Journal ArticleDOI
Prevention of the Transient Adverse Effects of a Gonadotropin-Releasing Hormone Analogue (Buserelin) in Metastatic Prostatic Carcinoma by Administration of an Antiandrogen (Nilutamide)
J.M. Kuhn,T. Billebaud,H. Navratil,A. Moulonguet,J. Fiet,P. Grise,J.F. Louis,P. Costa,J M Husson,R. Dahan +9 more
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TLDR
It is concluded that nilutamide can prevent the adverse consequences of the buserelin-induced transient rise in plasma testosterone levels in men with advanced prostate cancer treated with a GnRH analogue.Abstract:
Gonadotropin-releasing hormone (GnRH) analogues administered for the treatment of advanced prostatic cancer induce a transient increase in plasma testosterone levels during the first week of treatment, often with a secondary rise in plasma levels of prostatic acid phosphatase and a flareup of disease. To determine whether the antiandrogen nilutamide (Anandron) blocks these effects, we carried out a multicenter, placebo-controlled study of nilutamide in men with prostatic cancer treated with the GnRH analogue buserelin. Thirty-six men with disseminated prostatic cancer and elevated plasma levels of prostatic acid phosphatase were randomly assigned to two groups. Group 1 included 17 men who received buserelin (500 micrograms daily subcutaneously) and nilutamide (300 mg daily by mouth); group 2 included 19 men treated with buserelin and placebo. Symptoms were assessed, and plasma was collected before treatment, daily for 14 days, and on days 18, 22, and 29 after the initiation of treatment. Bone pain appeared or worsened in 5 of the 17 men in group 1 and in 12 of the 19 men in group 2 (P less than 0.05). Acute urinary obstruction occurred in one man in group 2. Despite similar changes in the plasma testosterone levels in both groups, the median concentration of plasma prostatic acid phosphatase decreased almost immediately in group 1, but increased transiently, then decreased on day 14 in group 2. Median levels of prostate-specific antigen decreased immediately in group 1 and decreased on day 8 in group 2. We conclude that nilutamide can prevent the adverse consequences of the buserelin-induced transient rise in plasma testosterone levels in men with advanced prostate cancer treated with a GnRH analogue.read more
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Journal ArticleDOI
EAU guidelines on prostate cancer. Part II: Treatment of advanced, relapsing, and castration-resistant prostate cancer ☆
Nicolas Mottet,Joaquim Bellmunt,Michel Bolla,Steven Joniau,Malcolm David Mason,Vsevolod Matveev,Hans-Peter Schmid,Theo van der Kwast,Thomas Wiegel,Filiberto Zattoni,Axel Heidenreich +10 more
TL;DR: A summary of the 2010 version of the EAU guidelines on the treatment of advanced, relapsing, and castration-resistant prostate cancer (CRPC) summarise the most recent findings and put them into clinical practice.
Guidelines on Prostate Cancer
Axel Heidenreich,Joaquim Bellmunt,Michel Bolla,Steven Joniau,Vsevolod Matveev,N. Mottet,Thomas Wiegel,Filiberto Zattoni +7 more
TL;DR: The introduction of an effective blood test, prostate specific antigen (PSA), has made it possible to diagnose more and more men in an earlier stage where they can be offered potentially curative treatments, and this is the subject of the EAU guidelines on prostate cancer.
Journal ArticleDOI
Androgen Deprivation Therapy for Prostate Cancer
TL;DR: Androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease and the benefits of ADT in other settings need to be weighed carefully against substantial risks and adverse effects on quality of life.
Journal ArticleDOI
Bilateral orchiectomy with or without flutamide for metastatic prostate cancer
Mario A. Eisenberger,Brent A. Blumenstein,E. David Crawford,Gary J. Miller,David G. McLeod,Patrick J. Loehrer,George Wilding,Kathy Sears,Daniel J. Culkin,Ian M. Thompson,Anton J. Bueschen,Bruce A. Lowe +11 more
TL;DR: The addition of flutamide to bilateral orchiectomy does not result in a clinically meaningful improvement in survival among patients with metastatic prostate cancer.
Journal ArticleDOI
Carcinoma of the Prostate
TL;DR: Important questions remain about the cause and prevention of prostatic cancer, but new advances permit earlier diagnosis and more accurate staging, and curative therapy is possible for localized disease with much less morbidity than previously.
References
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Journal ArticleDOI
Prostate-Specific Antigen as a Serum Marker for Adenocarcinoma of the Prostate
TL;DR: PSA is more sensitive than PAP in the detection of prostatic cancer and will probably be more useful in monitoring responses and recurrence after therapy, however, since both PSA and PAP may be elevated in benign prostatic hyperplasia, neither marker is specific.
Journal ArticleDOI
Prostate-Specific Antigen as a Serum Marker for Adenocarcinoma of the Prostate
TL;DR: PSA is more sensitive than PAP in the detection of prostatic cancer and will probably be more useful in monitoring responses and recurrence after therapy, however, since both PSA and PAP may be elevated in benign prostatic hyperplasia, neither marker is specific.
Journal ArticleDOI
New approach in the treatment of prostate cancer: Complete instead of partial withdrawal of androgens
Fernand Labrie,André Dupont,A. Bélanger,Y. Lacoursière,Jean-Pierre Raynaud,J.M. Husson,J. Gareau,Atilla T.A. Fazekas,J. Sandow,G. Monfette,J. G. Girard,Emond J,J. G. Houle +12 more
TL;DR: The present data show that complete withdrawal of androgens by combined hormonal therapy with the LHRH agonist (or castration) and a pure antiandrogen leads to a positive objective response in more than 95% of cases as opposed to 60%‐70% as reported by many groups using the previous partial hormonal therapy.
Journal ArticleDOI
Treatment of prostatic cancer with a gonadotropin-releasing hormone agonist analog: acute and long term effects on endocrine functions of testis tissue.
TL;DR: The elevation in serum PAP at the beginning of the agonist treatment and the small residual testicular T production after 6 months may not be clinically important, however, they indicate the necessity of comparative long term studies between orchiectomy and GnRH agonists in the treatment of patients with prostatic cancer.
Journal ArticleDOI
Importance of early tumour exacerbation in patients treated with long acting analogues of gonadotrophin releasing hormone for advanced prostatic cancer.
Jonathan Waxman,A. Man,William F. Hendry,H. N. Whitfield,G. M. Besser,R. C. Tiptaft,A. M. I. Paris,R. T. D. Oliver +7 more
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