21-27 of 27     Previous

Metabolic syndrome is a constellation of conditions including obesity, diabetes, hypertension, and alterations in serum lipids. It was originally defined as a syndrome that is linked with increased risk of heart disease. As the obesity epidemic has swept through the Western world, the rates of metabolic syndrome have likewise risen dramatically. As many of the conditions that constitute the metabolic syndrome have individually been linked with cancer, there is growing interest in the role of the metabolic syndrome with cancer. 
Recently, there has been a great deal of interest in prostate specific membrane antigen (PSMA) as a basis for positron emission tomography (PET) imaging of prostate cancer. As recently as a few years ago, there were only handfuls of abstracts on this subject matter at the major international urology conferences.  Over the past couple of years, there has literally been an explosion of clinical abstracts, particularly in the evaluation of Ga68 PSMA PET/CT as a staging tool at diagnosis and in the setting of evaluating biochemical recurrence following primary definitive treatment of localised disease.
Hot flashes.  Loss of Libido.  Impotence.  Fatigue.  Osteoporosis. Weight gain. Diabetes. Loss of muscle mass.  Gain in fat mass. Testicular shrinkage. Cardiovascular disease (still controversial). What do these all have in common?  No, they are not the rare side effects that may occur from a drug that you hear on a TV commercial.  These are all real and common side effects of androgen deprivation therapy (ADT) for prostate cancer. 
Androgen deprivation therapy (ADT) causes a host of well-recognized side effects. Recent epidemiological and clinical evidence suggests that ADT may also be associated with dementia and cognitive impairment. Potential physiological explanations for these observations include altered neuron growth and axonal regeneration, increased ß-amyloid protein levels, and exacerbation of cardio-metabolic disease (including but not limited to cerebrovascular disease), all of which may occur in an androgen-deprived state.
Radium-223 is a novel alpha emitting radiopharmaceutical with bone tropism, now FDA approved for men with symptomatic bone-metastatic castration-resistant prostate cancer.  Approval was based on the survival benefit observed in the phase 3 ALSYMPCA trial over best supportive care, which included oral steroids or hormonal therapies, bone anti-resorptive therapy, and palliative radiation.
In an era when all men got radiation or surgery, there was no need for risk stratification. However, as newer options became introduced, risk stratification became essential. Towards that effort, PSA, tumor grade, and stage have been the backbone of prostate cancer risk stratification for over 20 years. However, in an era of active surveillance for low-risk disease and multi-modal therapy for high-risk disease, it is clear that they are often not good enough. 
PSA screening is the backbone of early prostate cancer detection in the United States and increasingly in other parts of the world too. Due to concerns about over-detection and over-treatment of indolent disease (i.e. harms), PSA screening is controversial, despite level 1 evidence that screening vs. no screening can reduce the risk of death from prostate cancer (i.e. benefits).

21-27 of 27     Previous


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.