gene is a member of the RAD51 protein family. RAD51 family members are highly similar to bacterial RecA and Saccharomyces cerevisiae Rad51, and are known to be involved in the homologous recombination and repair of DNA. This protein can interact with the ssDNA-binding protein RPA and RAD52, and it is thought to play roles in homologous pairing and strand transfer of DNA. This protein is also found to interact with BRCA1 and BRCA2, which may be important for the cellular response to DNA damage. BRCA2 is shown to regulate both the intracellular localization and DNA-binding ability of this protein. Loss of these controls following BRCA2 inactivation may be a key event leading to genomic instability and tumorigenesis. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Aug 2009]
The protein encoded by this gene belongs to the DEAD-like helicase superfamily, and shares similarity with Saccharomyces cerevisiae Rad54, a protein known to be involved in the homologous recombination and repair of DNA. This protein has been shown to play a role in homologous recombination related repair of DNA double-strand breaks. The binding of this protein to double-strand DNA induces a DNA topological change, which is thought to facilitate homologous DNA paring, and stimulate DNA recombination. Alternative splicing results in multiple transcript variants encoding the same protein.[provided by RefSeq, Dec 2008]
Denosumab is a fully human monoclonal antibody directed against RANKL (receptor activator of nuclear factor|κB ligand), a key mediator of osteoclast formation, function, and survival. In M0 CRPC, denosumab has been|associated with increased bone-metastasis-free survival compared to placebo (median benefit: 4.2 months,|HR: 0.85, P = 0.028). However, this benefit did not translate into a survival difference (43.9 compared|to 44.8 months, respectively). The practical impact of this finding remains under discussion. The efficacy and|safety of denosumab (n = 950) compared with zoledronic acid (n = 951) in patients with metastatic CRPC|was assessed in a phase III trial. Denosumab was superior to zoledronic acid in delaying or preventing SREs,|as shown by time to first on-study SRE (pathological fracture, radiation or surgery to bone, or spinal cord|compression) of 20.7 vs. 17.1 months, respectively (HR 0.82; P = 0.008). Both urinary NTX and BAP were|significantly suppressed in the denosumab arm compared with the zoledronic acid arm (p < 0.0001 for both).|However, these positive findings were not associated with any survival benefit.
The protein encoded by this gene interacts with signaling pathways to coordinately regulate cell growth, cell proliferation, apoptosis, autophagy, and cell migration. This tumor suppressor also enhances retinoblastoma 1 gene expression in cancer cells. Alternative splicing results in multiple transcript variants encoding distinct isoforms. [provided by RefSeq, Nov 2009]
Cell specialized for oxygen transport, having a high concentration of hemoglobin in the cytoplasm and little else; biconcave, anucleate discs, 7nm diameter in mammals.
Definition: Single-stranded long chain of nucleotides containing ribose. It is the end product of DNA transcription by the enzyme RNA polymerase. It is essential in protein synthesis. CDISC Definition: Single-stranded long chain of nucleotides containing ribose. It is the end product of DNA transcription by the enzyme RNA polymerase. It is essential in protein synthesis. NCI-GLOSS Definition: One of two types of nucleic acid made by cells. Ribonucleic acid contains information that has been copied from DNA (the other type of nucleic acid). Cells make several different forms of ribonucleic acid, and each form has a specific job in the cell. Many forms of ribonucleic acid have functions related to making proteins. Ribonucleic acid is also the genetic material of some viruses instead of DNA. Ribonucleic acid can be made in the laboratory and used in research studies.
This gene encodes a component of the interferon-regulated 2-5A system that functions in the antiviral and antiproliferative roles of interferons. Mutations in this gene have been associated with predisposition to prostate cancer and this gene is a candidate for the hereditary prostate cancer 1 (HPC1) allele. [provided by RefSeq, Jul 2008]
A derivative of dipyridamole that is a phosphodiesterase inhibitor, with potential antiplatelet activity. Mopidamol inhibits the hydrolysis of cyclic nucleotides, such as cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), by cyclic nucleotide phosphodiesterases; thus, cAMP- and cGMP-dependent processes are potentiated. This leads to the induction of prostacyclin synthesis, the inhibition of thromboxane B2 synthesis and prevention of platelet activation and aggregation.
An arbitrary classification of a taxonomic group that is a division of a species.
Race refers to a population with common genetic and phenotypic features that separates them from other populations.Ethnicity pertains to the different cultural, socioeconomic, religious properties, including customs, language, diet and cultural identity
Surgery to remove all of the prostate through an incision between the scrotum and the anus. Nearby lymph nodes are sometimes removed through a separate incision in the wall of the abdomen.
Surgery to remove all of the prostate and nearby lymph nodes through an incision in the wall of the abdomen.
The simultaneous surgical resection of the urinary bladder and prostate gland with pelvic lymphadenectomy.
The surgical removal of all of the prostate as well as some surrounding tissue, including lymph nodes.
The surgical removal of all of the prostate as well as some surrounding tissue, including lymph nodes./NCI-GLOSS Definition: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy (surgery through an incision in the wall of the abdomen) and perineal prostatectomy (surgery through an incision between the scrotum and the anus).
Radical prostatectomy without pelvic node excision
无盆腔淋巴结切除的前列腺根治切除术
Radiofrequency ablation and electroporation
Radiotherapy for localised prostate cancer
Patients must be informed about acute and late genitourinary or gastrointestinal toxicity and the impact of irradiation on erectile function. In contemporary practice, the NCIC toxicity grading system is increasingly used, but most studies have used the RTOG scales, which are described in Tables 6.8.1 and 6.8.2. Risk factors for acute or late gastrointestinal toxicities after RT include advanced age, preexisting diabetes mellitus,haemorrhoids, inflammatory bowel disease, a history of prior abdominal surgery, larger rectal volume and the concomitant use of androgen deprivation. Pre-treatment genitourinary complaints, prior transurethral resection of the prostate and the presence of acute genitourinary toxicity are suggested as contributing to long-term urinary morbidity.
The only bone-specific drug that is associated with a survival benefit is alpharadin, a radium 223 a-emitter. In a large phase III trial (ALSYMPCA), 921 patients with symptomatic CRPC, who failed or were unfit for docetaxel therapy, were randomised to six injections of 50 kBq/kg alpharadin or placebo. The primary end-point was OS. Alpharadin significantly improved OS by 3.6 months (HR = 0.70; p < 0.001). It was also associated with prolonged time to first skeletal event, improvement in pain scores and improvement in QoL. The associated toxicity was minimal, especially haematologic toxicity, and did not differ significantly from that in the placebo arm.
Repeat biopsy after previously negative biopsy
The therapeutic results of cryotherapy have improved over time with the introduction of enhanced techniques such as gas-driven probes and transperineal probe placement, as used in third-generation cryosurgery. An objective assessment of PSA outcome is not easily performed because some institutions use PSA values < 0.1 ng/mL as an indicator of therapeutic success, whereas others use the old American Society of Therapeutic Radiology and Oncology (ASTRO) criteria, which require three initial consecutive increases in PSA level. With regard to second-generation CSAP, if a PSA nadir < 0.5 ng/mL is used, BDFS at five years is 60% and 36% for low-risk and high-risk patients, respectively.
Information on rice consumption was first assessed in 1980 in NHS participants using a validated semi-quantitative food frequency questionnaire (SFFQ), and repeated in 1984, 1986, and every 4 years thereafter. Similar SFFQs were administered every 4 years for NHS II participants during 1991 through 2009 and for HPFS participants during 1986 through 2008. In each SFFQ, we asked the participants how often, on average over the past year, they consumed a specified portion size of each food, with nine possible frequency choices ranging from “almost never” to “6 or more times per day”. For white rice and brown rice, we used 1 cup as the serving unit. The total rice intake was calculated as the sum of white rice and brown rice. In the current study, we categorized participants’ rice intake into 4 categories (< 1 serving per week, 1 serving per week, 2-4 servings per week and ≥ 5 servings per week). The reproducibility and validity of these SFFQs have been evaluated in detail elsewhere16-19. Assessments of white rice and brown rice consumption were moderately correlated with diet record assessments. For example, the corrected Pearson correlation coefficients between these 2 assessments were 0.53 for white rice and 0.41 for brown rice in the HPFS
Robot assisted laparoscopic radical prostatectomy
机器人辅助腹腔镜前列腺癌根治术
The maximum pressure exerted into the systemic arterial circulation during the contraction of the left ventricle of the heart.
This gene is one of several tumor-suppressing subtransferable fragments located in the imprinted gene domain of 11p15.5, an important tumor-suppressor gene region. Alterations in this region have been associated with the Beckwith-Wiedemann syndrome, Wilms tumor, rhabdomyosarcoma, adrenocortical carcinoma, and lung, ovarian, and breast cancer. This gene is imprinted, with preferential expression from the maternal allele. Mutations in this gene have been found in Wilms' tumor and lung cancer. This protein may act as a transporter of organic cations, and have a role in the transport of chloroquine and quinidine-related compounds in kidney. Several alternatively spliced transcript variants encoding different isoforms have been described. [provided by RefSeq, Oct 2015]
SLC22A18 solute carrier family 22 member 18
HET; ITM; BWR1A; IMPT1; TSSC5; ORCTL2; BWSCR1A; SLC22A1L; p45-BWR1A
Definition: A variation of a single nucleotide at a specific location of the genome due to base substitution, present at an appreciable frequency between individuals of a single interbreeding population. NCI-GLOSS Definition: DNA sequence variations that occur when a single nucleotide (adenine, thymine, cytosine, or guanine) in the genome sequence is altered; usually present in at least 1% of the population; pronounced snip.
Salvage brachytherapy for radiotherapy failure
Following local recurrence after previous definitive RT there is no indication for external beam salvage RT as the total dose is limited and therefore the chance of cure is low. For carefully selected patients with primary localised PCa and histologically proven local recurrence, high- or low-dose rate (H/LDR) brachytherapy remain effective treatment options with an acceptable toxicity profile. However, the published series are relatively small, therefore this treatment should be offered in experienced centres only. Fifty-two patients were treated at the Scripps Clinic with HDR-brachytherapy over a period of nine years. With a median followup of 60 months the 5-year biochemical control was 51% and only 2% grade 3 GU toxicities were reported.Comparable with these data, 42 patients were treated in a phase-II-trial at MSCCC in New York. Ofnote, the median pre-treatment dose was 81 Gy given with IMRT and the prescription HDR-dose of 32 Gy was delivered in four fractions over 30 hours. The biochemical relapse-free survival after 5 years was 69%(median follow-up 36 months). Grade 2 late side effects were seen in 15% and one patient developed Grade 3 incontinence. However, older data with higher rates of side effects have been reported.
放射治疗失败的挽救性近距离放射治疗
Salvage treatment after first-line docetaxel
All patients who receive docetaxel-based chemotherapy for CRPC will progress, thus, there have been many clinical trials investigating the role of salvage chemotherapy. Several groups have used second-line intermittent docetaxel re-treatment in patients who had clearly responded to first-line docetaxel. In general, a PSA response can be achieved in about 60% of patients with a median time to progression of about 6 months, while treatment-associated toxicity is minimal and similar to that of first-line docetaxel.
Saturation BiopsyTransperineal Template-Guided Stereotactic Saturation Prostate Biopsy
Proton beam radiation therapy in which magnets deflect and steer the proton beam. (Adapted from medicalphysicsweb)
Proton beam radiation therapy in which the proton beam is spread by placing scattering material in the path of the protons. (Adapted from medicalphysicsweb)
Any of the four periods into which the year is divided by the equinoxes and solstices.
The second most prevalent Gleason pattern in a prostate biopsy or prostatectomy specimen. The Gleason score is defined by adding the most prevalent (primary) and second most prevalent (secondary) patterns.
A nonmetallic chemical element found in trace amounts in human body. Selenium primarily occurs in vivo as selenocompounds, mostly selenoproteins such as glutathione peroxidase and thioredoxin reductase (enzymes responsible for detoxification). Alone or in combination with Vitamin E, selenocompounds act as antioxidants. These agents scavenge free radicals; prevent blood clots by inhibiting platelet aggregation; strengthen the immune system; and have been shown, in some instances, to inhibit chromosomal damage and mutations. Exhibiting chemopreventive activity, selenocompounds also inhibit the induction of protein kinase C. NCI-GLOSS Definition: A mineral that is needed by the body to stay healthy. It is being studied in the prevention and treatment of some types of cancer. Selenium is a type of antioxidant."
The removal of tissue from the seminal vesicles for the purpose of microscopic evaluation.
a biomarker of vitamin A to reflect body stores
A form of physical intimacy that can be directed to reproduction (one possible goal of sexual intercourse) and/or to enjoying the body of someone else; activities associated with sexual intercourse.
The bodily processes that include arousal, erection, orgasm, and ejaculation.
Short-term complications after radiotherapy
Side effects of percutaneous irradiation and brachytherapy
Radiotherapy affects erectile function to a lesser degree than surgery, according to retrospective surveys of patients. A meta-analysis has shown that the 1-year probability rates for maintaining erectile function were 0.76 after brachytherapy, 0.60 after brachytherapy + external irradiation, 0.55 after external irradiation,0.34 after nerve-sparing RP, and 0.25 after standard RP. When studies with more than 2 years of follow-up were selected (i.e. excluding brachytherapy), the rates became 0.60, 0.52, 0.25, and 0.25, respectively, with a greater spread between the radiation techniques and surgical approaches
经皮照射与近距离放射治疗的副作用
PA2024 (PAP/GM-CSF)-Loaded Dendritic Cell Vaccine/
A cell-based vaccine composed of autologous antigen-presenting peripheral blood mononuclear cells (enriched for a dendritic cell fraction) that have been exposed to a recombinant protein consisting of granulocyte-macrophage colony-stimulating factor (GM-CSF) fused to prostatic-acid phosphatase (PAP), a protein expressed by prostate cancer cells. Upon administration, the vaccine may stimulate an antitumor T-cell response against tumor cells expressing PAP. (NCI05)/NCI-GLOSS Definition: A drug used to treat prostate cancer that has spread. It is made from immune system cells collected from a patient with prostate cancer. The cells are treated with a protein that is made by combining a protein found on prostate cancer cells with a growth factor. When the cells are injected back into the patient, they may stimulate T cells to kill prostate cancer cells. Provenge is a type of vaccine and a type of cellular adoptive immunotherapy.
A natural and periodic state of rest during which consciousness of the world is suspended.
Supplemental Qualifiers for Environmental and Social Factors
A dataset containing supplemental information, specifically non-standard variables, to parent records in the environmental and social factors domain. CDISC Definition: A dataset used to represent non-standard variables and their association to parent records in the Environmental and Social Factors domain."
Environmental and Social Factors Supplemental Qualifiers Dataset
NCI-GLOSS Definition: A product from a plant of Asian origin that produces beans used in many food products. Soybean contains isoflavones (estrogen-like substances) that are being studied for the prevention of cancer, hot flashes that occur with menopause, and osteoporosis (loss of bone density). Soybean in the diet may lower cholesterol levels and reduce the risk of heart disease
Specific aspects of PCa treatment in older men
老年男性前列腺癌治疗的特殊方面
The technical name for a urine stream that splits is Split Stream Urination. Split stream urination is a condition that is very common in males than it is in females. It is characterized by urine splitting into two or more different directions during the act of urinating.
Stage IIA includes: (cT1a-c, cT2a, N0, M0, PSA equal or more than 10 and less than 20, Grade Group 1); (cT2b-c, N0, M0, PSA less than 20, Grade Group 1). cT1a: Prostate cancer in which the tumor is an incidental histologic finding in 5% or less of tissue resected. cT1b: Prostate cancer in which the tumor is an incidental histologic finding in more than 5% of tissue resected. cT1c: Prostate cancer in which the tumor is identified by needle biopsy found in one or both sides, but not palpable. cT2a: Prostate cancer in which the tumor involves one-half of one side or less. cT2b: Prostate cancer in which the tumor involves more than one-half of one side but not both sides. cT2c: Prostate cancer in which the tumor involves both sides. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 1: Gleason Score 6 or less, Gleason Pattern 3 or less+3. (AJCC 8th ed.)
Stage IIB includes: T1-2, N0, M0, PSA less than 20, Grade Group 2. T1: Prostate cancer with clinically inapparent tumor that is not palpable. T2: Prostate cancer in which the tumor is palpable and confined within the prostate. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 2: Gleason Score 7, Gleason Pattern 3+4. (AJCC 8th ed.)
Stage IIC includes: (T1-2, N0, M0, PSA less than 20, Grade Group 3); (T1-2, N0, M0, PSA less than 20, Grade Group 4). T1: Prostate cancer with clinically inapparent tumor that is not palpable. T2: Prostate cancer in which the tumor is palpable and confined within the prostate. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 3: Gleason Score 7, Gleason Pattern 4+3. Grade Group 4: Gleason Score 8, Gleason Pattern 4+4. (AJCC 8th ed.)
Stage IIIA includes: T1-2, N0, M0, PSA 20 or more, Grade Group 1-4; T1: Prostate cancer with clinically inapparent tumor that is not palpable. T2: Prostate cancer in which the tumor is palpable and confined within the prostate. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 1: Gleason Score 6 or less, Gleason Pattern 3 or less+3. Grade Group 2: Gleason Score 7, Gleason Pattern 3+4. Grade Group 3: Gleason Score 7, Gleason Pattern 4+3. Grade Group 4: Gleason Score 8, Gleason Pattern 4+4. (AJCC 8th ed.)
Stage IIIB includes: T3-4, N0, M0, PSA: Any, Grade Group 1-4; T3: Prostate cancer with extraprostatic tumor that is not fixed or does not invade adjacent structures. T4: Prostate cancer in which the tumor is fixed or invades adjacent structures other than seminal vesicles such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 1: Gleason Score 6 or less, Gleason Pattern 3 or less+3. Grade Group 2: Gleason Score 7, Gleason Pattern 3+4. Grade Group 3: Gleason Score 7, Gleason Pattern 4+3. Grade Group 4: Gleason Score 8, Gleason Pattern 4+4. (AJCC 8th ed.)
Stage IIIC includes: Any T, N0, M0, PSA: Any, Grade Group 5. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 5: Gleason Score 9 or 10, Gleason Pattern 4+5, or 5+4, or 5+5. (AJCC 8th ed.)
Stage III includes: T3, N0, M0, Any G. T3: Tumor extends through the prostatic capsule. T3a: Extracapsular extension (unilateral or bilateral). T3b: Tumor invades seminal vesicle(s). N0: No regional lymph node metastasis. M0: No distant metastasis. (AJCC 6th ed.) - 2003
/Cancer of the Prostate Stage III AJCC v6
Stage III Cancer of the Prostate AJCC v6
Stage III includes: IIIA: T1-2, N0, M0, PSA 20 or more, Grade Group 1-4; IIIB: T3-4, N0, M0, PSA: Any, Grade Group 1-4; IIIC: Any T, N0, M0, PSA: Any, Grade Group 5. T1: Prostate cancer with clinically inapparent tumor that is not palpable. T2: Prostate cancer in which the tumor is palpable and confined within the prostate. T3: Prostate cancer with extraprostatic tumor that is not fixed or does not invade adjacent structures. T4: Prostate cancer in which the tumor is fixed or invades adjacent structures other than seminal vesicles such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 1: Gleason Score 6 or less, Gleason Pattern 3 or less+3. Grade Group 2: Gleason Score 7, Gleason Pattern 3+4. Grade Group 3: Gleason Score 7, Gleason Pattern 4+3. Grade Group 4: Gleason Score 8, Gleason Pattern 4+4. Grade Group 5: Gleason Score 9 or 10, Gleason Pattern 4+5, or 5+4, or 5+5. (AJCC 8th ed.)
Stage II includes: (T1a, N0, M0, G2, 3-4); (T1b, N0, M0, Any G); (T1c, N0, M0, Any G); (T1, N0, M0, Any G); (T2, N0, M0, Any G). T1: Clinically inapparent tumor neither palpable nor visible by imaging. T1a: Tumor incidental histologic finding in 5% of tissue resected. T1c: Tumor identified by needle biopsy (e.g. because of elevated PSA). T2: Tumor confined with in the prostate. N0: No regional lymph node metastasis. M0: No distant metastasis. G2: Moderately differentiated (moderate anaplasia) (Gleason 5-6). G 3-4: Poorly differentiated/undifferentiated (marked anaplasia) (Gleason 7-10). (AJCC 6th ed.) - 2003
Stage II includes: IIA: (cT1a-c, cT2a, N0, M0, PSA equal or more than 10 and less than 20, Grade Group 1); (cT2b-c, N0, M0, PSA less than 20, Grade Group 1); IIB: T1-2, N0, M0, PSA less than 20, Grade Group 2; IIC: (T1-2, N0, M0, PSA less than 20, Grade Group 3); (T1-2, N0, M0, PSA less than 20, Grade Group 4). cT1a: Prostate cancer in which the tumor is an incidental histologic finding in 5% or less of tissue resected. cT1b: Prostate cancer in which the tumor is an incidental histologic finding in more than 5% of tissue resected. cT1c: Prostate cancer in which the tumor is identified by needle biopsy found in one or both sides, but not palpable. cT2a: Prostate cancer in which the tumor involves one-half of one side or less. cT2b: Prostate cancer in which the tumor involves more than one-half of one side but not both sides. cT2c: Prostate cancer in which the tumor involves both sides. T1: Prostate cancer with clinically inapparent tumor that is not palpable. T2: Prostate cancer in which the tumor is palpable and confined within the prostate. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 1: Gleason Score 6 or less, Gleason Pattern 3 or less+3. Grade Group 2: Gleason Score 7, Gleason Pattern 3+4. Grade Group 3: Gleason Score 7, Gleason Pattern 4+3. Grade Group 4: Gleason Score 8, Gleason Pattern 4+4. (AJCC 8th ed.)
Stage IVA includes: Any T, N1, M0, PSA: Any, Grade Group: Any. N1: Prostate cancer with metastases in regional node(s). M0: Prostate cancer without evidence of distant metastasis. (AJCC 8th ed.)
Stage IVB includes: Any T, N0, M1, PSA: Any, Grade Group: Any. N0: Prostate cancer with no positive regional nodes. M1: Prostate cancer with distant metastasis. (AJCC 8th ed.)
Stage IV includes: (T4, N0, M0); (Any T, N1, M0); (Any T, Any N, M1) (Any G). T4: Tumor is fixed or invades adjacent structures other than seminal vesicles: bladder neck, external sphincter, rectum, levator muscles, and/or pelvic wall. N1: Metastasis in regional lymph node(s). M1: Distant metastasis. (AJCC 6th ed.) - 2003
Stage IV includes: IVA: Any T, N1, M0, PSA: Any, Grade Group: Any; IVB: Any T, N0, M1, PSA: Any, Grade Group: Any. N0: Prostate cancer with no positive regional nodes. N1: Prostate cancer with metastases in regional node(s). M0: Prostate cancer without evidence of distant metastasis. M1: Prostate cancer with distant metastasis. (AJCC 8th ed.)
Stage I includes: T1, N0, M0, G1. T1: Tumor invades subepithelial connective tissue. N0: No regional metastasis. M0: No distant metastasis. G1: Well differentiated (slight anaplasia) (Gleason 2-4). (AJCC 6th ed.) - 2003
Stage I includes: (cT1a-c, cT2a, N0, M0, PSA less than 10, Grade Group 1); (pT2, N0, M0, PSA less than 10, Grade Group 1). cT1a: Prostate cancer in which the tumor is an incidental histologic finding in 5% or less of tissue resected. cT1b: Prostate cancer in which the tumor is an incidental histologic finding in more than 5% of tissue resected. cT1c: Prostate cancer in which the tumor is identified by needle biopsy found in one or both sides, but not palpable. cT2a: Prostate cancer in which the tumor involves one-half of one side or less. pT2: Prostate cancer which is organ confined. N0: Prostate cancer with no positive regional nodes. M0: Prostate cancer without evidence of distant metastasis. Grade Group 1: Gleason Score 6 or less, Gleason Pattern 3 or less+3. (AJCC 8th ed.)
Hydroxymethylglutaryl Coenzyme A Reductase Inhibitors
Any substance that inhibits HMG-CoA reductase, a key enzyme in cholesterol synthesis. Inhibition of HMG-CoA reductase acts to lower plasma cholesterol and lipoprotein levels. NCI-GLOSS Definition: Any of a group of drugs that lower the amount of cholesterol and certain fats in the blood. Statins inhibit a key enzyme that helps make cholesterol. Statin drugs are being studied in the prevention and treatment of cancer."
hydroxymethylglutaryl-coenzyme A reductase inhibitor statin
Steroid hormone receptors are proteins found in either the cytoplasm or nucleus of eukaryotic cells which bind to and regulate the transcription of DNA under the regulation of steroid hormones. These proteins are the first receptors assigned to the steroid/thyroid/retinoid nuclear receptor superfamily, a group of transcription factors whose activity is regulated by small lipid-soluble molecules.
These compounds are synthetic derivatives of hydroxyprogesterone. Their main pharmacological side-effects are secondary to castration, while gynaecomastia is quite rare. The non-pharmacological side effects are cardiovascular toxicity (4-40% for CPA) and hepatotoxicity.
Storage symptoms may be due to an overactive bladder (OAB). OAB is when there is a feeling of urgency to urinate, usually with frequency and nocturia can happen with or without urge incontinence.
Strategies to counteract the cardiotoxicity of oestrogen therapy
Two strategies have been attempted to neutralise oestrogen cardiotoxicity. Parenteral oestrogen (polyoestradiol phosphate) to avoid first-pass hepatic metabolism was as effective as CAB for survival, but with still more non-fatal cardiovascular events. The use of either warfarin sodium, 1 mg/day, or aspirin, 75-100 mg/day in combination with DES,1 mg/day or 3 mg/day, did not suppress the thromboembolic complications associated with DES. These results precluded oestrogen as a standard first-line treatment.
A naturally-occurring phytochemical belonging to the class of isothiocyanates. As the aglycone metabolite of glucosinolate glucoraphanin (sulforaphane glucosinolate), sulforaphane acts as an antioxidant and potent stimulator of endogenous detoxifying enzymes. This agent displays anticarcinogenic properties due to its ability to induce phase II detoxification enzymes, such as glutathione S-transferase and quinone reductase, thereby providing protection against certain carcinogens and toxic, reactive oxygen species. Broccoli sprouts contain large amounts of sulforaphane, which is also found in other cruciferous vegetables including cabbage and kale. (NCI04)
Removal of prostate tissue following a midline abdominal incision from the umbilicus to the pubic area and a small incision of the lower anterior bladder wall.
The branch of medical science that treats disease or injury by operative procedures.
The determination of the presence of actual or potential neoplastic tissue which has been left outside the boundary of a resected specimen within the patient.
Identifying prostate problems early is a way to reduce future prostate problems; symptoms include frequent urination, blood in urine, painful urination, dribbling urination, inability to urinate, painful ejaculation, and pain in back, hips, thighs, pelvis and/or rectum.
A primary tumor TNM finding indicating that there is no evidence of primary tumor.
A clinical and/or pathologic primary tumor TNM finding indicating that the cancer is limited to the site of growth.
A general term that refers to a TNM finding of a primary tumor limited to the site of growth. The definition of T1a TNM finding depends on the specific type of cancer that it refers to; for example, for breast cancer it refers to a primary tumor that is more than 0.1cm, but not more than 0.5 cm in greatest dimension; for kidney cancer it refers to a primary tumor that is 4 cm or less in greatest dimension; and for thyroid cancer it refers to a primary tumor that is 1 cm or less in greatest dimension.
A general term that refers to a TNM finding of a primary tumor limited to the site of growth. The definition of T1b TNM finding depends on the specific type of cancer that it refers to; for example, for breast cancer it refers to a primary tumor that is more than 0.5 cm, but not more than 1.0 cm in greatest dimension; for kidney cancer it refers to a primary tumor that is more than 4 cm, but not more than 7 cm in greatest dimension; and for thyroid cancer it refers to a primary tumor that is more than 1 cm but not more than 2 cm in greatest dimension.
A general term that refers to a TNM finding of a primary tumor limited to the site of growth. The definition of T1c TNM finding depends on the specific type of cancer that it refers to; for example, for breast cancer it refers to a primary tumor that is more than 1.0 cm, but not more than 2.0 cm in greatest dimension; for uterine corpus cancer it refers to a primary tumor that invades one-half or more of the myometrium; and for melanoma of the iris it refers to a primary tumor limited to the iris with secondary glaucoma.
A general term that refers to a TNM finding of primary tumor growth beyond the level of in situ cancer, minimal subepithelial invasion, or minimal greatest diameter. The definition of T2 TNM finding depends on the specific type of cancer that it refers to; for example, for breast cancer it refers to primary tumor that is more than 2.0 cm, but not more than 5.0 cm in greatest dimension; for cutaneous melanoma it refers to primary tumor that is 1.01 to 2 mm in thickness, with or without ulceration; for colorectal cancer it refers to primary tumor with invasion into the muscularis propria; and for bladder cancer it refers to primary tumor with invasion into the muscle layer.
A general term that refers to a TNM finding of a primary tumor growth beyond the level of in situ cancer, minimal subepithelial invasion, or minimal greatest diameter. The definition of T2a TNM finding depends on the specific type of cancer that it refers to; for example, for kidney cancer it refers to a primary tumor that measures more than 7 cm but less than or equal to 10 cm in greatest dimension, and is limited to the kidney; for bladder cancer it refers to a primary tumor that invades the superficial muscularis propria (inner half); for cervical cancer it refers to a primary tumor that invades beyond the uterus but not to the pelvic wall or to the lower third of vagina and there is no parametrial invasion.
A general term that refers to a TNM finding of a primary tumor growth beyond the level of in situ cancer, minimal subepithelial invasion, or minimal greatest diameter. The definition of T2b TNM finding depends on the specific type of cancer that it refers to; for example, for kidney cancer it refers to a primary tumor that measures more than 10 cm in greatest dimension, and is limited to the kidney; for bladder cancer it refers to a primary tumor that invades the deep muscularis propria (outer half); for cervical cancer it refers to a primary tumor that invades beyond the uterus but not to the pelvic wall or to the lower third of vagina and there is parametrial invasion.
A general term that refers to a TNM finding of a primary tumor growth beyond the level of in situ cancer, minimal subepithelial invasion, or minimal greatest diameter. The definition of T2c TNM finding depends on the specific type of cancer that it refers to; for example, for prostate cancer it refers to a primary tumor that involves both lobes of the prostate gland; for ovarian cancer it refers to a primary tumor that involves one or both ovaries with extension or implants on the uterus and/or fallopian tubes, or other pelvic tissues, with malignant cells in either ascites or peritoneal washings; for fallopian tube cancer it refers to a primary tumor with pelvic extension and malignant cells in ascites or peritoneal washings.
A clinical and/or pathologic primary tumor TNM finding usually indicating that the cancer is locally invasive, without infiltration of adjacent structures.
A general term that refers to a TNM finding of a primary tumor usually indicating that the cancer is locally invasive. The definition of T3a TNM finding depends on the specific type of cancer that it refers to; for example, for kidney cancer it refers to a primary tumor that grossly extends into the renal vein or its segmental (muscle containing) branches or the tumor invades perirenal and/or renal sinus fat but does not extends beyond Gerota's fascia; for cervical cancer it refers to a primary tumor that involves the lower third of vagina, without extension to pelvic wall; for liver cancer it refers to the presence of multiple tumors measuring more than 5 cm in greatest dimension.
A general term that refers to a TNM finding of a primary tumor usually indicating that the cancer is locally invasive. The definition of T3b TNM finding depends on the specific type of cancer that it refers to; for example, for kidney cancer it refers to a primary tumor that grossly extends into the vena cava below the diaphragm; for cervical cancer it refers to a primary tumor that extends to the pelvic wall and/or causes hydronephrosis or nonfunctioning kidney; for liver cancer it refers to a single tumor or multiple tumors of any size involving a major branch of the portal vein or hepatic vein.
A clinical and/or pathologic primary tumor TNM finding indicating direct invasion of adjacent structures by cancer.
Tumor-node-metastasis (TNM) Prostate tumor staging
This gene encodes a tumor suppressor protein containing transcriptional activation, DNA binding, and oligomerization domains. The encoded protein responds to diverse cellular stresses to regulate expression of target genes, thereby inducing cell cycle arrest, apoptosis, senescence, DNA repair, or changes in metabolism. Mutations in this gene are associated with a variety of human cancers, including hereditary cancers such as Li-Fraumeni syndrome. Alternative splicing of this gene and the use of alternate promoters result in multiple transcript variants and isoforms. Additional isoforms have also been shown to result from the use of alternate translation initiation codons from identical transcript variants (PMIDs: 12032546, 20937277). [provided by RefSeq, Dec 2016]
A quantitative measurement of the amount of triglyceride present in a sample.
The protein encoded by this gene belongs to a group of apparently inactive homologs of ubiquitin-conjugating enzymes. The gene product contains a coiled-coil domain that interacts with stathmin, a cytosolic phosphoprotein implicated in tumorigenesis. The protein may play a role in cell growth and differentiation and act as a negative growth regulator. In vitro steady-state expression of this tumor susceptibility gene appears to be important for maintenance of genomic stability and cell cycle regulation. Mutations and alternative splicing in this gene occur in high frequency in breast cancer and suggest that defects occur during breast cancer tumorigenesis and/or progression. [provided by RefSeq, Jul 2008]
Discomfort elicited through touch or pressure.
NCI-GLOSS Definition: A hormone made mainly in the testes (part of the male reproductive system). It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Testosterone may also be made in the laboratory and is used to treat certain medical conditions.
A measure of the variation of the intensity of a surface, quantifying properties such as smoothness, coarseness, regularity, and resiliency. The term is often used as a descriptor for the structure or organization of a tissue or organ. The three principal approaches used to describe texture are statistical, structural and spectral.
There was one question on obstructive voiding symptoms: “Do you have voiding symptoms in terms of weak stream or difficulty emptying the bladder?” The answers were ranked on an ordinal scale from 1 to 3, i.e. 1 = no symptoms, 2 = minor/moderate symptoms and 3 = major/severe symptoms. Data were dichotomized so that men who answered “2” or “3” were regarded as having voiding symptoms while those who answered “1” were regarded as being asymptomatic. Biopsy findings were classified as “cancer” or “benign outcome”.
An action or administration of therapeutic agents to produce an effect that is intended to alter or stop a pathologic process.
Lycopene is a carotenoid that is present in tomatoes, processed tomato products and other fruits. It is one of the most potent antioxidants among dietary carotenoids. Dietary intake of tomatoes and tomato products containing lycopene has been shown to be associated with a decreased risk of chronic diseases, such as cancer and cardiovascular disease.
The value of the sum of the primary and secondary Gleason scores (range 2-10). If three patterns are identified, it is the sum of the primary pattern score and the score of the least well-differentiated pattern.
The total amount of prostate-specific antigen (PSA) in the blood. It includes the amount of free PSA and the amount of PSA attached to other proteins.
A method of ultrasound imaging in which the ultrasound probe is pressed against the skin of the abdomen in order to create an image of the abdominal organs.
Transition Zone Prostate Specific Antigen Density
The ratio of serum PSA to transition zone volume. Takes into account the size of the prostate in determining the significance of an elevated PSA level.
A procedure in which a sample of tissue is removed from the prostate for examination under a microscope. The sample is removed with a thin needle that is inserted through the skin between the scrotum and rectum and into the prostate.
A procedure in which a sample of tissue is removed from the prostate using a thin needle that is inserted through the rectum and into the prostate. Transrectal ultrasound (TRUS) is usually used to guide the needle. The sample is examined under a microscope to see if it contains cancer.
Transrectal ultrasonography guided biopsy
A procedure that uses transrectal ultrasound to image the prostate and guide the placement of a biopsy needles to obtain a tissue sample.
A procedure in which a sample of tissue is removed from the prostate for examination under a microscope. A thin, lighted tube is inserted through the urethra into the prostate, and a small piece of tissue is removed with a cutting loop.
Transurethral Electrovaporization of the Prostate
Application of electrical energy to electrosurgically vaporize or remove the obstructive enlarged prostatic tissue. In electrosurgical vaporization, the electrode rapidly heats the tissue cells so that they turn into steam, leaving a space where the prostate tissue was previously present. (from Columbia University Department of Urology)
Transurethral Microwave Thermotherapy of the Prostate
A procedure for treatment of benign prostatic hypertrophy that uses microwave energy delivered through the urethra to destroy prostate tissue.
Transurethral Needle Ablation of the Prostate
A procedure for treatment of benign prostatic hypertrophy that uses low energy radio frequency energy delivered through the urethra to destroy prostate tissue./NCI-GLOSS Definition: A procedure that is used to treat benign prostatic hypertrophy (BPH). A small probe that gives off low-level radiofrequency energy is inserted through the urethra into the prostate. The energy from the probe heats and destroys the abnormal prostate tissue without damaging the urethra.
Prostate tissue removal via a cystoscope./NCI-GLOSS Definition: Surgery to remove tissue from the prostate using an instrument inserted through the urethra.
Treatment of PSA-only recurrence after treatment with curative intent
"Primary curative procedures such as RP, and RT are well-established therapeutic options in the management of localised PCa. Despite technical improvements, there is still a significant risk of cancer recurrence after therapy. Between 27% and 53% of all patients undergoing RP or RT develop PSA-recurrence. While a rising PSA level universally antedates metastatic progression and prostate-cancer-specific mortality (PCSM), physicians must inform the patient that the natural history of PSA-only recurrence may be prolonged and that a PSA rise is not a surrogate for these survival endpoints. Physicians treating patients with PSA-only recurrence face a difficult set of decisions in attempting to delay the onset of metastatic disease and death while avoiding over-treating patients whose disease may never affect their OS or QoL. It has to be emphasised that the treatment recommendations for these patients should be given after discussion with a multidisciplinary team."
根治性目的治疗后仅限PSA复发的治疗
The timing and mode of treatment for PSA-only recurrences after RP or RT are still controversial.
6-D-Tryptophanluteinizing Hormone-releasing Factor
A synthetic decapeptide agonist analog of luteinizing hormone releasing hormone (LHRH). Possessing greater potency than endogenous LHRH, triptorelin reversibly represses gonadotropin secretion. After chronic, continuous administration, this agent effects sustained decreases in LH and FSH production and testicular and ovarian steroidogenesis. Serum testosterone concentrations may fall to levels typically observed in surgically castrated men. (NCI04)/NCI-GLOSS Definition: A drug that is used to treat advanced prostate cancer, and is being studied in the treatment of breast cancer. It belongs to the family of hormonal drugs called gonadotropin-releasing hormone analogs.
A primary tumor TNM finding indicating that the status of the primary tumor cannot be assessed.
A nitrogenous compound containing a carbonyl group attached to two amine groups with osmotic diuretic activity. In vivo, urea is formed in the liver via the urea cycle from ammonia and is the final end product of protein metabolism. Administration of urea elevates blood plasma osmolality, resulting in enhanced flow of water from tissues, including the brain, cerebrospinal fluid and eye, into interstitial fluid and plasma, thereby decreasing pressure in those tissues and increasing urine outflow.
High frequency sound, generally with a frequency greater than 20,000 Hz.
Ultrasound-guided fine-needle aspiration biopsy
A diagnostic procedure that uses an ultrasound image to guide the placement of a biopsy needle into the prostate to obtain a tissue sample.
A technique in which high-frequency sound waves are bounced off internal organs and the echo pattern is converted into a 2 dimensional picture of the structures beneath the transducer.
2-Dimensional Grayscale Ultrasound Imaging
The invisible ultraviolet spectrum makes up one specific portion of sunlight. This unique portion accounts for three percent of all solar radiation reaching the earth. UV radiation causes many health problems. NCI-GLOSS Definition: Invisible rays that are part of the energy that comes from the sun. Ultraviolet radiation that reaches the Earth's surface is made up of two types of rays, called UVA and UVB. Ultraviolet radiation also comes from sun lamps and tanning beds. It can cause skin damage, premature aging, melanoma, and other types of skin cancer. It can also cause problems with the eyes and the immune system. Skin specialists recommend that people use sunscreens that protect the skin from both kinds of ultraviolet radiation. In medicine, ultraviolet radiation also comes from special lamps or a laser and is used to treat certain skin conditions such as psoriasis, vitiligo, and skin tumors of cutaneous T-cell lymphoma."
An acute and compelling urge to urinate.
Laboratory analysis of urine, commonly used to aid in the diagnosis of disease or to detect the presence of a specific substance. It involves examination of the urine by physical or chemical means as well as microscopic examination that helps to screen for urinary tract infections, renal disease, and diseases of other organs, that result in abnormal metabolites (break-down products) appearing in the urine.
The two main pathways for metabolism of estrogens are 16α-hydroxylation and 2-hydroxylation. The major estrogen metabolites excreted in urine are the parent estrone (E1) and 17β-estradiol (E2), 2-hydroxy products [2-hydroxyesterone (2-OHE1), 2-hydroxyestradiol (2-OHE2), 2-methoxyesterone (2-MeOE1)] and 16α-hydroxy products [estriol (E3) and 16α-hydroxyestrone (16α-OHE1)]
Preparations containing substances with antigenic properties administered to activate the immune system, thereby inducing an immune response./CTEP Definition: A substance or group of substances administered to induce the immune system to recognize and destroy tumors or microorganisms, which can be used for prevention, amelioration, or treatment of diseases./NCI-GLOSS Definition: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. A vaccine can help the body recognize and destroy cancer cells or microorganisms.
Surgical removal of part or all of the vas deferens. NCI-GLOSS Definition: An operation to cut or tie off the two tubes that carry sperm out of the testicles."
Definition: Edible plants from the family Brassicaceae (also called Cruciferae). NCI-GLOSS Definition: A member of the family of vegetables that includes broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, and turnips. These vegetables contain substances that may protect against cancer
A group of organic food substances found in animals and plants in small quantities. They must be supplied in diet or dietary supplement and are essential for normal metabolism. CRCH Definition: A class of micronutrients that regulate and support chemical reactions in the body. NCI-GLOSS Definition: A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body's fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E."
Voiding symptoms are usually due to a blockage at the outlet of base of the bladder, making it more difficult to pass urine. The blockage may be caused by an enlarged prostate gland or scarring of the urethra (the tube that carries the urine). Enlargement of the prostate gland can lead to both storage and voiding symptoms and is a common cause of symptoms in men.
Blood cells that are devoid of hemoglobin, capable of ameboid motion and phagocytosis, and act as the principal components of the immune system.
The ratio of the abdominal circumference at the navel to maximum hip and buttocks circumference; looks at the proportion of fat stored on the body around the waist and hip. Carrying extra weight around the waist is a greater health risk than carrying extra weight around the hips or thighs. CDISC Definition: A relative measurement (ratio) of the waist circumference to the hip circumference."
A synthetic anticoagulant. Warfarin inhibits the regeneration of vitamin K1 epoxide and so the synthesis of vitamin K dependent clotting factors, which include Factors II, VII, IX and X, and the anticoagulant proteins C and S. This inhibition results in a sequential depression of Factors VII, IX, X and II activities. Vitamin K is an essential cofactor for the post ribosomal synthesis of the vitamin K dependent clotting factors. The vitamin promotes the biosynthesis of gamma-carboxyglutamic acid residues in these proteins which are essential for biological activity. NCI-GLOSS Definition: A drug that prevents blood from clotting. It belongs to the family of drugs called anticoagulants (blood thinners)."
Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) How big a problem, if any, has each of the following been for you? Weak urine stream/incomplete bladder emptying.
EPIC-CP - Weak Urine Stream or Incomplete Bladder Emptying
Cronobacter (in TSB), inoculated skim milk (0% fat), low-fat milk (1% and 2% fat) and whole-fat milk (3.5% fat) were treated with 0.0, 0.1, 0.5, 0.75, 1.0, 2.0, 3.0, 4.0, 5.0 and 6.0 kGy X-ray doses
XRCC3 X-ray repair cross complementing 3
This gene encodes a member of the RecA/Rad51-related protein family that participates in homologous recombination to maintain chromosome stability and repair DNA damage. This gene functionally complements Chinese hamster irs1SF, a repair-deficient mutant that exhibits hypersensitivity to a number of different DNA-damaging agents and is chromosomally unstable. A rare microsatellite polymorphism in this gene is associated with cancer in patients of varying radiosensitivity. Alternatively spliced transcript variants encoding the same protein have been identified. [provided by RefSeq, Jul 2008]
This gene encodes a transcription factor with multiple homeodomains and zinc finger motifs, and regulates myogenic and neuronal differentiation. The encoded protein suppresses expression of the alpha-fetoprotein gene by binding to an AT-rich enhancer motif. The protein has also been shown to negatively regulate c-Myb, and transactivate the cell cycle inhibitor cyclin-dependent kinase inhibitor 1A (also known as p21CIP1). This gene is reported to function as a tumor suppressor in several cancers, and sequence variants of this gene are also associated with atrial fibrillation. Multiple transcript variants expressed from alternate promoters and encoding different isoforms have been found for this gene. [provided by RefSeq, Sep 2009]
An element with atomic symbol Zn, atomic number 30, and atomic weight 65.39.
Affecting both sides of the body or a matched pair of organs.
Metastatic Malignant Neoplasm in the Bone
The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas.
Metastatic Malignant Neoplasm to the Bone
This region of the prostate gland that is located between the peripheral and transition zones, surrounding the ejaculatory ducts. It gives rise to a very small percentage of prostate cancers, though these cancers are frequently more aggressive, often resulting in invasion of the seminal vesicles.
A synthetic 4-azasteroid compound. Dutasteride competitively and specifically binds to isoenzymes 1 and 2 of 5 alpha-reductase, forming stable enzyme complexes and inhibiting the conversion of testosterone to 5 alpha-dihydrotestosterone (DHT); the reduction in DHT activity may mitigate or prevent enlargement of the prostate gland. The type 2 5 alpha-reductase isoenzyme is primarily active in the reproductive tissues, while the type 1 isoenzyme is also active in skin and the liver./NCI-GLOSS Definition: A drug used to treat symptoms of an enlarged prostate gland. It is being studied in the treatment of male hair loss and prostate cancer. Avodart blocks enzymes the body needs to make male sex hormones. It is a type of 5-alpha reductase inhibitor.
Situated outside of a capsule, esp. outside the capsular ligament of a joint.
A synthetic 4-azasteroid compound. Finasteride competitively binds to and inhibits steroid type II 5-alpha-reductase in the prostate gland, liver, and skin, thereby interfering with the enzymatic conversion of testosterone to 5-dihydrotestosterone (DHT) and reducing serum DHT levels. The reduction in serum DHT levels results in diminished stimulation of androgen receptors in the nuclei of prostate cells and, so, diminished prostate cell proliferation./NCI-GLOSS Definition: A drug used to reduce the amount of male hormone (testosterone) produced by the body.
6-[O-(1,1-Dimethylethyl)-D-serine]-10-deglycinamide Luteinizing Hormone-Releasing Factor (Pig)
The vertical measurement or distance from the base to the top of an object; the vertical dimension of extension.
iodine-125 in granular form is the radioactive element of reference, while palladium-103 may be used for less differentiated tumours with a high doubling time. The doses delivered to the planning target volume are 144 Gy for iodine-125 and 125 Gy for palladium-103. A Gleason score of 7 is still a ‘grey area’, but patients with a Gleason score of 4 + 3 showed no difference in outcome
Ir-192/Iridium Ir 192/IRIDIUM IR-192/Iridium-192
6-D-Leucine-9-(N-ethyl-L-prolinamide)-1-9-luteinizing Hormone-releasing Factor (Pig)
6-D-Leucine-9-(N-ethyl-L-prolinamide)-10-deglycinamide Luteinizing Hormone-Releasing Factor (Pig)
MEDROXYPROGESTERONE ACETATE/Medroxyprogesterone acetate
A synthetic, acetate derivative of the sex hormone progesterone. Medroxyprogesterone 17-acetate (NCI04)/NCI-GLOSS Definition: A drug used to prevent endometrial cancer. It is also used to treat menstrual disorders and as a form of birth control. It is a form of the female hormone progesterone and belongs to the family of drugs called progestins.
17-Hydroxy-6alpha-methylpregn-4-ene-3,20-dione Acetate
(-2)pro-prostate-specific antigen, human
No morphologic evidence of regional lymph node metastasis by routine histologic staining, in accordance with TNM classification system guidelines.
Prostate Cancer pNX TNM Finding v6 and v7
Prostate cancer in which the regional lymph nodes were not sampled. (from AJCC 6th and 7th Eds.)
A pathologic primary tumor TNM stage finding. The definition of pT2 stage finding depends on the particular type of cancer that it refers to; for example, for breast cancer, pT2 stage finding is defined as follows: cancer with tumor size more than 2.0 cm, but not more than 5.0 cm in greatest dimension; for colorectal cancer, pT2 stage finding is defined as follows: cancer with invasion into the muscularis propria. (from AJCC 6th and 7th Eds.)
A pathologic primary tumor TNM stage finding. The definition of pT2a stage finding depends on the particular type of cancer that it refers to; for example, for prostate cancer, pT2a stage finding is defined as follows: cancer limited to one-half or less of one lobe of the prostate gland; for lung cancer, pT2a stage finding is defined as follows: cancer with a tumor size more than 3 cm but 5 cm or less in greatest dimension. (from AJCC 7th Ed.)
A pathologic primary tumor TNM stage finding. The definition of pT2b stage finding depends on the particular type of cancer that it refers to; for example, for prostate cancer, pT2b stage finding is defined as follows: cancer involving more than one-half of one lobe, but not both lobes of the prostate gland; for lung cancer, pT2b stage finding is defined as follows: cancer with a tumor size more than 5 cm but 7 cm or less in greatest dimension. (from AJCC 7th Ed.)
A pathologic primary tumor TNM stage finding. The definition of pT2c stage finding depends on the particular type of cancer that it refers to; for example, for prostate cancer, pT2c stage finding is defined as follows: cancer involving both lobes of the prostate gland; for fallopian tube cancer, pT2c stage finding is defined as follows: cancer with pelvic extension and malignant cells in ascites or peritoneal washings. (from AJCC 7th Ed.)
A pathologic primary tumor TNM stage finding. The definition of pT3 stage finding depends on the particular type of cancer that it refers to; for example, for breast cancer, pT3 stage finding is defined as follows: cancer with tumor size more than 5.0 cm in greatest dimension; for kidney cancer, pT3 stage finding is defined as follows: cancer with tumor extending into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota's fascia. (from AJCC 7th Ed.)
A pathologic primary tumor TNM stage finding. The definition of pT3a stage finding depends on the particular type of cancer that it refers to; for example, for cervical cancer, pT3a stage finding is defined as follows: cancer involves lower third of vagina, without extension to pelvic wall; for kidney cancer, pT3a stage finding is defined as follows: cancer with tumor grossly extending into the renal vein or its segmental (muscle containing) branches or tumor invading perirenal and/or renal sinus fat but not beyond Gerota's fascia. (from AJCC 7th Ed.)
A pathologic primary tumor TNM stage finding. The definition of pT3b stage finding depends on the particular type of cancer that it refers to; for example, for cervical cancer, pT3b stage finding is defined as follows:cancer extends to pelvic wall and/or causes hydronephrosis or nonfunctioning kidney; for kidney cancer, pT3b stage finding is defined as follows: cancer with tumor grossly extending into the vena cava below the diaphragm. (from AJCC 7th Ed.)
A pathologic primary tumor TNM stage finding. The definition of pT4 stage finding depends on the particular type of cancer that it refers to; for example, for breast cancer, pT4 stage finding is defined as follows: cancer with tumor of any size with direct extension to chest wall or skin, but only as described in pT4 sub-categories, in accordance with TNM guidelines; for cervical cancer, pT4 stage finding is defined as follows: cancer invades mucosa of bladder or rectum, and/or extends beyond true pelvis (bullous edema is not sufficient to classify a tumor as T4). (from AJCC 7th Ed.)
A radioisotope of the metal palladium used in brachytherapy implants or 'seed'. With a half-life of 17 days, palladium 103 administered with brachytherapy allows continuous, tumor-site specific low-energy irradiation to the tumor cell population while sparing normal adjacent tissues from radiotoxicity. (NCI04)/NCI-GLOSS Definition: A radioactive form of palladium (a metallic element that resembles platinum). When used to treat prostate cancer, radioactive seeds (small pellets that contain radioactive palladium) are placed in the prostate. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.
The region of the prostate that is located most superficial and posterior as compared to the other prostate zones. It is located closest to the rectum, and is easily palpated on digital rectal exam. This zone of the prostate surrounds the distal urethra, and is the zone of origin for the vast majority of prostatic cancers.
The volume of the prostate can be estimated by the formula 0.52 × length × width × height. A volume of over 30 cm3 is regarded as prostatomegaly (enlarged prostate).
Metastatic tumour of unspecified origin in the lung.
The zone of the prostatic parenchyma that surrounds the proximal urethra.
Transitional Zone of the Prostatic Parenchyma
Positron Emission Tomography and Computed Tomography Scan
正电子发射断层扫描（PET）和计算机断层扫描（CT）
Positron Emission Tomography/Computed Tomography
A technique for measuring the gamma radiation produced by collisions of electrons and positrons (anti-electrons) within living tissue. In positron emission tomography (PET), a subject is given a dose of a positron-emitting radionuclide attached to a metabolically active substance (for example, 2-fluoro-2-deoxy-D-glucose (FDG), which is similar to a naturally occurring sugar, glucose, with the addition of a radioactive fluorine atom). When living tissue containing the positron emitter is bombarded by electrons, gamma radiation produced by collisions of electrons and positrons is detected by a scanner, revealing in fine detail the tissue location of the metabolically-active substance administered./CDISC Definition: An imaging technique for measuring the gamma radiation produced by collisions of electrons and positrons (anti-electrons) within living tissue. In positron emission tomography (PET), a subject is given a dose of a positron-emitting radionuclide attached to a metabolically active substance. A scanner reveals the tissue location of the metabolically-active substance administered./NCI-GLOSS Definition: A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.//A method of examining structures within the body by scanning them with X rays and using a computer to construct a series of cross-sectional scans along a single axis./NCI-GLOSS Definition: A series of detailed pictures of areas inside the body; the pictures are created by a computer linked to an x-ray machine./CDISC Definition: An imaging technique for examining structures within the body by scanning them with X rays and using a computer to construct a series of cross-sectional scans along a single axis.
A prostate biopsy collection protocol that consists of sextant cores plus 6 lateral peripheral zone cores.
A proprietary blood test for prostate cancer screening that measures four kallikrein markers (total, free, and intact prostate-specific antigen, and human kallikrein-related peptidase 2 [hK2]).
Treatment with a 5a-reductase inhibitor with the goal of suppressing the conversion of testosterone to dihydrotestosterone.
A prostate biopsy collection protocol that consists of sextant cores plus 2 lateral peripheral zone cores.
Prostate carcinoma that grows and continues to spread despite the surgical removal of the testes or medical intervention to block androgen production.
Metastatic Castration-Resistant Prostate Carcinoma
Bilateral orchiectomy, either total or subcapsular pulpectomy, is a simple, cheap and virtually complication-free surgical procedure. It is easily performed under local anaesthesia and is the quickest way to achieve a castration level, usually within less than 12 hours. It is irreversible and does not allow for intermittent treatment.
There are conflicting results from the many studies comparing CAB with monotherapy. The largest RCT in 1,286 M1b patients found no difference between surgical castration plus flutamide compared to surgical castration without flutamide. Systematic reviews have shown that CAB using non-steroidal anti-androgen (NSAA) appears to provide a small survival advantage (< 5%) vs. monotherapy (surgical castration or LHRH agonists) beyond 5 years. However, some of the larger trials included in these reviews were methodologically flawed and it is unlikely that this small advantage, if any, is useful in daily clinical practice. LHRH analogues and NSAA have the highest estimated quality-adjusted survival. However, the use of CAB increases side effects and the economic cost. There is an incremental cost of more than US$1 million per quality-adjusted life-year vs. orchiectomy alone.
A method of examining structures within the body by scanning them with X rays and using a computer to construct a series of cross-sectional scans along a single axis.
Cryosurgical ablation of the prostate (CSAP)
Chloro-6-hydroxy-17 Alpha Methylene-1 Alpha, 2 Alpha Pregnadiene-4,6 Dione-3, 20 Acetate
3'H-Cyclopropa(1,2)pregna-1,4,6-triene-3,20-dione, 17-(Acetyloxy)-6-chloro-1,2-dihydro-, (1beta,2beta)-
The acetate salt of a synthetic steroidal antiandrogen with weak progestational and antineoplastic activities. Cyproterone binds the androgen receptor (AR), thereby preventing androgen-induced receptor activation in target tissues and inhibiting the growth of testosterone-sensitive tumor cells. This agent also exerts progestational agonist properties at the level of the pituitary that reduce luteinizing hormone (LH), resulting in reductions in testicular androgen secretion and serum testosterone levels. Treatment with cyproterone alone results in incomplete suppression of serum testosterone levels./NCI-GLOSS Definition: A synthetic hormone being studied for treatment of hot flashes in men with prostate cancer who have had both testicles removed by surgery.
6-Chloro-1b,2b-dihydro-17a-hydroxy-3'H-cyclopropa[1,2]pregna-1,4,6-triene-3,20-dione Acetat Andro-Diane
Early studies by the Veterans Administration (VACURG) tested oral Diesthylstilboesterol (DES) at 5 mg/day. This dosage was associated with high cardiovascular morbidity and mortality, which was secondary to first-pass hepatic metabolism and the formation of thrombogenic metabolites. Lower doses of 1 mg/day and 3 mg/day were found to be as effective as bilateral orchiectomy, with still more side effects compared to castration.
A physical examination in which the qualified health care worker inserts a lubricated, gloved finger of one hand into the RECTUM and may use the other hand to press on the lower ABDOMEN or pelvic area to palpate for abnormalities in the lower rectum, and nearby organs or tissues. The method is commonly used to check the lower rectum, the PROSTATE gland in men, and the UTERUS and OVARIES in women.
Emission computed tomography (ECT) is a type of tomography involving radioactive emissions.
Evaluation of life expectancy, comorbidity and health status
In localised disease, > 10 years life expectancy is considered mandatory for any benefit from local treatment. Life expectancy varies within each age group. This can be explained by comorbidity, which is more important than age in predicting death in localised PCa. Besides comorbidities, dependence in daily activities, malnutrition and cognitive impairment are associated with worse survival.
Extented pelvic lymph node dissection (eLND)
Basic Behavioral Studies in Cancer-Related Behaviors
Basic behavioral studies designed to strengthen the understanding of the determinants and processes that influence cancer-related risk behaviors.
High-intensity focused ultrasound of the prostate (HIFU)
HIFU consists of focused ultrasound waves, emitted from a transducer, that cause tissue damage by mechanical and thermal effects as well as by cavitation. The goal of HIFU is to heat malignant tissues above 65°C so that they are destroyed by coagulative necrosis.HIFU is performed under general or spinal anaesthesia, with the patient lying in the lateral position.
Radiation treatment in which the total dose of radiation is divided into large doses and treatments are given less than once a day.
A procedure that uses a computer to create a picture of a tumor to help guide the radiation beam during radiation therapy. The pictures are made using CT, ultrasound, X-ray, or other imaging techniques. Image-guided radiation therapy makes radiation therapy more accurate and causes less damage to healthy tissue.
An advanced form of 3-Dimensional Conformal Radiation Therapy (3D CRT) that involves the use of varying intensities of small radiation beams to produce dosage distributions that are more precise than those possible with 3D CRT./CDISC Definition: An advanced form of 3-Dimensional Conformal Radiation Therapy (3D CRT) that involves the use of varying intensities of small radiation beams to produce dosage distributions that are more precise than those possible with 3D CRT. (NCI)/NCI-GLOSS Definition: A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor.
Intermittent versus continuous androgen deprivation therapy (IAD)
Long-term castration stimulates prostate cell apoptosis. After an average period of 24 months, the tumour relapses, characterised by a castrate-independent state of growth. Experimental data indicate that castrateindependent progression may begin early after castration, coinciding with the cessation of androgen-induced differentiation of stem cells. It has been suggested that stopping castration prior to progression would mean that any subsequent tumour growth would be solely sustained by the proliferation of androgendependent stem cells. The stem cells should therefore be susceptible once again to androgen withdrawal. Thus, IAD could delay the emergence of the androgen-independent clone. This rationale has been developed mainly through models (e.g. the Shionoggi breast model), which may be significantly different to tumour behaviour in men. Other possible benefits of IAD include the preservation of QoL in off-treatment periods and a reduction in treatment cost. IAD is feasible and accepted by patients. Two independent reviews summarised the clinical efficacy of this attitude. They were based on seven RCTs. Of the seven trials, only three trials were in patients with M1 disease. The three remaining trials were combinations of different relapse situations, mainly locally advanced and metastatic cases. The design of the seven trials is summarised in Table 6.6.1, while the main results for survival are summarised in Table 6.6.2. The most important survival finding was the lack of a significant difference in OS between continuous and intermittent ADT. Table 6.6.3 summarises the expected treatment benefits of IAD. The most important finding was that the benefit in overall QoL was at best minimal if any. However, some treatment side effects were decreased using IAD.
Lower urinary tract symptoms (LUTS) include voiding or obstructive symptoms such as hesitancy, poor and/or intermittent stream, straining, prolonged micturition, feeling of incomplete bladder emptying, dribbling, etc, and storage or irritative symptoms such as frequency, urgency, urge incontinence, and nocturia.
Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance
Imaging that uses radiofrequency waves and a strong magnetic field rather than x-rays to provide amazingly clear and detailed pictures of internal organs and tissues. The technique is valuable for the diagnosis of many pathologic conditions, including cancer, heart and vascular disease, stroke, and joint and musculoskeletal disorders.
Detection and measurement of the resonant spectra of molecular species in a tissue or sample.
Spectroscopy, Nuclear Magnetic Resonance
Multiparametric magnetic resonance imaging
The combination of multiple magnetic resonance techniques, including diffusion weighted imaging, dynamic contrast-enhanced imaging, and spectroscopy, to achieve an image that will allow for better identification of tumor size and location, as well as possibly identifying cancer spread and aggressiveness.
New compounds (for the castrate resistant status only)
During castration, the occurrence of castration-resistant status (CRPC) is systematic. It is thought that it is mediated through two main overlapping mechanisms, which are androgen-receptor (AR)-independent and AR-dependent (see Section 6.11 - Castrate-resistant Prostate Cancer). In CRPC, the intracellular androgen level is increased compared to androgen sensitive cells, and an over-expression of the AR has been observed in CRPC, suggesting an adaptative mechanism. This has led to the development of two new major compounds targeting the androgen axis: abiraterone acetate and enzalutamide.
Non-steroidal anti-androgen (NSAA) monotherapy
A systematic review has been published comparing non-steroidal antiandrogen monotherapy to castration (either medical or surgical) by the Cochrane group. The key message is that use of non-steroidal antiandrogen monotherapy compared with medical or surgical castration monotherapy for advanced PCa is less effective in terms of OS, clinical progression, treatment failure and treatment discontinuation due to adverse events. The evidence quality was rated as moderate.
The scientific study of an organism's vital functions, including growth and development, the absorption and processing of nutrients, the synthesis and distribution of proteins and other organic molecules, and the functioning of different tissues, organs, and other anatomic structures. Physiology studies the normal mechanical, physical, and biochemical processes of animals and plants.
Prostate cancer antigen 3 (~4 kb) is encoded by the human PCA3 gene. This non-coding RNA may be involved in prostate carcinoma.
An assay system that indirectly measures the amount of three forms of prostate-specific antigen (PSA) in a patient serum sample and then uses those values to calculate a score that estimates the patient's probability of having prostate cancer. The PSA forms that are examined are total PSA, free PSA, and an isoform of PSA that has a propeptide comprised of two amino acid residues ([-2]proPSA).
Treatment of a disease by means of exposure of the target or the whole body to radiation. Radiation therapy is often used as part of curative therapy and occasionally as a component of palliative treatment for cancer. Other uses include total body irradiation prior to transplantation./CDISC Definition: Treatment of a disease by means of exposure of the target or the whole body to radiation./NCI-GLOSS Definition: The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body.
Salvage High-intensity focused ultrasound (HIFU)
Salvage radical prostatectomy after RT has the longest history and best likelihood of local control relative to other salvage treatments. However, this must be weighed against the possible adverse events, which are increased compared to primary surgery because of the risk of fibrosis and poor wound healing due to radiation.
Smoke from burning tobacco(cigarettes,cigars,or pipes)and exhaled by a smoker. Tobacco smoke contains nicotine, a stimulant, and other biologically active chemicals having carcinogenic properties.
Testosterone-lowering therapy (castration)
Therapeutic role of extended lymph node dissection (eLND)
Three-dimensional conformal radiotherapy (3D-CRT)
Anatomical data is acquired by scanning the patient in a treatment position. The data are transferred to the three-dimensional (3D) treatment planning system, which visualises the clinical target volume and then adds a surrounding safety margin. Real-time verification of the irradiation field using portal imaging allows comparison of the treated and simulated fields, and correction of deviations where displacement is more than 5 mm. Threedimensional|CRT improves local control through dose escalation, without significantly increasing the risk of morbidity.
A procedure that uses sound waves to create a video image of the pelvic organs and tissues. A small, lubricated probe placed into the rectum releases sound waves, which create echoes as they enter a pelvic organ. The echoes that bounce back are sent to a computer that translates the pattern of echoes into a picture of the specific organ under examination. This procedure is most often used to evaluate the prostate gland.
Whole-body and axial magnetic resonance imaging (MRI)
Diffusion-weighted whole-body MRI and the so-called axial MRI (evaluation of the spine and the pelvi-femoral area only) are more sensitive than bone scan and targeted radiographs and seem equally effective as 11C-Choline PET/CT in detecting bone metastases in patients with high-risk PCa. Their sensitivity for lymph node metastases remains low, even if it is slightly higher than that of 11C-Choline PET/CT in high-risk patients. However, little is known regarding the accuracy of whole-body or axial MRI in patients with biochemical failure after RP or radiation therapy. Therefore, the role of these techniques in detecting occult bone or lymph node metastases in the case of biochemical failure remains to be assessed.