ANAHEIM, Ca. (May 23, 2007) � Urologic conditions can have substantial negative effects on patient�s quality of life. Examinations of the factors related to individual cases and evolving treatment options brings new information that will inevitably affect patient care and illicit further studies.
Among the research presented during the 102nd Annual Scientific Meeting of the American Urological Association in Anaheim, Ca. include the following topics:
Has PSA-Induced Stage Migration Ended? (Abstract 1886)
As prostate cancer screening becomes more prevalent, its effect on identifying earlier stage disease has plateaued, suggesting that the current prostate cancer detection rate may be a more accurate reflection of the disease�s true incidence. After examining 3,364 patients treated by radical prostatectomy between 1987 and 2005 as well as 2,256 specimens removed between 1999 and 2005, researchers from Cleveland, Ohio and Florida established temporal trends in rates of extraprostatic extension, organ-confined disease and clinically insignificant disease. Data showed that the decreasing trend for extraprostatic extension and increasing trend for organ-confined disease that was clearly evident in the early PSA era has diminished since 1998, suggesting that the reservoir of undetected disease may be becoming depleted so that cancers detected now are a more true reflection of prostate cancer incidence.
Use of Cycloxygenase-2 Inhibitor for Prevention of Urethral Structures Secondary to Transurethral Resection of the Prostate (Abstract 1731)
The post-operative inflammatory process can precede scar formation that can lead to strictures in patients undergoing transurethral resection of the prostate (TURP). Researchers in Rome investigated whether the administration of a COX-2 inhibitor (a type of non-steroidal anti-inflammatory drug, or NSAID) following TURP can help prevent urethral strictures, a side-effect of the treatment. In this prospective, unblended, randomized single-center study, 96 patients with BPH were randomized to receive a COX-2 inhibitor or not following catheter removal post-surgery. Patients were examined at one-month out-patient follow-up, and then assessed over one-year with urethroscopy. Patients receiving the COX-2 inhibitor did not develop urethral stricture, while 17 percent of patients not receiving the drug were diagnosed with stricture at one year. Patients who received the COX-2 inhibitor also had better mean and median flow-rate (Qmax) scores at one-month follow-up. The results of the study suggest that a COX-2 inhibitor can effectively prevent development of post-TURP urethral stricture by reducing the inflammatory process that leads to scarring.
Early Diagnosis of Prostate Cancer with Endorectal MAGNETIC RESONANCE Spectroscopic Imaging: Preliminary Results (Abstract 1954)
Prostate biopsy is an invasive but necessary part of prostate-cancer diagnosis. In this retrospective study, researchers explored whether non-invasive magnetic resonance spectroscopy can be used in prostate-cancer diagnosis. A prospective study was performed on 51 non-symptomatic patients who underwent an endorectal magnetic resonance spectroscopy prior to biopsy. Within the group, 23 patients were ultimately diagnosed with prostate cancer. Spectroscopy results were compared with the results of the biopsies and the presence of a tumor was graded in a one to four scale for both resonance and spectroscopy. The images were examined for the presence of lesions and chloline+creatine/citrate (CC/Ci) ratio, which was found to be more discriminatory for prostate cancer diagnosis than total PSA.
How to Screen for Prostate Cancer in 2007: detection and Characteristics in Men Age 55-74, in Men with PSA Levels Less than 3 NG/ML, four and eight years after the Initial Screening (Abstract 1757)
It may not always be best to diagnose all cancers in low PSA ranges, according to researchers in the Netherlands who examined the risk associated with detecting prostate cancer in potentially incurable stages at men four and eight years after their initial screening. After a four-year screening interval in men whose initial PSA was less that 3 ng/ml, only 14 cancers in over 15,000 men became evident (two were potentially incurable). PSA progression occurred in 9.9 percent of the men and 275 cases of prostate cancer were found (seven were potentially incurable). The results suggest that a four-year screening interval may be sufficient for most men who present with a low initial PSA, but should be adjusted based on initial PSA level since those with higher initial PSA levels were more likely to develop prostate cancer.
�About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 15,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their patients, including UrologyHealth.org, an award-winning on-line patient education resource, and the American Urological Association Foundation, Inc., formerly AFUD.
