Showing papers on "Cancer published in 1981"

Mutation and Cancer: A Model for Human Carcinogenesis

Abstract: A model for carcinogenesis is presented that provides a framework for understanding the roles of "spontaneous" events, hereditary factors, and environmental agents in human carcinogenesis and for interpreting experimental carcinogenesis. This model incorporates two features: a) transition of target stem cells into cancer cells via an intermediate stage in two irreversible steps, and b) growth and differentiation of normal target and intermediate cells. Cast in mathematical terms, the model can be fitted to age-specific incidence data on human cancers of both children and adults and can illuminate the relative importance of agents that affect transition rates, tissue growth, and tissue differentiation. This is illustrated by application of the model to a) the epidemiology of lung cancer with emphasis on the role of cigarette smoking and b) the epidemiology of breast cancer with emphasis on the roles of hormones, radiation, and hereditary. The nature of the two events and of the intermediate stage is considered in light of hereditary conditions that predispose to cancer in humans. The modes of action of radiation and chemicals in carcinogenesis are discussed, as are predictions based on the model and amenable to experimental verification.

The anthracycline antineoplastic drugs.

Abstract: PERHAPS no family of chemotherapeutic agents has been so rapidly accepted as a major therapeutic tool in treating patients with cancer as have the anthracyclines. Since the first clinical trials of...

Clinical Gynecologic Oncology

Abstract: Dedications Contributors Preface Acknowledgements 1. Preinvasive Disease of the Cervix, William T. Creasman 2. Preinvasive Disease of the Vagina and Vulva and Related Disorders, William T. Creasman 3. Invasive Cervical Cancer, Bradley J. Monk and Krishnansu S. Tewaria 4. Endometrial Hyperplasia, Estrogen Therapy, and the Prevention of Endometrial Cancer, Joan L. Walker and Rosemary E. Zuna 5. Adenocarcinoma of the Uterus, William T. Creasman 6. Sarcoma of the Uterus, D. Scott McMeekin 7. Gestational Trophoblastic Disease, John Soper and William T. Creasman 8. Invasive Cancer of the Vulva, Frederick B. Stehman 9. Invasive Cancer of the Vagina and Urethra, Brian M. Slomovitz and Robert L. Coleman 10. The Adnexal Mass and Early Ovarian Cancer, Philip J. DiSaia 11. Epithelial Ovarian Cancer, Larry J. Copeland 12. Germ Cell, Stromal, and Other Ovarian Tumors, Michael A. Bidus, Christopher M. Zahn and G. Scott Rose 13. Fallopian Tube Cancer, Jan S. Sunde, Keith J. Kaplan and G. Scott Rose 14. Breast Diseases, James V. Fiorica 15. Colorectal and Bladder Cancer, Philip J. DiSaia 16. Cancer in Pregnancy, Krishnansu S. Tewari 17. Complications of Disease and Therapy, Daniel L. Clarke-Pearson 18. Basic Principles of Chemotherapy, Christina S. Chu and Stephen C. Rubin 19. Tumor Immunology, Host Defense Mechanisms, and Biologic Therapy, Philip J. DiSaia 20. Genes and Cancer, David G. Mutch and Philip J. DiSaia 21. Palliative Care and Quality of Life, Bradley J. Monk and Lari Wenzel 22. Role of Laparoscopic Surgery in Gynecologic Malignancies, Robert S.Mannel 23. Epidemiology of Commonly Used Statistical Terms, and Analysis of Clinical Studies, Wendy R. Brewster APPENDICES A. Staging, William T. Creasman B. Modified from Common Terminology Criteria for Adverse Events (CTCAE), Philip J. DiSaia C. Blood Component Therapy, Philip J. DiSaia D. Suggested Recommendations for Routine Cancer Screening, William T. Creasman E. Nutritional Therapy, Philip J. DiSaia F. Basic Principles in Gynecologic Radiotherapy, Catheryn M. Yashar Index

Accuracy of cancer death certificates and its effect on cancer mortality statistics.

Abstract: A study to determine the accuracy of cancer mortality data was done using cancer deaths occurring during 1970 and 1971 in eight of the nine areas included in the Third National Cancer Survey (TNCS). Death certificates with an underlying cause of death of cancer were compared to the hospital diagnosis for 48,826 resident cases of single primary cancers. The underlying cause of death as coded on the death certificate was found to be accurate for about 65 per cent of the cancer deaths in this study. Misclassification problems occurred for colorectal cancer, the second leading cause of death from cancer. Colon cancer was overreported and rectal cancer was under-reported on death certificates. Other misclassification problems were found for cancers of the uterus, brain, and buccal cavity including most of its sub-sites. Physicians tended to report a non-specific site of cancer on the death certificate rather than the specific site identified by the hospital diagnosis.

Lung cancer and passive smoking.

Abstract: Fifty-one women with lung cancer and 163 other hospital patients were interviewed regarding the smoking habits of themselves and their husbands. Forty of the lung cancer cases and 149 of the other patients were non-smokers. Among the non-smoking women there was a statistically significant difference between the cancer cases and the other patients with respect to their husbands' smoking habits. Estimates of the relative risk of lung cancer associated with having a husband who smokes were 2.4 for a smoker of less than one pack and 3.4 for women whose husbands smoked more than one pack of cigarettes per day. The limitations of the data are examined; it is evident that further investigation of this issue is warranted.

Testicular Cancer as a Model for a Curable Neoplasm: The Richard and Hinda Rosenthal Foundation Award Lecture

Abstract: The combination of platinum, vinblastine, and bleomycin was first used at Indiana University in 1974. Thirty of 47 patients (64%) survived for 5 years, and 27 (57%) are currently disease free (NED) and cured of their neoplasm. From 1976 to 1978, 78 consecutive patients were entered on a random prospective study that indicated that equal therapeutic results could be achieved with a lower dosage (0.3 mg/kg) of vinblastine. Fifty-two (67%) patients are continuously NED, and 57 (73%) are currently NED for 2 or more years. Our third-generation study, done in conjunction with the Southeastern Cancer Study Group, tested the hypothesis of whether maintenance vinblastine was necessary to ensure optimal cure rates in disseminated testicular cancer. One hundred thirteen patients entered this maintenance study, and the results demonstrated that cure in a far-advanced cancer could be achieved with only 12 weeks of therapy (remission induction) because the relapse rate in such patients was only 7%. The cure rate for patients presenting with locoregional disease (Stages A and B) should approach 100%. Platinum, vinblastine, and bleomycin will regularly produce a 70% complete remission rate, and a further 10% of patients will be rendered NED with surgical resection of residual disease. The relapse rate with four courses of remission induction therapy in a large cooperative group study (Southeastern Cancer Study Group) was only 7%. The high success rate in disseminated disease has allowed the option of high cure rate in Stage B disease (positive retroperitoneal nodes) with or without adjuvant chemotherapy. At Indiana University, 137 patients have been followed with Stage A and B nonseminomatous testicular cancer from 1973 to 1979 with a minimum follow-up of 2 years, and currently 135 are alive and well. Successful treatment strategies in testicular cancer have yielded a cure rate unparalleled in cancer treatment.

Prostate antigen: A new potential marker for prostatic cancer

Abstract: A prostate-specific antigen, distinct from acid phosphatase, was identified by immunologic procedures in prostate tissues (normal, benign hypertrophic, and cancerous) and seminal plasma, as well as in sera of patients with prostatic cancer and of nude mice bearing human prostatic tumor. This antigen was shown by immunoperoxidase staining to be confined to epithelial cells comprising the prostatic ductal elements. Prostate antigen was purified from prostatic tissue and seminal plasma, and it was shown to have a molecular weight of 33,000-34,000 with no subunit component. The isoelectric point of purified antigen was around 6.9, though several unpurified isomers with different isoelectric points also were observed. Serum-borne prostate antigen showed a molecular weight of 90,000-100,000 but it exhibited a molecular weight of 36,000 in the presence of sodium dodecyl sulfate. A sandwich-type, peroxidase-linked immunosorbent assay capable of detecting 0.1 ng of the antigen per milliliter of blood was developed. With this technique, serum level of the antigen was found to increase in patients with prostatic cancer as compared with normal males. The prostate-specific antigen can be a useful marker for detection of prostatic cancer.

Psychological depression and 17-year risk of death from cancer.

Abstract: Psychological depression, measured in 1957-1958 by the Minnesota Multiphasic Personality Inventory at the baseline examination of 2,020 middle-aged employed men, was associated (p less than 0.001) with a twofold increase in odds of death from cancer during 17 years of follow-up. The association did not vary appreciably in magnitude among the early (1958-1962), middle (1963-1968), and later (1969-1974) years of follow-up, persisted after adjustment for age, cigarette smoking, use of alcohol, family history of cancer, and occupational status, and was apparently not specific to any particular site or type of cancer. This result, predicted in advance on the basis of findings by other investigators, is consistent with the hypothesis that psychological depression is related to impairment of mechanisms for preventing the establishment and spread of malignant cells.

Efforts to explain spontaneous regression of cancer

Abstract: After a study of the 176 cases (Everson and Cole) of spontaneous regression of cancer and recent progress in immunology, the author is convinced stimulation of the immune process is the most important factor in S.R. of cancer. Stimulating factors are numerous including bacterial products, enzymes, infections, hormones, trauma, etc. Of the 176 cases reported by Everson and Cole, 71 (40%) were associated with some type of operative trauma. Since the effective anticancer agent interferon is an important protective agent (especially antiviral) in the human body, this product could readily play an important role. Immunoglobulins appear to be possible factors. The blocking and unblocking agents of the Hellstroms and associates support this supposition. Elimination of carcinogens appears important, considering the remarkable disappearance of cancer of the bladder in 12 of 13 patients having diversion of the urine from the bladder to the colon by transplantation of the ureters from the bladder to the colon. Innumerable antigens unknown to us at the present time could act as stimulants to our immune system, and thus cause regression of cancer. Hormonal factors must obviously be considered, but the author is doubtful that they exert an important role.

Cancer Incidence by Levels of Cholesterol

Abstract: In 5,209 subjects studied for 24 years in Framingham, Mass, 691 cases of cancer were documented, with histological confirmation for 94%. Predetermined personal characteristics were tested for associations with subsequent occurrence of cancer at specific sites using multiple logistic regression. Significant associations of various cancer sites with cigarette smoking, alcohol use, education, height, weight, and parity agreed with other studies. Serum cholesterol level was inversely associated with incidence of colon cancer and with other sites only in men; these inverse associations were statistically significant after adjustment for age, alcohol consumption, cigarette smoking, education, systolic blood pressure, and relative weight. Associations may reflect effects of competing lethal diseases, underlying pathophysiological mechanisms that promote or inhibit development of cancer in men, biologic or social response to early and undiagnosed states of cancer. ( JAMA 1981;245:247-252)

A comparison of cancer risk in crohn's disease and ulcerative colitis

Abstract: The authors estimated cancer risk among 589 patients hospitalized with Crohn's disease between 1960-1976 by calculating the ratios of observed number of cancers (O) in our hospital sample to the expected number of cancers (E) based on the age- and sex-specific cancer rates of a standard population. The authors then compared these O/E ratios with the O/E ratios similarly calculated among 267 patients hospitalized with ulcerative colitis. The risk of colorectal cancer was significantly increased in Crohn's disease (O/E = 6.9, P less than 0.001). This increase was similar in magnitude to that found in left-sided ulcerative colitis (O/E = 8.6, P less than 0.001) but was much less than that found in universal ulcerative colitis (O/E = 26.5, P less than 0.001). The incidence of small bowel cancer was greatly increased in the combined group of regional enteritis and ileocolitis (O/E = 85.8, P less than 0.001), and even more so in the regional enteritis group alone (O/E = 114.5, P less than 0.001). The incidence of extraintestinal cancer did not increase in any of the patient groups.

Time Trends in Lung Cancer Mortality Among Nonsmokers and a Note on Passive Smoking

Abstract: Lung cancer mortality rates were computed for nonsmokers in the American Cancer Society's prospective study for three 4-year periods from 1960 to 1972 and in the Dorn study of veterans for three 5-year periods from 1954 to 1969. There was no evidence of any trend in these rates by 5-year age groups or for the total groups. No time trend was observed in nonsmokers for cancers of other selected sites except for a decrease in cancer of the uterus. Compared to nonsmoking women married to nonsmoking husbands, nonsmokers married to smoking husbands showed very little, if any, increased risk of lung cancer.

Immunologic mechanisms in UV-radiation carcinogenesis

Abstract: Publisher Summary The chapter presents the new or altered antigens on cancer cells, tests of cancer induction and cancer antigenicity in immunosuppressed hosts, and an examination of the immunosuppressive potency of various carcinogens. These approaches have led to the conclusion that, in cancers associated with oncogenic viruses, the immune system can play a decisive role in both cancer development and subsequent growth. The immune response is intimately involved in cancer development in the case of UV carcinogenesis because of the peculiar immunologic consequences of UV exposure and the unusual antigenic characteristics of the resulting tumors. If the only measure of antigenicity available is the immune response induced by the tumor in its primary host, then one would conclude incorrectly that the tumors were not antigenic. The responses of the primary host can be used to define antigenicity. This tumor system provides an illustration of the fact that the primary host is not necessarily equivalent to the normal recipient of a transplanted syngeneic tumor. The immunologic studies of UV carcinogenesis demonstrate that the regulatory pathways described for exogenous antigens also control the immune response against tumor-specific transplantation antigens (TSTA), even in the autochthonous host. An antigenicity is dictated in some orderly way by the carcinogen the UV tumor system has provided with a unique opportunity to explore many facets of the complex relationship between a developing cancer and the host immune system. It is clear, at least in this system of highly antigenic tumors, that host immunologic factors are as important in cancer pathogenesis as the initial transforming events. The unusual combination of carcinogenic and immunologic changes mediated by UV radiation has permitted to observe the extent to that carcinogen-induced tumors can be antigenic and an illustration of the capability of normal immunologic mechanisms to eliminate highly antigenic syngeneic and autochthonous tumors.

Pituitary metastasis: Incidence in cancer patients and clinical differentiation from pituitary adenorna

Abstract: Symptomatic pituitary metastases are uncommon and may be difficult to differentiate from pituitary adenomas. In order to ascertain the incidence of pituitary tumors in cancer patients and to characterize the clinical presentation of pituitary metastases, we reviewed the clinical experience with these tumors at Memorial Sloan-Kettering Cancer Center (MSKCC) during the period 1976-1979 and a recent series of 500 consecutive autopsies in which the pituitary fossa and gland were examined. In the clinical series, a histologic diagnosis was made in three of five patients. Radiologic evaluation, including polytomography and computed tomography, did not reliably distinguish metastasis from adenoma, but the clinical syndromes were distinctive. In the autopsy series, pituitary metastases were found in 3.6% of cases, pituitary adenomas in 1.8%.

Depressed immunity and the development of cancer.

Abstract: Various disorders of immune competence are associated with increases in uncommon tumors, particularly non-Hodgkin's lymphomas (NHLs), which often exhibit unusual features: they are frequently extranodal, show a broad spectrum of lesions, ranging from benign polyclonal hyperplasia to frankly malignant monoclonal lymphomas, and are frequently localized to the brain. Of 7136 tumors in organ transplant recipients, the predominant lesions are NHLs, carcinomas of the skin and lips, carcinomas of the vulva/perineum, Kaposi's sarcoma (KS), and renal carcinomas. Skin cancers present unusual features: predominance of squamous cell carcinomas, young age of the patients, and a high incidence of multiple tumors. Cancers of the vulva/perineum occur at a much younger age than in the general population. In AIDS patients the most common malignancy is KS, which occurs in 14%, whereas NHLs afflict 2.9%. A variety of other tumors occur in these patients. The most common tumors in patients with primary immunodeficiency states are NHLs (49%), leukemias (13%), various carcinomas (9%), and Hodgkin's disease (7%).

An epidemiologic study of epithelial carcinoma of the ovary

Abstract: A case-control study to identify risk factors for epithelial ovarian cancer was undertaken among women ages 45-74 who had been admitted to 7 hospitals in Connecticut between July 1977-March 1979. Characteristics which were found to increase the risk of epithelial ovarian cancer included being white never having been pregnant having menopause occur at a late age a family history of ovarian or endometrial cancer and ovulating for a long period of years. Prior use of postmenopausal estrogens did not alter the risk for epithelial ovarian cancer but there was some indication that oral contraceptives protect against ovarian cancer. Women with ovarian cancer were somewhat more likely to have had a history of an underactive thyroid and were somewhat less likely to have had a history of overactive thyroid than controls although these trends were not statistically significant. (authors)

The Cancer Family Syndrome Rare Cutaneous Phenotypic Linkage of Torre's Syndrome

Abstract: • Sebaceous neoplasia have been observed in members of four families exhibiting the cancer family syndrome (CFS). This disorder is characterized by adenocarcinomas, particularly involving the (proximal) colon, endometrium, and ovary; an excess of multiple primary cancer; early age of cancer onset; and autosomal dominant pattern of inheritance. Multiple adenomatous polyps are lacking in this disorder. In four patients from three of these cancer-prone kindreds, cutaneous lesions were accompanied by multiple visceral adenocarcinomas, fulfilling the criteria for Torre's syndrome, a disease that heretofore has not shown notable familial clustering characteristic of the CFS. Therefore, the coexistence of rare sebaceous neoplasia and visceral cancer in CFS supports the notion that some cases of Torre's syndrome may in fact represent the more full phenotypic expression of the gene responsible for the CFS. (Arch Intern Med1981;141:607-611)

Natural history of adrenal cortical carcinoma: A clinicopathologic study of 42 patients

Abstract: To study the biologic behavior and natural history of this rare but challenging tumor faced by oncologists, a clinicopathologic study of 42 patients with histologically proven adrenal cortical carcinoma from Roswell Park Memorial Institute (1929--1977) was done. These constituted .04% of all cancer cases and 0.2% of all autopsy cases. Age range was 3--74 years with median of 53 years; female to male ratio was 1.5 to 1. Clinical manifestations were: abdominal mass (36%), metastatic disease (30%), hormonal excess (17%) and weakness with lethargy (17%). Nine of ten functioning tumors were seen in female patients. Tumors arose in left adrenal in 26 patients, right adrenal in 12, and in four the site could not be determined because of bilateral presence of cancer. Median duration of symptoms was six months. At diagnosis, 52% had distant metastases, 41% had locally advanced tumor and 7% had tumor confined to adrenal. Sixteen patients underwent "curative" resection. Tumor diameter ranged from 1--30 cm with median of 10 cm. Of 28 patients who received different chemotherapeutic regimens, three (11%) had objective response; four of ten patients had objective response to radiation therapy. Overall median and five-year survival rates were 14 months and 24%. Prolonged survival (P less than .05) was noted in women, patients who had "curative" resection, a disease-free interval of more than 12 months, and tumor size greater than 10 cm diameter. Patients with functional tumors had longer median survival than those with non-functional ones (28 vs. 12), but P value was greater than .05. A second primary cancer was noted in 22.4% of cases, breast and lymphoma being the most common. At autopsy in 31 patients, the most common metastatic sites were retroperitoneal lymph nodes 68%, lung 71%, liver 42%, and bone 26%. To improve survival, an aggressive surgical approach is recommended to extirpate the tumor with involved organs and retroperitoneal lymph nodes. Adrenal carcinoma should be suspected in patients with metastatic cancer with an occult primary.

Nutrient intakes in relation to cancer incidence in Hawaii.

Abstract: A representative sample of 4657 adults greater than or equal to 45 years of age from the 5 main ethnic groups in Hawaii (Caucasians, Japanese, Chinese, Filipinos and Hawaiians) were interviewed during 1977-1979 regarding their diets. Quantitative food-consumption histories were obtained, from which average daily intakes of fat (saturated, unsaturated, cholesterol, meat, dairy, fish, animal, vegetable and total), protein (animal, meat, fish, dairy and total), carbohydrate, and vitamins A and C (including supplements) were calculated using food-consumption data from standard sources. Multiple regression analysis, with sex as a controlled variable, was used to assess the statistical relationship between these ethnic-sex-specific intakes and corresponding population-based cancer incidence rates of 15 selected sites for which nutrient components are suspected to be either causal or protective. Based on pre-set criteria for establishing important relationships, significant positive associations were found for 6 of the cancer sites: breast cancer with fat (saturated, unsaturated, animal, total) and protein (animal), corpus-uteri cancer with the same components as breast cancer, prostate cancer with fat (saturated, animal) and protein (animal, total), stomach cancer with fat (fish only) and protein (fish only), lung cancer with cholesterol, and laryngeal cancer with cholesterol. Breast and corpus-uteri cancers also showed significant negative associations with carbohydrate intake. The implications of these findings for future research are discussed.

Epidemiological Correlations between Diet and Cancer Frequency

Abstract: The literature concerning international correlations between dietary items and cancer frequency is reviewed. An updated correlation of the most recent data on cancer mortality and food consumption is made. Strong and consistent correlations are reported between death rates of cancers of the colon and breast and the per capita consumption of total fat and of nutrients derived from animal sources, especially beef, pork, eggs, and milk. Similar but less consistent correlations have been reported with cancers of the prostate, ovary, and endometrium. In addition, correlations between precursor lesions of coronary heart disease and colon cancer in New Orleans autopsy populations are reported. Some studies suggest that milk intake correlates better with atherosclerotic disease while beef intake correlates better with colon cancer. Negative correlations of colon cancer rates and vegetable consumption are reported. Colon cancer rates also show negative correlations with stool weight, irrespective of the type of vegetable responsible for the increased bulk. Epidemiological data are consistent with the hypothesis that excessive beef and low vegetable consumption are causally related to colon cancer. These food items probably do not have a direct carcinogenic role but rather provide a microenvironment favorable to the actions of carcinogens.

The role of maintenance therapy in disseminated testicular cancer: A Southeastern cancer study group (SECSG) protocol

Abstract: We concluded a prospective study of the value of maintenance therapy in disseminated testicular cancer after chemotherapy-induced complete remission or chemotherapy cytoreduction followed by surgical resection of residual teratoma. A group of 171 patients were randomized to treatment consisting of cisplatin, vinblastine, and bleomycin, or these drugs plus doxorubicin. There was no apparent difference between these two induction regimens. Complete remission was achieved in 113 patients (66 per cent), and 19 (11 per cent) were free of disease by surgical resection of residual tumor. Of the 171 who started, 113 were eligible to receive either maintenance doses of vinblastine (58 patients) or no further therapy (55 patients) after remission-induction therapy. There was a 9 per cent relapse rate during maintenance with vinblastine and a 7 per cent relapse rate with no maintenance therapy; the overall relapse rate was 8 per cent (nine of 113). Our data indicate that maintenance therapy is unnecessary in disseminated testicular cancer.

Fundamentals of oncology

Abstract: the hypothalamic-pituitary hormones and the gonadal steroids in both men and women. The remainder of the book describes the classification, investigation and treatment of functional infertility. Inexperienced readers may not realise that the classifications given are not in universal use and that the account of anovulatory infertility is incomplete the polycystic ovary syndrome is not mentioned and there is no discussion of weight-related amenorrhoea. Relatively little space is given to hyper-prolactinaemia and its management with bromocriptine and disproportionately much to the use ofhuman menopausal gonadotrophins. Admittedly, the latter presents more difficulties in practice but the former is necessary more often. Only those involved in research will be interested in the effects of compounds such as RO 8347 and Epimestrol. The section on male infertility is valuable and suggests that the logical investigation of male infertility is becoming possible. In fact, this book is not meant to be a comprehensive textbook but an account of the views and work of a team of distinguished Israeli gynaecological endocrinologists. As such it is of interest to all who work in the same field.

Effect of Warfarin on Survival in Small Cell Carcinoma of the Lung: Veterans Administration Study No. 75

Abstract: In a controlled, randomized study, survival of patients with small cell carcinoma of the lung (SCCL) was prolonged on addition of warfarin sodium to combination chemotherapy plus radiation therapy. Median survival for 25 control patients was 24 weeks and for 25 warfarin-treated patients was 50 weeks. This difference could not be accounted for by differences between groups in performance status, extent of disease, age, or sex. The survival advantage associated with warfarin administration was observed both for patients with extensive disease and for those who failed to achieve complete or partial remission. The warfarin-treated group also demonstrated a significantly increased time to first evidence of disease progression. These results suggest that warfarin may be useful in the treatment of SCCL and also support the hypothesis that the blood coagulation mechanism may be involved in the growth and spread of cancer in man. ( JAMA 1981;245:831-835)

Use of human prostate-specific antigen in monitoring prostate cancer.

Abstract: The newly reported human prostate-specific antigen (PA) is a specific histiotypic product of human prostate. With the use of a sensitive enzyme immunoassay, the circulating PA in prostatic cancer patients has been evaluated clinically. In 96 patients with advanced stage of disease (D2) and receiving chemotherapies, the pretreatment serum PA levels were found to be of prognostic value with regard to the patient survival. Ten patients with metastatic prostate cancer were monitored for more than 32 weeks by 183 serial PA values and were found generally to respond to the treatment. Additionally, in another group of 32 patients who underwent curative therapies for localized prostate cancer, 161 serum samples were evaluated during periods of 12 to 114 weeks (average 56 weeks). Of these patients, five developed metastases during follow-up, and all were shown to exhibit increasingly elevated PA values, either corresponding to or prceding the clinical diagnosis of disease recurrence. These results suggest that PA is a new marker with potential value to merit further clinical study.