Prostate cancer values

Scardino PT, Shinohara K, Wheeler TM, Carter SS (1989) Staging of prostate cancer. Value of ultrasonography. Urol Clin N Am 16 713-734... 

Babson proposed a-naphthyl phosphate as an essentially specific substrate for the activity of prostatic acid phosphatase in serum (104). However Marshall, Price, and Amador found that this substrate is not specific for the prostatic enzyme because urine of human females contain 50 times more acid a-naphthyl phosphatase than male serum and 50% as much activity as male urine. Platelets have significant activity and the serum activity can increase to abnormal values following clotting. These workers also observed elevated activities in females with skeletal metastases of the breast. In 50 hospitalized male patients who had no evidence of prostatic cancer and 25 hospitalized female patients, the incidence of false positive results was 12%, a magnitude sufficient to preclude meaningful clinical interpretation (105). 

Ultrasensitive assays for PSA contribute to the earlier detection of prostate cancer relapse and (or) residual disease in prostatectomized patients as well as the more timely evaluation of response to current therapies. PSA determinations can be useful in detecting metastatic or persistent disease in patients following surgical or medical treatment of prostate cancer. Persistent elevation of PSA following treatment, or an increase in the pretreatment PSA concentrations, is indicative of recurrent or residual disease. Hence, PSA is widely accepted as an aid in the management of prostate cancer patients, and serum levels are most useful when sequential values are obtained and monitored over time. After complete removal of the prostate gland (radical prostatectomy), PSA levels should become very low or undetectable. A rise of the serum PSA level in prostatectomy patients indicates residual prostate tissue, recurrence, or metastasis of the disease (13, 16, 24, 36). 

An important qualification must be made. While a biomarker may be of proven value in establishing whether a drug has the desired effect in patients or healthy volunteers (see Section 4.6.3) and for evaluation of the dose-response relationship, a biomarker may not be a surrogate for the clinical endpoint. Thus, suppression of testosterone after an initial rise will give an almost immediate endpoint for the effect of GnRH analogues in prostate cancer but the relationship breaks down later in the disease. Measures of blood glucose control are vital... 

Megestrol acetate has also proved of value in patients with metastatic prostatic cancer, epithelial ovarian cancer, or malignant melanoma and is therefore used in both sexes. The adverse effects are very similar in men to those seen with oncological doses in women loss of libido and potency is likely to occur in male patients. In one clinical study of 43 men with recurrent and metastatic cancer of the prostate given megestrol acetate 160 mg/ day orally, five developed a symptomatic rise in liver... 

In recent RT-PCR studies, many kallikreins have been proposed as new biomarkers for malignancies other than prostate cancer. Breast, ovarian, and testicular cancers are the most studied. Certain kallikreins were found to be differentially expressed in various malignancies (up- or downregulated), and the increase or decrease of their expression may be associated with prognosis [43, 58, 70, 89-94]. We have immunohistochemically evaluated some kallikreins in malignant diseases, including two series of prostate and renal cell carcinoma, and have examined their prognostic values [84, 85]. 

Prognostic Value of Kallikrein Genes/Proteins in Prostate Cancer... 

Bennett and Le Vier reported that 23 also increases the dopamine content of the brain thus it has possible use in the treatment of Parkinson s syndrome (79). Because of its effect in decreasing the size of the prostate gland, the compound also may have value in the treatment of prostate cancer (80). 

Effect on the Predictive Value of Serum Prostate-Specific Antigen in the Early Detection of Prostate Cancer in Men with Benign Prostatic Elyperplasia... 

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