Prostate Restored
Photo: eberhard grossgasteiger
The PSA level also tends to rise in men with benign prostatic hyperplasia (BPH) and is a good marker for prostate volume. PSA levels are usually elevated in men with acute bacterial prostatitis.
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Read More »The use of this method for clinical decision-making has been limited. With this technology, cancer cells can be identified in the circulation and in the bone marrow of patients with all stages of prostate cancer. This indicates that cancer cells begin leaving the prostate early in the development of the disease, but most of them do not survive, and their identification does not correlate with patient prognosis or survival. Ferrari et al demonstrated that PSMA RT-PCR technology was superior to standard histologic techniques for detecting micrometastases in lymph nodes removed during radical prostatectomy. [19] In this study, lymph nodes were obtained from 33 patients with Gleason scores of 7 or higher and serum PSA levels of 10 or higher who were undergoing radical prostatectomy. Routine pathology examinations identified cancer cells in 4 (12%) of these patients. [19] PSA or PSMA expression occurred in 27 (82%) of the patients. The 4 patients with positive lymph node findings also had positive results for both PSA and PSMA. Among the 29 patients with no histologic evidence of disease, 23 (79%) tested positive with RT-PCR. In these 23 patients, PSMA was detected more frequently than PSA, though in 2 patients, only PSA was found. Although these findings demonstrate that prostate cancer cells or fragments of these cells can be found in pelvic lymph nodes, the status of these cells and their viability cannot be ascertained. This observation is another indication of the early egress of cancer cells from the prostate, but there is not necessarily any correlation with patient prognosis and survival. PSMA serves as the basis for the ProstaScint scan. This is an imaging study used to detect metastatic cancer. Its primary use has been to identify prostate cancer cells in lymph nodes and in the prostate base. PSMA is being evaluated as a means of providing therapy. When PSMA is used as an immunotherapeutic agent, dendritic cells are primed with PSMA and infused into the patient. This is intended to produce a specific immune response to prostate cells. With PSMA used as a guide to identify and target prostate cells, radioactive isotopes and cytotoxic agents can be delivered to these cells.
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Read More »The cell cycle inhibitor p27 is a putative tumor suppressor gene. Loss of p27 is associated with a poor prognosis in patients with breast, colorectal, and prostate carcinoma. In men treated with radical prostatectomy, loss of p27 expression correlates with an increased probability of cancer recurrence and lower survival rates. Decreased p27 expression also is associated with high-grade cancer cells, positive surgical margins, seminal vesicle invasion, and lymph node metastases.
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