Carcinoma of the prostate

Tartrate is a most widely used inhibitor of prostatic acid phenylphosphatase activity. With this inhibitor Bonner and associates detected five cases of unsuspected carcinoma of the prostate in 221 hospital patients and clarified the diagnoses in another four patients (98). Nonetheless, the diagnostic specificity of an elevated 1-tartrate inhibited activity is not absolute, as Fishman et. al found it elevated in 48 of 1,190 males without cancer. Whitmore and associates also observed this activity to be elevated in 3 of 20 patients with uncomplicated nodular hyperplasia (102). Hill compared the total versus the "prostatic" serum activities in 20 patients with localized untreated carcinoma of the prostate and observed... 

Gutman, A. B. and Gutman, . B. An "acid" phosphatase occurring in the serum of patients with metastasizing carcinoma of the prostate gland. J. Clin. Invest. (1938), 17, 473-478. 

A 75-year-old male, postprostatectomy for carcinoma of the prostate with local metastasis found during surgery would best be treated with which of the following ... 

Prostatic carcinoma Examine patients prior to starting therapy with alfuzosin to rule out the presence of carcinoma of the prostate. 

Fosfestrol is indicated in the treatment of carcinoma of the prostate. It is a synthetic non-steroidal estrogen which is dephosphorylated to stilboestrol. Polyestradiol phosphate is an oestrogen with sustained activity that is exclusively used for prostate cancer. It is stored in tissues and slowly dephosphorylated to estrogen. 

GnRH analogues (see Chapter 59) can induce chemical castration by suppressing the pulsatile release of LH and FSH, hence inhibiting testicular steroidogenesis. Administration of these compounds reduces circulating testosterone levels. These compounds are inhaled, injected subcutaneously, or implanted subcutaneously. They are used in males in the treatment of precocious puberty and carcinoma of the prostate. 

Indications Palliative treatment of advanced carcinoma of the prostate and in combination with flutamide for the management of locally confined Stage T2b-T4 (Stage B2-C) carcinoma of the prostate, and the management of endometriosis. Zoladex is also used as an endometrial-thinning agent... 

Palliative treatment of advanced carcinoma of the prostate, advanced breast cancer, and management of endometriosis... 

Androgens should not be administered to male patients with carcinoma of the prostate or breast. Until more is known about the effects of these hormones on the central nervous system in developing children, they should be avoided in infants and young children. 

Profound hypocalcemia occurred in a patient with osteoblastic metastatic carcinoma of the prostate after treatment with diethylstilbestrol 15 mg/day for 7 days (SED-12,1032) (4). 

Diethylstilbestrol can cause hepatic adenomas and carcinomas in experimental animals (10), and hepatocellular carcinoma has been reported in a man who took a total of 668 g over 12 years for suspected carcinoma of the prostate (11). 

Harley HA, Mason R, Phillips PJ. Profound hypocalcaemia associated with oestrogen treatment of carcinoma of the prostate. Med J Aust 1983 2(l) 41-2. 

Mesenteric venous thrombosis has been reported in men taking estrogen therapy for carcinoma of the prostate (SED-12,1032) (44). 

When megestrol acetate was used alongside diethylstil-bestrol or ethinylestradiol in men with previously untreated metastatic carcinoma of the prostate, there was a high incidence of feminizing adverse effects (70-74%), no doubt attributable to the estrogens a higher than expected rate of cardiovascular complications (18%) and an unexplained need for cortisone replacement (13%) were also observed (12). 

Crombie C, Raghavan D, Page J, Woods R, Dailey D, Devine R, Rosen M. Phase II study of megestrol acetate for metastatic carcinoma of the prostate. Br J Urol 1987 59(5) 443-6. 

A 65-year-old man, with metastatic carcinoma of the prostate was treated with flutamide 250 mg/day orally followed after 6 days by 7.5mg leuprolide intramuscularly. Two days later he developed bleeding and hematomas. His hemoglobin fell from 12.4 to 7.8 g/dl and he had a disseminated intravascular coagulopathy. 

Morsi A, Jamal S, Silverberg JD. Pituitary apoplexy after leuprolide administration for carcinoma of the prostate. Clin Endocrinol (Oxf) 1996 44(1) 121 1. 

Bern MM. Coagulopathy, following medical therapy, for carcinoma of the prostate. Haematology 2005 10(l) 65-8. 

Mitoxantrone Novantrone Carcinoma of the prostate acute nonlymphocytic leukemia Cough, shortness of breath leukopenia or infection stomatitis/mucositis Gl problems [stomach pain, nausea, vomiting, diarrhea, Gl bleeding]... 

Decensi AU, Boccardo F, Guameri D, Positano N, Paoletti MC, Costantini M, Martorana G, Giuliani L (1991) Monotherapy with nilutamide, a pure nonsteroidal antiandrogen, in untreated patients with metastatic carcinoma of the prostate. The Italian Prostatic Cancer Project. J Urol 146 377-381... 

Airhart RA, Barnett TF, Sullivan JW, Levine RL, Schlegel JU (1978) Flutamide therapy for carcinoma of the prostate. South Med J 71 798-801... 

Zoladex implants are indicated for use in the palliative treatment of advanced breast cancer in pre- and peri-menopausal women, in the palliative treatment of advanced carcinoma of the prostate and in the management of endometriosis, including pain relief and the reduction of endometriotic lesions. The implant is fabricated by dispersing goserelin in a PLGA matrix and molding it into a cylindrical shape, which can be injected subcutaneously. 

H21. Huggins, C., and Hodges, C. V., Studies on prostate cancer. 1. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res. 1, 293-297 (1941). 

K27. Kumar, V. L., Wadhwa, S. N., Kumar, V., and Farooq, A., Androgen, estrogen, and progesterone receptor content and serum hormone profiles in patients with benign hypertrophy and carcinoma of the prostate. J. Surg. Oncol. 44, 122-128 (1990). 

V4. Van Laar, J. H., Berrevoets, C. A., Trapman, J., Zegers, N. D., and Brinkmann, A. O., Hormone-dependent androgen receptor phosphorylation is accompanied by receptor transformation in human lymph node carcinoma of the prostate cells. J. Biol. Chem. 266, 3734-3738 (1991). 

Carcinoma of the prostate is today one of the three most frequent causes of death from neoplastic disease in men in the United States (G4). The early studies of Gutman and his associates (Gil, G12, R6, S30) established that serum acid phosphatase activity was elevated very frequently in patients with metastatic carcinoma of the prostate. It is of interest to consider briefly the uncertainties inherent in the development of this relationship. Skeletal metastases, if sufficiently large, are of course detectable by roentgenographic examination, but smaller ones may not be, and metastases to soft tissues may likewise be undetectable. For example, in 15 cases of metastazing carcinoma reported by Gutman... 

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