Serum prostate-specific antigen

BARNES s (2001) The effect of isolated soy protein on plasma biomarkers in elderly men with elevated serum prostate specific antigen. J Urol. 165 (1) 294-300. 

Serum prostate specific antigen (PSA) will be increased. 

NCCLS Document 1/L A 19-A. Primary reference preparations used to standardize calibration of immunochemical assays for serum prostate-specific antigen (PSA) Approved Guideline. NCCLS, Villanova, PA National Committee for Clinical Laboratory Standards (1996). 

Oesterling, J. E., Jacobson, S. J., Chute, C. G., et al. Serum prostate specific antigen in a commonly-based population of healthy men. Establishment of age-specific reference ranges. JAMA 270,860-864 (1993). 

Roehrbom, C. G Gregory, A., McConnell, J. D., et al. Comparison of three assays for total serum prostate-specific antigen and percentage of free prostate-specific antigen in predicting prostate histology. J. Urol. 48,23-32 (1996). 

Numberless phytotherapeutic preparations for the treatment of BPH are on the market. However, the active ingredients and the mode of action remain unknown for most of them. Serenoa repens (also known as saw palmetto from the American dwarf palm) has been investigated in a number of scientific experiments and in chnical trials. It has been proposed that it inhibits the 5aR-2. Since Serenoa repens has no effect on serum prostate-specific antigen (PSA) levels, the mode of action might certainly differ from the mode of action of finasteride or dutasteride [129]. 

The effect of adding finasteride 5 mg/day to high-dose bicalutamide 150 mg/ day has been studied in 41 men with advanced prostate cancer treated over a mean of 3.9 years (21). The serum prostate-specific antigen (PSA) concentration was measured every 2 weeks until disease progression. At the first nadir of PSA, the median fall from baseline was 96.5% a second nadir occurred in 30 of 41 patients, with a median fall of 98.5% from baseline. The median times to each nadir were 3.7 and 5.8 weeks respectively. The median time to treatment failure was 21 months. Adverse effects were minor, including gynecomastia. Sex drive was normal in 17 of 29 men at baseline and in 12 of 24 men at the second PSA nadir, but one-third of the men had spontaneous erections at both times. The authors concluded that finasteride provided additional intracellular androgen blockade when added to bicalutamide. The duration of control was comparable to that achieved with castration, with preserved sexual function in some patients. 

In an open comparative study of androgenetic alopecia in 90 men oral finasteride (1 mg/day for 12 months n = 65) was compared with 5% topical minoxidil solution twice daily (n = 25) (22). The cure rates were 80% for oral finasteride and 52% for topical minoxidil. The adverse effects were all mild, and did not lead to withdrawal of treatment. Of the 65 men given oral finasteride, six had loss of libido, and one had an increase in body hair at other sites irritation of the scalp was seen in one of those who used minoxidil. These adverse events disappeared as soon as the treatment was withdrawn. The laboratory data did not show any statistically or clinically significant changes from baseline values to the endpoint, except for the serum total testosterone concentration, which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were reduced from baseline values. 

Finasteride reduces serum prostate-specific antigen concentrations (60). In participants in the Prostate Cancer Prevention Trial who had an end of study biopsy (928... 

Christensson A, Bjork T, Nilsson O, et al. Serum prostate specific antigen complexed to alpha 1-antichymotrypsin as an indicator of prostate cancer. J Urol 1993 150 100-105. 

Fig. 5. Four-year incidences of AUR and/or BPH-related surgery in patients treated with placebo or finasteride, stratified in tertiles by baseline serum prostate-specific antigen (PSA) level and baseline prostate volume. (From Roehrborn et al., 1999b.)...

Prostate Volume and Serum Prostate-Specific Antigen Predictors of Responsiveness to 5a-Reductase Inhibitors in Men with Benign Prostatic Hyperplasia... 

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

Marberger MJ, Andersen JT, Nickel JC, et al. Prostate volume and serum prostate specific antigen as predictors of acute urinary retention. Combined experience from three large multicenter national placebo-controlled trials. Eur Urol 2000 38 563-568. 

Roehrborn CG, McConnell J, Bonilla J, et al. Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia—Proscar long term efficacy and safety study. J Urol 2000 163 13-20. 

Pannek J, Marks LS, Pearson JD, et al. Influence of finasteride on free and total serum prostate specific antigen levels in men with benign prostatic hyperplasia. J Urol 1998 159 449 53. 

For the man with symptomatic hypogonadism (decreased libido, energy loss, and erectile dysfunction), a normal prostate examination, and a normal serum prostate-specific antigen, testosterone can be considered as adjunctive therapy. Testosterone patches (2.5-5 mg daily), intramuscular injections (10 to 400 mg every 2 to 4 weeks), 1% topical gel, pellet implants (150 50 mg every 3-6 months), and a buccal formulation are available (see Table 88-6). Testosterone replacement increases bone density in men. The benefits of therapy need to be... 

Shen S, Lepor H, Yaffee R, Taneja SS. Ultrasensitive serum prostate specific antigen nadir accurately predicts the risk of early relapse after radical prostatectomy. J Urol. 2005 173 777. 

Jenkins, D.J.A. C.W.C. Kendall M.A. D Costa C.-J. Jackson E. Vidgen W. Singer J.A. Silver-man G. Koumbridis J. Honey A.V. Rao, et al. Soy consumption and phytoestrogens Effect on serum prostate specific antigen when blood lipids and oxidized low-density lipoprotein are reduced in hyperlipidemic men./. Urol 2003, 169, 507-511. 

Proscar decreases serum prostate-specific antigen (PSA) levels. The client should have a PSA level drawn before beginning Proscar and a level drawn after 6 months. If the PSA level does not drop, the client should be assessed for cancer of the prostate. 

Urban, D., Irwin, W., Kirk, M., Markiewicz, M.A., Myers, R., Smith, M., Weiss, H., Grizzle, W.E., and Barnes, S. 2001. The effect of isolated soy protein on plasma biomarkers in elderly men with elevated serum prostate specific antigen. J. Urol. 165, 294—300. 

In the first phase I study, ten patients with recurrent prostate cancer underwent hyperthermia sessions alone, whereas in the second phase I trial eight patients also with recurrent prostate cancer were treated combining hyperthermia and low dose brachytherapy. Intraprostatic median temperatures measured in 90% of the cases (T90) were 40.1 °C for hyperthermia alone and 39.9 °C for the combined study. Differences between the planned and actual spatial distribution of the nanoparticles after injection were reported for those patients previously irradiated patients. Regarding adverse side effects, there is a temporal impairing of patients quality of life and local discomfort has been observed for field intensities over 4-5 kAm The potential efficacy of the proposed therapy was based on the decrease of the serum prostate-specific antigen in both groups of patients. 

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