DOCSLIB.ORG

NCCN Guidelines for Patients Early Stage Prostate Cancer

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
NCCN Guidelines for Patients Early Stage Prostate Cancer our Pleaseonline surveycomplete at NCCN.org/patients/survey NCCN GUIDELINES FOR PATIENTS® 2020 Prostate Cancer Early Stage Presented with support from: Available online at NCCN.org/patients Ü Prostate Cancer It's easy to get lost in the cancer world Let Ü NCCN Guidelines for Patients® be your guide 9 Step-by-step guides to the cancer care options likely to have the best results 9 Based on treatment guidelines used by health care providers worldwide 9 Designed to help you discuss cancer treatment with your doctors NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 1 About NCCN Guidelines for Patients® are developed by the National Comprehensive Cancer Network® (NCCN®) NCCN Clinical Practice NCCN Guidelines NCCN Ü Ü Guidelines in Oncology for Patients (NCCN Guidelines®) 9 An alliance of leading 9 Developed by doctors from 9 Present information from the cancer centers across the NCCN cancer centers using NCCN Guidelines in an easy- United States devoted to the latest research and years to-learn format patient care, research, and of experience 9 For people with cancer and education 9 For providers of cancer care those who support them all over the world Cancer centers 9 Explain the cancer care that are part of NCCN: 9 Expert recommendations for options likely to have the NCCN.org/cancercenters cancer screening, diagnosis, best results and treatment Free online at Free online at NCCN.org/patientguidelines NCCN.org/guidelines and supported by funding from NCCN Foundation® These NCCN Guidelines for Patients are based on the NCCN Guidelines® for Prostate Cancer (Version 2.2020, May 21, 2020). © 2020 National Comprehensive Cancer Network, Inc. All rights reserved. NCCN Foundation seeks to support the millions of patients and their families NCCN Guidelines for Patients and illustrations herein may not be reproduced in affected by a cancer diagnosis by funding and distributing NCCN Guidelines for any form for any purpose without the express written permission of NCCN. No Patients. NCCN Foundation is also committed to advancing cancer treatment one, including doctors or patients, may use the NCCN Guidelines for Patients for by funding the nation’s promising doctors at the center of innovation in cancer any commercial purpose and may not claim, represent, or imply that the NCCN research. For more details and the full library of patient and caregiver resources, Guidelines for Patients that have been modified in any manner are derived visit NCCN.org/patients. from, based on, related to, or arise out of the NCCN Guidelines for Patients. The NCCN Guidelines are a work in progress that may be redefined as often National Comprehensive Cancer Network (NCCN) / NCCN Foundation as new significant data become available. NCCN makes no warranties of any 3025 Chemical Road, Suite 100 kind whatsoever regarding its content, use, or application and disclaims any Plymouth Meeting, PA 19462 responsibility for its application or use in any way. 215.690.0300 NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 2 Supporters Endorsed by California Prostate Cancer Coalition Prostate Cancer Foundation (CPCC) The Prostate Cancer Foundation is the world’s leading CPCC is pleased to endorse this important resource. philanthropic organization dedicated to funding We believe it to be the most understandable and life-saving cancer research. The NCCN Patient comprehensive guide for men diagnosed with Guidelines Prostate Cancer Early Stage outlines prostate cancer who want to really understand what essential information about diagnosis and treatment in the disease is about and what their specific treatment a comprehensible format. They serve as a foundation options are. prostatecalif.org of knowledge as patients and families begin to discuss treatment options with their health care provider. Malecare Cancer Support pcf.org Malecare Cancer Support group members know that nothing is more perplexing than prostate Urology Care Foundation cancer treatment choice making. The NCCN Patient The Urology Care Foundation is the world’s leading Guidelines provide an excellent starting point for nonprofit urological health foundation – and the discussion, particularly for African Americans who die official foundation of the American Urological from prostate cancer at twice the rate as Caucasian Association. As an organization that strongly believes men. malecare.org in providing prostate cancer patients, caregivers, and those impacted by this disease the educational tools National Alliance of State Prostate Cancer and resources necessary to make informed care and treatment decisions, we are pleased to endorse the Coalitions (NASPCC) NCCN Guidelines for Patients. urologyhealth.org NASPCC strongly endorses the NCCN Guidelines for Patients Prostate Cancer Early Stage, as an invaluable resource for patients and others. It is Veterans Prostate Cancer Awareness a reliable wealth of important information about Veterans Prostate Cancer Awareness commends the prostate cancer in an understandable format. National Comprehensive Cancer Network (NCCN) for naspcc.org developing the Patient Guidelines for use as the standard in education and awareness for prostate cancer patients and providers. On behalf of all Veterans, VPCa thanks National Prostate Cancer Awareness NCCN for providing this valuable tool to use as guidance Foundation (PCaAware) on the journey through prostate cancer. vetsprostate.org A wonderful resource for patients seeking a better and clearer understanding of the journey that lies ahead. pcaaware.org ZERO – The End of Prostate Cancer Every 16 minutes a man loses his battle with prostate cancer. As the leading national prostate cancer advocacy organization, ZERO is proud to support NCCN Guidelines for Patients, a premiere resource to help patients and families navigate their prostate cancer journey. Additional free resources and support programs for the prostate cancer community can be found at zerocancer.org With generous support from Marianne and Donald Green Francine Parnes NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 3 NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 4 Prostate Cancer Contents 6 Prostate cancer basics 10 Prostate cancer tests 17 Prostate cancer staging 26 Planning your treatment 31 Prostate cancer treatment 44 Initial treatment by risk group 61 Making treatment decisions 71 Words to know 74 NCCN Contributors 75 NCCN Cancer Centers 76 Index NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 5 1 Prostate cancer basics 7 The prostate 8 Facts about prostate cancer 8 How prostate cancer spreads 9 Review NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 6 1 Prostate cancer basics The prostate The prostate is a gland located below The prostate is found below the bladder near the bladder. In early prostate cancer, the base of the penis and in front of the rectum. cancer is found in the prostate and may The prostate can be felt during a rectal exam. be in nearby lymph nodes. This chapter As a man ages, the prostate tends to grow presents an overview of prostate cancer. larger. The prostate surrounds the urethra. The urethra is a tube that carries urine from the bladder and The prostate out of the body. Above the prostate and behind the bladder are two seminal vesicles. Seminal vesicles are also glands that make a fluid that is The prostate is a walnut-sized gland. A gland part of semen. Semen leaves the body through is an organ that makes fluids or chemicals the the urethra. body needs. The prostate gland produces a white-colored fluid that is part of semen. Semen is made up of sperm from the testicles and fluid from the prostate and other sex glands. During ejaculation, semen is released from the body through the penis. The prostate The prostate gland is located below the bladder. NCCN Guidelines for Patients®: Early-Stage Prostate Cancer, 2020 7 1 Prostate cancer basics Facts about prostate cancer Facts about prostate cancer How prostate cancer spreads A risk factor is anything that increases your Cancer is a disease that starts in the cells of chance of cancer. your body. Prostate cancer starts in the cells of the prostate gland. Almost all prostate cancers A few facts: are adenocarcinomas. An adenocarcinoma is cancer in the cells that secrete fluids or other All men are at risk for prostate cancer. substances. Adenocarcinomas of the prostate are the focus of this book. 1 out of 9 men will develop prostate cancer. Unlike normal cells, cancer cells can grow or Not all men diagnosed with prostate spread to form tumors in other parts of the cancer need treatment. Usually prostate body. cancer grows slowly and stays in the prostate. Cancer that has spread is called a metastasis. Age is the most common risk factor. The Cancer that is contained entirely within older a man is, the greater the chance of the prostate is called localized prostate getting prostate cancer. cancer. Cancer that has spread from the prostate African-American men gland to nearby lymph nodes, but no All men are at risk for prostate cancer, but further, is called regional prostate cancer. African-American men are more likely to get prostate cancer and at a younger age. Cancer Cancer that has spread beyond the in African-American men tends to be more prostate or regional lymph nodes is called aggressive and more advanced. However, once distant metastasis, and may be referred to diagnosed, African-Americans have similar as metastatic prostate cancer. treatment results as other men with the same cancer stage. Cancer can spread to distant sites through blood. Although cancer can spread through Family history your blood, you cannot spread your cancer to Men who have a family member with prostate other people if they are exposed to your blood. cancer have a greater chance of getting Prostate cancer can metastasize in the bones, prostate cancer. Those with a family history of lymph nodes, liver, lungs, and other organs. certain cancers are at risk for prostate cancer. If you learn that someone in your family had Cancer can also spread through the lymphatic prostate cancer, ask your doctor about prostate system.
Load more

Recommended publications
  • The Role of Lymphadenectomy in Prostate Cancer Patients
    Acta Clin Croat (Suppl. 1) 2019; 58:24-35 Professional paper doi: 10.20471/acc.2019.58.s2.05 THE ROLE OF LYMPHADENECTOMY IN PROSTATE CANCER PATIENTS Dean Markić1,2, Romano Oguić1,2, Kristian Krpina1, Ivan Vukelić1, Gordana Đorđević3,4, Iva Žuža5 and Josip Španjol1,2 1Department of Urology, University Hospital Rijeka, Rijeka, Croatia; 2Department of Urology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; 3Department of Pathology, University Hospital Rijeka, Rijeka, Croatia; 4Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; 5Department of Radiology, University Hospital Rijeka, Rijeka, Croatia SUMMARY – Prostate cancer is one of the most important men’s health issues in developed countries. For patients with prostate cancer a preoperative staging of the disease must be made. In- volvement of lymph nodes could be assessed using imaging methods (CT or/and MRI), however, newer methods also exist (PET/CT, PSMA PET/CT). For some patients during radical prostatec- tomy a pelvic lymphadenectomy is recommended. Pelvic lymphadenectomy is indicated in intermedi- ate- and high-risk group patients and with increased probability of lymph node invasion. The most used prediction tools for preoperative assessment of lymph nodes are Briganti and MSKCC nomo- grams and Partin tables. Pelvic lymphadenectomy can include different lymph nodes group, but extended lymphadenectomy is the recommended procedure. In 1-20% of patients, the lymph node invasion is present. Pelvic lymphadenectomy is primarily a diagnostic and staging method, and in minority of patients with positive lymph nodes it can be a curative method, too. In other patients with positive lymph nodes adjuvant therapy (radiotherapy and androgen deprivation therapy) can be beneficial.
    [Show full text]
  • Grading Evolution and Contemporary Prognostic Biomarkers of Clinically Significant Prostate Cancer
    cancers Review Grading Evolution and Contemporary Prognostic Biomarkers of Clinically Significant Prostate Cancer Konrad Sopyllo 1, Andrew M. Erickson 2 and Tuomas Mirtti 1,3,* 1 Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; konrad.sopyllo@helsinki.fi 2 Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK; [email protected] 3 Department of Pathology, HUS Diagnostic Centre, Helsinki University Hospital, 00029 Helsinki, Finland * Correspondence: tuomas.mirtti@helsinki.fi Simple Summary: Prostate cancer treatment decisions are based on clinical stage and histological diagnosis, including Gleason grading assessed by a pathologist, in biopsies. Prior to staging and grading, serum or blood prostate-specific antigen (PSA) levels are measured and often trigger diagnostic examinations. However, PSA is best suited as a marker of cancer relapse after initial treatment. In this review, we first narratively describe the evolution of histological grading, the current status of Gleason pattern-based diagnostics and glance into future methodology of risk assessment by histological examination. In the second part, we systematically review the biomarkers that have been shown, independent from clinical characteristics, to correlate with clinically relevant end-points, i.e., occurrence of metastases, disease-specific mortality and overall survival after initial treatment of localized prostate cancer. Abstract: Gleason grading remains the strongest prognostic parameter in localized prostate ade- nocarcinoma. We have here outlined the evolution and contemporary practices in pathological evaluation of prostate tissue samples for Gleason score and Grade group. The state of more observer- Citation: Sopyllo, K.; Erickson, A.M.; Mirtti, T. Grading Evolution and independent grading methods with the aid of artificial intelligence is also reviewed.
    [Show full text]
  • Prostate Cancer Early Detection, Diagnosis, and Staging Finding Prostate Cancer Early
    cancer.org | 1.800.227.2345 Prostate Cancer Early Detection, Diagnosis, and Staging Finding Prostate Cancer Early Catching cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. ● Can Prostate Cancer Be Found Early? ● Screening Tests for Prostate Cancer ● American Cancer Society Recommendations for Prostate Cancer Early Detection ● Insurance Coverage for Prostate Cancer Screening Diagnosis and Planning Treatment After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. ● Signs and Symptoms of Prostate Cancer ● Tests to Diagnose and Stage Prostate Cancer ● Prostate Pathology ● Prostate Cancer Stages and Other Ways to Assess Risk ● Survival Rates for Prostate Cancer ● Questions To Ask About Prostate Cancer 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Can Prostate Cancer Be Found Early? Screening is testing to find cancer in people before they have symptoms. For some types of cancer, screening can help find cancers at an early stage, when they are likely to be easier to treat. Prostate cancer can often be found early by testing for prostate-specific antigen (PSA) levels in a man’s blood. Another way to find prostate cancer is the digital rectal exam (DRE). For a DRE, the doctor puts a gloved, lubricated finger into the rectum to feel the prostate gland. These tests and the actual process of screening are described in more detail in Screening Tests for Prostate Cancer. If the results of either of these tests is abnormal, further testing (such as a prostate biopsy) is often done to see if a man has cancer.
    [Show full text]
  • MR Imaging of Early Prostate Cancer
    PROSTATE CANCER: LATEST IN IMAGING TESTS AND STAGING CLASSIFICATION Jin Wei Kwek MBBS, FRCR(UK), FAMS Senior Consultant, Div of Oncologic Imaging, Dy Director, Div of Cancer Education Adj Asst Prof, Duke-NUS Medical School Prostate Cancer: Imaging Test SCOPE • Diagnosis of prostate cancer, staging classification and risk assessment • Imaging tests and applications. Prostate Cancer - Diagnosis Diagnosis of Prostate Cancer Trans-Rectal US guided Biopsy • High specificity but Low sensitivity (FN up to 30%) Cancer at Apex • May miss aggressive cancer and detect insignificant cancer Anterior • Missed Cancers: Apex, Lateral Cancer and Anterior cancers • Potential role for imaging in Lateral Cancer detecting clinically significant tumour and guiding biopsy Parker C et al Ann Oncol 2015 Patel AR et al Urol 2004 Prostate Cancer: Imaging Tests TNM Staging Classification • Majority new diagnosed cT1c – non palpable • T2 Tumour confined within the prostate1 • T2a Tumour involves one half of one lobe or less • T2b Tumour involves more than half of one lobe, but not both lobes • T2c Tumour involves both lobes • T3 Tumour extends through the prostatic capsule2 • T3a Extracapsular extension (unilateral or bilateral) including microscopic bladder neck involvement • T3b Seminal vesicle(s) invasion • T4 Tumour is fixed or invades adjacent structures other than seminal vesicles: external sphincter, rectum, levator muscles, and/or pelvic wall Prostate Cancer: Imaging Test TNM Staging Classification N-Regional Lymph Nodes (Below common iliac bifurcation) • NX Regional lymph nodes cannot be assessed • N0 No regional lymph node metastasis • N1 Regional lymph node metastasis M-Distant Metastasis • M1a Non-regional lymph node(s) • M1b Bone(s) • M1c Other site(s) Prostate Cancer: Imaging Test AJCC 8th Edition Changes Ref: CA Cancer J Clin 2017;67:245-253 Prostate Cancer: Imaging Test AJCC 8th Ed: Radiological Considerations 1) T Stage: MRI most useful for demarcation of extent of primary tumour and extraprostatic extension .
    [Show full text]
  • New Circulating Biomarkers for Prostate Cancer
    Prostate Cancer and Prostatic Diseases (2008) 11, 112–120 & 2008 Nature Publishing Group All rights reserved 1365-7852/08 $30.00 www.nature.com/pcan REVIEW New circulating biomarkers for prostate cancer K Bensalah, Y Lotan, JA Karam and SF Shariat Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA The introduction of prostate-specific antigen (PSA) revolutionized prostate cancer (PCa) screening and ushered the PSA era. However, its use as a screening tool remains controversial and changes in the epidemiology of PCa have strongly limited its prognostic role. Therefore, we need novel approaches to improve our ability to detect PCa and foretell the course of the disease. To improve the specificity of total PSA, several approaches based on PSA derivatives have been investigated such as age-specific values, PSA density (PSAD), PSAD of the transition zone, PSA velocity and assessment of various isoforms of PSA. With recent advances in biotechnology such as high- throughput molecular analyses, many potential blood biomarkers have been identified and are currently under investigation. Given the plethora of candidate PCa biomarkers, we have chosen to discuss a select group of candidate blood-based biomarkers including human glandular kallikrein, early prostate cancer antigens, insulin-like growth factor-I (IGF-I) and its binding proteins (IGFBP- 2 and IGFBP-3), urokinase plasminogen activation system, transforming growth factor-b1, interleukin-6, chromogranin A, prostate secretory protein, prostate-specific membrane antigen, PCa-specific autoantibodies and a-methylacyl-CoA racemase. While these and other markers have shown promise in early phase studies, no single biomarker is likely to have the appropriate degree of certainty to dictate treatment decisions.
    [Show full text]
  • NCCN Guidelines for Patients® Prostate Cancer Prostate About This Booklet
    VERSION 1.2014 Also available at NCCN.org/patients NCCN Guidelines for Patients® Prostate Cancer Prostate About this booklet Its purpose Prostate cancer is the most common type of cancer in men living in the United States. Learning that you have prostate cancer can feel overwhelming. The goal of this booklet is to help you get the best cancer treatment. This booklet presents which cancer tests and treatments are recommended by experts in prostate cancer. Supported by the NCCN Foundation® The NCCN Foundation supports the mission of the National Comprehensive Cancer Network® (NCCN®) to improve the care of patients with cancer. One of its aims is to raise funds to create a library of booklets for patients. Learn more about the NCCN Foundation at NCCN.org/foundation. The source of the information NCCN is a not-for-profit network of 23 of the world’s leading cancer centers. Experts from NCCN have written treatment guidelines for prostate cancer doctors. These treatment guidelines suggest what the best practice is for cancer care. The information in this booklet is based on these guidelines. For more information This booklet focuses on prostate cancer. NCCN also offers booklets on colon and lung cancers. Visit NCCN.org/patients for the full library of booklets. © 2014 National Comprehensive Cancer Network, Inc. All rights reserved. The NCCN Guidelines for Patients® and illustrations herein may not be reproduced in any form for any purpose without the express written permission of NCCN. NCCN Guidelines for Patients®: Prostate Cancer 2 Version 1.2014 PartTable X: of Loremcontents Ipsum How to use this booklet Part 7 – Treatment for advanced cancer 4 63 Presents options for when local cancer treatments aren’t enough.
    [Show full text]
  • Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update
    Change Notice: Any information related to Prostate-Specific Antigen (PSA) in the following guideline may have been revised in the American Urological Association's (AUA) PSA Best Practice Statement: 2009 Update. In the case of any discrepency in recommendations between guidelines pertaining to PSA, please refer to the AUA's PSA Best Practice Statement: 2009 Update for the latest AUA recommendation regarding PSA testing. Prostate Cancer Members, (specialty): Ian Thompson, M.D., Chair, (Urology) James Brantley Thrasher, M.D., Co-Chair, (Urology) Gunnar Aus, M.D., (Urology) Arthur L. Burnett, M.D., (Sexual Medicine) Edith D. Canby-Hagino, M.D., (Urology) Guideline for the Michael S. Cookson, M.D., (Urology) Anthony V. D’Amico, M.D., Ph.D., (Radiation Oncology) Roger R. Dmochowski, M.D., (Urology) David T. Eton, Ph.D., (Health Services Research) Jeffrey D. Forman, M.D., (Radiation Oncology) S. Larry Goldenberg, O.B.C., M.D., (Urology) Management of Clinically Javier Hernandez, M.D., (Urology) Celestia S. Higano, M.D., (Medical Oncology) Stephen R. Kraus, M.D., (Neurourology) Judd W. Moul, M.D., (Urology) Catherine M. Tangen, Dr. P.H., (Biostatistics and Clinical Trials) Localized Prostate Consultants: Hanan S. Bell, Ph.D. Patrick M. Florer Diann Glickman, Pharm.D. Scott Lucia, M.D. Timothy J. Wilt, M.D., M.P.H., Data Extraction Cancer: 2007 Update AUA Staff: Monica Liebert, Ph.D. Edith Budd This publication was supported by Grant Number C12/CCC323617-01 Michael Folmer from Centers for Disease Control and Prevention. Its contents are solely Katherine Moore the responsibility of the authors and do not necessarily represent the official views of Centers for Disease Control and Prevention.
    [Show full text]
  • Molecular Genetic Predictors of Prostate Cancer Progression After
    Molecular genetic predictors of prostate cancer progression after radical prostatectomy Simon RJ Bott MB.BS, FRCS (Eng). The Prostate Cancer Research Centre, University College London. Dissertation for the degree of Doctor of Medicine University of London, 2005. UMI Number: U592749 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Dissertation Publishing UMI U592749 Published by ProQuest LLC 2013. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Acknowledgements I would like to thank the following people for providing support, inspiration and guidance in the generation o f this thesis. Professor Roger Kirby, Professor of Urology, St George’s Hospital, London. Dr M Constance Parkinson, Consultant Histopathologist, UCL Hospitals Trust, London. Dr Joel Hooper, Senior Scientist, The Genome Centre, William Harvey Research Institute, Queen Mary's School of Medicine, London. Dr Charles Mein, Laboratory Manager, The Genome Centre, William Harvey Research Institute, Queen Mary's School of Medicine, London. Dr Chris Jones, Senior Lecturer, Chester Beatty Research Laboratories, London. Dr Garreth Griffiths, Senior Medical Statistician, MRC Clinical Trials Unit, London. Dr David Hudson, Lead Scientist, Prostate Stem Cell Laboratory, Institute of Cancer Research, Surrey.
    [Show full text]
  • Prostate Cancer
    3/2/2014 Prostate Cancer Davis A Romney, MD Ironwood Cancer and Research Centers Feb 18, 2014 Overview • Start with the basics: Definition of cancer • Most common cancers in men • Prostate, lung, and colon cancers • Cancer statistics • Prostate cancer screening • US Preventative Services Task Force and PSA screening • Prostate cancer workup • Technological advances in prostate cancer treatment • Q&A session What is Cancer? • A group of over 100 diseases characterized by uncontrolled abnormal cell growth • Benign – growth is limited to the surrounding environment without the ability to metastasize • Malignant – cancerous cells have the ability not only to invade locally but also to metastasize to distant sites in the body via the blood stream or lymphatic channels • Cancer is named based on its site of origin (eg. prostate cancer or lung cancer) • When cancer metastasizes to another organ it is still named based on its site of origin (eg. breast cancer that has spread to the lung is not called lung cancer but rather metastatic breast cancer to the lung.) 1 3/2/2014 Where does cancer come from? • Cells in our bodies are constantly dividing • Errors in DNA sequences can lead to genetic mutations • Mutations in genes that regulate cellular replication can lead to uncontrolled cell growth: oncogenes vs tumor suppressor genes What causes DNA mutations? • Random errors in DNA replication • Mutagens such as carcinogens found in cigarettes, industrial chemicals, etc. • Radiation from the natural environment (eg. Radon gas) • Viruses that integrate
    [Show full text]
  • Prostate Cancer–Pretreatment Detection, Surveillance, and Staging
    Revised 2016 American College of Radiology ACR Appropriateness Criteria® Prostate Cancer–Pretreatment Detection, Surveillance, and Staging Variant 1: Clinically suspected prostate cancer, no prior biopsy (biopsy naïve). Detection. Radiologic Procedure Rating Comments RRL* TRUS-guided biopsy prostate 9 O MRI (with or without contrast) in biopsy- naïve patients may be performed before TRUS-guided biopsy so the targeted sample may be obtained using MRI or MRI pelvis without and with IV contrast 7 TRUS fusion technology in patients with O appropriate targets. MRI is complementary to TRUS-guided biopsy in this setting. MRI-targeted biopsy prostate 7 O MRI pelvis without IV contrast 6 O CT abdomen and pelvis with IV contrast 3 ☢☢☢ TRUS prostate 2 O CT abdomen and pelvis without IV 2 contrast ☢☢☢ CT abdomen and pelvis without and with 2 IV contrast ☢☢☢☢ Bone scan whole body 1 ☢☢☢ *Relative Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate Radiation Level Variant 2: Clinically suspected prostate cancer, prior negative TRUS-guided biopsy. Detection. Radiologic Procedure Rating Comments RRL* MRI pelvis without and with IV contrast 8 O MRI-targeted biopsy prostate 8 O Repeat TRUS-guided systematic biopsy is a reasonable option, but MRI (with or without contrast) should be performed first TRUS-guided biopsy prostate 7 so that MRI-targeted biopsies (fusion or O in-bore technique) can be obtained from appropriate suspicious lesions. MRI pelvis without IV contrast 6 O TRUS prostate 2 O CT abdomen and pelvis with IV contrast 2 ☢☢☢ CT abdomen and pelvis without IV 2 contrast ☢☢☢ CT abdomen and pelvis without and with 2 IV contrast ☢☢☢☢ Bone scan whole body 1 ☢☢☢ *Relative Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate Radiation Level ACR Appropriateness Criteria® 1 Prostate Cancer–Pretreatment Detection Variant 3: Clinically established low-risk prostate cancer.
    [Show full text]
  • Current Perspectives of Sentinel Lymph Node Dissection at the Time of Radical Surgery for Prostate Cancer Gavish Munbauhal, Thomas Seisen, Florie D
    Current perspectives of sentinel lymph node dissection at the time of radical surgery for prostate cancer Gavish Munbauhal, Thomas Seisen, Florie D. Gomez, Benoit Peyronnet, Olivier Cussenot, Shahrokh F. Shariat, Morgan Rouprêt To cite this version: Gavish Munbauhal, Thomas Seisen, Florie D. Gomez, Benoit Peyronnet, Olivier Cussenot, et al.. Current perspectives of sentinel lymph node dissection at the time of radical surgery for prostate cancer. Cancer Treatment Reviews, WB Saunders, 2016, 50, pp.228-239. 10.1016/j.ctrv.2016.09.020. hal-01558320 HAL Id: hal-01558320 https://hal-univ-rennes1.archives-ouvertes.fr/hal-01558320 Submitted on 25 Sep 2017 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. CURRENT PERSPECTIVES OF SENTINEL LYMPH NODE DISSECTION AT THE TIME OF RADICAL SURGERY FOR PROSTATE CANCER. Gavish Munbauhal1, Thomas Seisen1,2, Florie Gomez3, Benoit Peyronnet4, Olivier Cussenot2,5, Shahrokh F. Shariat6, Morgan Rouprêt1,2 * 1Academic Department of Urology of La Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris, Faculté de Médecine
    [Show full text]
  • Preoperative Staging of Pelvic Lymph Nodes in Prostate Cancer by 11C-Choline PET
    Preoperative Staging of Pelvic Lymph Nodes in Prostate Cancer by 11C-Choline PET Igle J. de Jong, MD1,2; Jan Pruim, PhD2; Philip H. Elsinga, PhD2; Willem Vaalburg, PhD2; and Han J. Mensink, PhD1 1Department of Urology, Groningen University Hospital, Groningen, The Netherlands; and 2PET Center, Groningen University Hospital, Groningen, The Netherlands lymph node staging in prostate cancer, but this invasive Prostate cancer is known for its difficulties in preoperative stag- procedure is associated with morbidity (3). ing of pelvic lymph nodes by conventional imaging techniques. Conventional imaging techniques such as CT and MRI Thus, a histopathologic examination of the pelvic lymphadenec- have been shown to have a low sensitivity in determination tomy specimen is mandatory for patients at risk for metastatic of tumor involvement of pelvic lymph nodes, because nodal disease. The aim of this study was to evaluate the strength and accuracy of 11C-choline PET in preoperative noninvasive stag- involvement is not always correlated with enlargement (4– ing of pelvic lymph nodes in prostate cancer. Methods: In a 6). Therefore, imaging techniques that are not dependent on prospective study we examined 67 consecutive patients with anatomic distortions could be of use for lymph node staging. histologically proven prostate cancer with 11C-choline PET. The In this respect, PET has been studied widely using 18F-FDG results of PET were compared with the results of histology of the as the radiopharmaceutical. Preliminary data were encour- pelvic lymph nodes and with the follow-up data. Conventional aging (7); nevertheless, 18F-FDG PET has not gained broad axial imaging was routinely performed using MRI or CT.
    [Show full text]