scholarly journals Cosmetic Appeal, HRQoL, and Effectiveness of Simple and Pseudotesticular Techniques of Orchidectomy in Prostate Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Ijeoma N. C. Chibuzo ◽  
Augustine O. Takure ◽  
Olayiwola B. Shittu ◽  
Linus I. Okeke
Keyword(s):  
Prostate Cancer ◽  
Sexual Function ◽  
Low Income ◽  
Therapeutic Efficacy ◽  
Effective Means ◽  
Locally Advanced ◽  
Psychological Impact ◽  
Cost Effective ◽  
Serum Testosterone ◽  
Significant Difference

Introduction. Orchidectomy is the most cost-effective means of hormonal therapy for locally advanced or metastatic prostate cancer (LAMP). However, cost-effectiveness should not detract from health-related quality of life (HRQoL) considerations. Bilateral simple orchidectomy (BSO) has been linked to negative psychometric deficits from an empty scrotum. This study compared the HRQoL, therapeutic efficacy, and cosmetic appeal of BSO with endogenous pseudotesticular techniques of bilateral subcapsular orchidectomy (BSCO) and bilateral-epididymal-sparing orchidectomy (BESO). Research Design. Nigerian patients with LAMP were randomised into three surgical arms: BSO, BSCO, and BESO. Expanded Prostate Cancer Index Composite-26 HRQoL and sociodemographic questionnaires were administered before and three months after orchidectomy. Serum testosterone and PSA were measured at 0, 1, 2, and 3 hours; 7 days; and 3 months postoperatively. Pseudotesticular volumes and cosmetic appeal were assessed at 3 months. Result. Sixty-three patients were recruited (24 BSO, 21 BSCO, 18 BESO), 73% of whom were low-income earners. There was no significant difference in the procedure cost nor the PSA or testosterone nadirs achieved over the three-month follow-up period (11.3, 12.6, 15.2 ng/ml ( p = 0.667 ) and 0.44, 0.64, 0.79 nmol/l ( p = 0.603 ) respectively). Those with pseudotesticles (BSCO, BESO) felt less emasculated ( p = 0.010 ). BSCO produced the least sexual bother, highest sexual function, and largest pseudotesticular volumes. The cosmetic appeal scores were similar between groups (77.9 ± 22.8, 81 ± 13.9, and 81.9 ± 22.5, respectively, p = 0.858 ). Conclusion. Endogenous pseudotesticular techniques, when compared with BSO, reduce the negative psychological impact experienced by patients without increasing costs. BSCO produced the best pseudotesticular volumes and postoperative sexual function. This study is registered with the ClinicalTrials.gov of the National Institute of Health U.S. National Library of Medicine as TEPSO study, NCT03744494: Comparison of the Therapeutic Efficacy and Patient Satisfaction of Three Techniques of Bilateral Orchidectomy in Prostate Cancer Patients of a Nigerian Sub-population. Registration completed on 16th of November, 2018 (registered retrospectively) NCT03744494.

scholarly journals Stimulation of a non-functioning pituitary macroadenoma after administration of goserelin acetate for locally advanced prostate cancer causing a sustained elevation in PSA and testosterone

2013 ◽  
Vol 6 (2) ◽  
Author(s):  
Fady R. Youssef ◽  
Robert T. Robinson ◽  
Nigel R. Boucher
Keyword(s):  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Locally Advanced ◽  
Elevated Serum ◽  
Serum Testosterone ◽  
Androgen Deprivation ◽  
Alternative Methods ◽  
Pituitary Macroadenoma ◽  
Locally Advanced Prostate Cancer ◽  
Long Acting

Long-acting luteinizing hormone-releasing hormone (LHRH) agonists, such as goserelin, have been used for locally advanced and metastatic prostate cancer for many years and are the main forms of androgen deprivation therapy (ADT). Acting on pituitary LHRH receptors, they initially stimulate a transient rise in serum follicle stimulating hormone (FSH) and LH. Long-term administration of an LHRH analogue will eventually lead to down regulation of LHRH receptors, thus suppressing FSH and LH secretion. This in turn suppresses testosterone production hence achieving and maintaining androgen deprivation. This case highlights the potential anomaly of a sustained elevated serum testosterone in the context of newly diagnosed locally advanced prostate cancer with a co-existing pituitary macroadenoma after administration of LHRH analogues. Alternative methods of androgen deprivation must be considered in such patients.

scholarly journals Caeruloplasmin oxidase activity: measurement in serum by use of o-dianisidine dihydrochloride on a microplate reader

2017 ◽  
Vol 55 (1) ◽  
pp. 149-157 ◽  
Author(s):  
Karolina M Stepien ◽  
Mark Guy
Keyword(s):  
Oxidase Activity ◽  
Effective Means ◽  
Cost Effective ◽  
Reference Interval ◽  
Response To Treatment ◽  
Activity Measurement ◽  
Enzymatic Method ◽  
Limit Of Quantification ◽  
Significant Difference ◽  
Microplate Reader

Background The enzymatic method of caeruloplasmin measurement is based on copper-dependent oxidase activity. The advantage of the oxidase determination is that it has a much lower detection limit compared with immunoassay-based methods. It has found its application in both the diagnosis of Wilson’s disease and also in the monitoring of patients’ response to treatment. Methods The method previously described in literature was adapted for use on a 96-well plate. Caeruloplasmin oxidase activity results were derived from the equation: caeruloplasmin oxidase activity = (A15−A5) × 185 U/L. Results Repeatability (intra-batch) imprecision ranged from 6 to 15% and intermediate (inter-batch) imprecision varied from 7 to 16% for caeruloplasmin oxidative activities of 14, 29, 45 and 99 U/L. Between 3 and 92 U/L, the assay appeared linear with a regression coefficient R2 = 0.9958. The lower limit of quantification was 4 U/L. Samples were stable over a five-week period at 4℃ and for at least four freeze–thaw cycles. There was a statistically significant difference between the areas under ROC curve for copper-to-caeruloplasmin ratios between caeruloplasmin oxidative activity and immunoassay-based methods ( P < 0.0171). The reference interval for caeruloplasmin activity was determined to be 12–166 U/L. Conclusions Using the oxidative assay provides a cost-effective means of estimating caeruloplasmin concentrations. The method is easily adaptable to a 96-well plate format that facilitates high throughput of samples in a busy laboratory. The enzymatic method is more sensitive and specific for differentiating between Wilson’s and non-Wilson’s when compared with immunoassay-based methods.

Misunderstanding of prostate cancer (CaP) among African American (AA) men of lower socioeconomic status (Lo-SES)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6114-6114
Author(s):  
E. M. Nelson ◽  
G. Fraser ◽  
A. F. Connors ◽  
M. J. Barry ◽  
M. Krahn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factor ◽  
Sexual Function ◽  
Low Income ◽  
Demographic Data ◽  
Bowel Function ◽  
Reading Level ◽  
Cancer Knowledge ◽  
Annual Household Income ◽  
Cross Sectional

6114 Background: CaP disproportionately affects AA men. The objective of this investigation was to assess understanding of the prostate and CaP among Lo-SES, predominantly AA men. Methods: We performed cross sectional, semistructured interviews of 105 men, age 40 and older, in two low-income medical clinics. CaP knowledge was assessed using a subset of questions by Mercer et al. Can J of Public Health 88(5):327, 1997. Patients were shown two male anatomic figures and asked to identify the prostate, bladder, bowels, and penis: 1) Please point to the _____ on the picture of the man. 2) What does the ____ do? Patients’ understanding of sexual, urinary, and bowel function was evaluated using semi-qualitative methods coded by two independent investigators. Demographic data were collected and literacy measured using REALM. Results: Patients’ median age was 58 and 87% self-identified their race as AA. Median annual household income was $16,000. Median reading level was 4th-6th grade. Although 87% of patients had heard of the prostate, only 24% could locate the prostate, and 3% could explain prostate function. Because many men learn about the prostate in the context of CaP screening during physical exam, 23% of patients thought the prostate was synonymous with prostate cancer, 15% of patients believed the prostate is located in the rectum and 4% confused prostate cancer with colorectal cancer. Prostate cancer knowledge was poor and the concept of a risk factor was not understood well. Only 7% could name a single risk factor for CaP including 3% who named race. Just 22% of men cited surgery or radiation therapy as treatments for CaP and 11% could name a side effect of early CaP treatment. Domain confusion was common: 43% of patients confused bowel function with urinary function, 21% confused urinary with sexual function, and 20% confused bowel with sexual function. Conclusions: Baseline understanding of CaP, anatomy, bowel, urinary, and sexual function is poor among older, lo-SES AA men. Substantial patient education is required for CaP screening and treatment efforts in this population with consideration for low literacy. [Table: see text]

Feasibility of two schedules of weekly paclitaxel as (neo)adjuvant treatment for patients (PTS) with HER2-negative breast cancer (BC) in the Brazilian community setting.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 122-122
Author(s):  
Iuri Amorim Santana ◽  
Julia Andrade De Oliveira ◽  
Alan Alves Amaral ◽  
Laura Testa ◽  
Luciana Garcia Landeiro ◽  
...  
Keyword(s):  
Adverse Events ◽  
Safety Profile ◽  
Locally Advanced ◽  
Community Setting ◽  
Dose Intensity ◽  
Cost Effective ◽  
Phase Iii ◽  
Weekly Paclitaxel ◽  
Historical Cohort ◽  
Significant Difference

122 Background: Paclitaxel is one of the most active drugs in BC and the weekly administration has been shown more effective and better. GEICAM9906 was a phase III trial that demonstrated the effectiveness and safety of a pragmatic dose-dense schedule of 100mg/m2 of paclitaxel given over 8 consecutive weeks (w), without G-CSF support. This schedule has been adopted at our institution in 2009 for HER2 negative disease and herein we present the first off-trial experience and also compare its safety profile with that of a historical cohort of pts treated with the conventional 80mg/m2 x12w schedule. Methods: The study consists of a retrospective review of medical files from pts with locally advanced BC treated with (neo)adjuvant paclitaxel-based therapy with one of two schedules: (1) 80 mg/m² x 12w or (2) 100 mg/m² x 8w. Adverse events (AE) were graded according to Common Terminology Criteria for Adverse Events 4.0 (CTCAE). Results: We reviewed files from 326 women with a median age of 52 (±10.9). Seventy and 256 pts received schedule (1) and (2), respectively. No significant difference was observed in the incidence of G3/4 toxicity: pneumonitis (2.8% vs 0.3% p=0.097), neuropathy (2.8% vs 0.7% p=0.303); hand-foot syndrome (1.4% vs 0.3% p=0.538); anaemia (0 vs 0.6% p=0.624); neutropenia (5.7% vs 6.2% p=0.408) with only one case of febrile neutropenia in schedule (2) arm; without cases of grade 3/4 thrombocytopenia, nausea, mucositis or anaphylaxis in both groups. Also, no significant difference was seen when comparing all grades toxicty. The dose intensity of paclitaxel was higher in schedule (2) with 97.72 mg/m² per week vs 77.07 mg/m² per week (p<0.0001). Conclusions: Weekly paclitaxel given according to GEICAM9906 is a pragmatic and well tolerated schedule when used in the Brazilian community setting, with a safety profile comparable to the conventional 80mg/m2 x12w schedule. In addition to being convenient to pts, it may also be cost-effective because of a lower number of clinic visits and infusions.

Effect of serum testosterone on treatment outcomes in patients with intermediate- to high-grade prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 180-180
Author(s):  
Matthew W. Jackson ◽  
Emma Ramahi ◽  
Gregory P. Swanson ◽  
Joseph W. Basler
Keyword(s):  
Prostate Cancer ◽  
Treatment Outcomes ◽  
Serum Testosterone ◽  
Biochemical Failure ◽  
Study Cohort ◽  
Potential Marker ◽  
Primary Endpoints ◽  
Increased Risk ◽  
Significant Difference ◽  
Adenocarcinoma Of The Prostate

180 Background: Low serum testosterone (TS) has been suggested to be a potential marker for more aggressive prostate cancer. However, there are conflicting data regarding whether or not patients with low TS have a higher rate of biochemical recurrence following radical prostatectomy (RP). We evaluated the relationship between postoperative TS and treatment outcomes in patients with Gleason 7–10 adenocarcinoma of the prostate. Methods: Our retrospective study cohort included 462 men diagnosed with Gleason 7–10 prostate cancer who underwent RP between 1998 and 2008 at a single institution. Patients were stratified into five groups on the basis of their postoperative TS percentile within the study cohort (<10th percentile, 10–25, 25–75, 75–90, or >90th percentile). Primary endpoints for comparison were biochemical failure free survival (BFFS) and overall survival (OS). PSA >0.2 ng/dl was used to define biochemical failure. Results: In the study cohort, mean TS was 345.2 ng/dl ± 125.2 and range 107–872 ng/dl. 44 of the 462 men had TS ≤203 ng/dl. This group had a 5-year BFFS of 43% which was significantly worse than all other TS strata (p=0.0017). Range of 5-year BFFS in all other percentile groups was 61.4 – 68.6%. There was no significant difference noted between patients with TS ≥508 ng/dl (>90th percentile) and all other TS strata (p=0.694). Furthermore, no difference in OS was noted among any of the groups (p=0.842). Groups did not differ significantly with respect to age, BMI, presence of diabetes, or known cardiovascular disease. Conclusions: Patients with exceedingly low TS are at significantly increased risk for biochemical failure following RP. Further prospective study is warranted to elucidate interventions that might improve biochemical outcomes in these patients. [Table: see text]

scholarly journals Exercise intervention and sexual function in advanced prostate cancer: a randomised controlled trial

2020 ◽  
pp. bmjspcare-2020-002706
Author(s):  
Daniel A Galvão ◽  
Dennis R Taaffe ◽  
Suzanne K Chambers ◽  
Ciaran M Fairman ◽  
Nigel Spry ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sexual Health ◽  
Sexual Function ◽  
Advanced Prostate Cancer ◽  
Bowel Function ◽  
Exercise Programme ◽  
Supervised Exercise ◽  
Metastatic Setting ◽  
Significant Difference ◽  
And Function

ObjectivesTreatments for prostate cancer such as androgen deprivation therapy (ADT), surgery and radiation therapy can adversely affect sexual, urinary and bowel function. Preliminary research has demonstrated the efficacy of exercise to preserve sexual function in men with localised prostate cancer receiving ADT, though this has yet to be investigated in a metastatic setting. We examined the effects of a 12-week exercise programme comprising resistance, aerobic and flexibility training on sexual health and function in men with advanced prostate cancer.MethodsPatients with prostate cancer (70.0±8.4 year; body mass index 28.7±4.0 kg/m2) with bone metastases (rib/thoracic spine, 66.7%; lumbar spine, 43.9%; pelvis, 75.4%; femur, 40.4%; humerus, 24.6%; other sites, 70.2%) were randomly assigned to supervised exercise 3 days/week (n=28) or usual care (n=29). Sexual health and function were assessed using the International Index of Erectile Function, the Expanded Prostate Cancer Index Composite and the EORTC-PR25 at baseline and 12 weeks.ResultsPatients attended 89% of planned sessions and there were no adverse events. After adjusting for baseline values, there was no significant difference between groups for any measure of sexual function and activity (p>0.05). Additionally, there was no significant difference between groups for urinary and bowel function assessed by the EORTC-PR25 (p>0.05).ConclusionsA short-term programme of supervised exercise does not appear to enhance indices of sexual health and function in men with advanced prostate cancer. Limitations of the intervention included the conservative modular exercise programme, which deliberately avoided loading bone metastatic sites.Trial registration numberACTRN12611001158954.

scholarly journals INTRATESTICULAR INJECTION OF 20% HYPERTONIC SODIUM CHLORIDE AS A NOVEL CASTRATION METHOD: A PRECLINICAL STUDY

1970 ◽  
Vol 17 (1) ◽  
Author(s):  
Marta Hendry ◽  
Sunaryo Hardjowijoto ◽  
Basuki B Purnomo ◽  
Endang Joewarini ◽  
Dewa Ketut Meles ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Serum Sodium ◽  
Cost Effective ◽  
Serum Testosterone ◽  
Preclinical Study ◽  
Significant Rise ◽  
Lethal Level ◽  
Significant Difference ◽  
One Way Anova ◽  
Group Serum

Objectives: To demonstrate that intratesticular injection of 20% hypertonic sodium chloride can result in permanent castration and to evaluate serum changes in sodium chloride levels. Materials and Methods: A total of 40 Wistar rats were divided into 4 groups, consisting of bilateral orchidectomy (n=10), control (n=10) and 2 groups receiving intratesticular injections of 20% sodium chloride (n=10 in each group). Serum testosterone was measured on day 0, day 1, day 15 and day 30. Serum sodium chloride was assessed before injection, at 1 hour and 24 hours after injection. All testicles were harvested for histological examination. One way ANOVA and student t-test were used for statistical analysis. Results: Serum testosterone decreased to castrate levels in the orchidectomy and injected groups with no significant difference (p>0,05). Significant rise in serum sodium chloride was found 1 hour post injection (p<0,05) but after 1 day it decreased significantly (p<0,05). There was no significant difference in histopathological findings between the 2 injected groups after day 15 and 30 (p>0,05). Conclusion: Twenty percent hypertonic chloride injection has the same permanent castration effect with bilateral orchidectomy in rats. The serum sodium chloride changes did not reach the lethal level for rats. Therefore this treatment has a promising potential as a novel and cost-effective castration method with the additional benefit of retaining both testes.

Testosterone replacement therapy in men with prostate cancer after proton therapy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 208-208
Author(s):  
Curtis Bryant ◽  
Bradford S. Hoppe ◽  
Nancy P. Mendenhall ◽  
Randal H. Henderson ◽  
Romaine Charles Nichols ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sexual Function ◽  
Replacement Therapy ◽  
Proton Therapy ◽  
Serum Testosterone ◽  
Biochemical Failure ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Previously Treated

208 Background: Testosterone replacement therapy (TRT) in patients previously treated for prostate cancer is controversial. We analyzed biochemical relapse and sexual function in patients treated for prostate cancer with proton therapy (PT) at our institution who were later treated with TRT for hypogonadism. Methods: We reviewed the medical records of 27 patients with biopsy-proven, localized prostate cancer treated with definitive proton therapy (PT) at our institution between 2006 and 2012. Each patient had hypogondal symptoms and low-serum testosterone and received testosterone replacement after PT. Biochemical failure was defined by the Phoenix definition. Sexual function was reported using patient-reported data from the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Rates of sexual potency were also reported. Results: Twenty-three patients were included in the present analysis. The median follow-up duration was 38 months after PT and 14 months after initiation of TRT. After one to six months on TRT, the median serum testosterone level in this patient cohort increased from 238 to 497. No patient experienced a biochemical failure. The median prostate-specific antigen (PSA) did not significantly rise during the follow-up period. EPIC sexual summary, sexual function, and sexual bother scores all increased after initiation of TRT. The median sexual bother scores increased from 43.8 before TRT to 59.4 after 7 or more months of TRT. The median sexual summary scores improved from 50 to 61.8 and the median sexual function scores improved from 41.7 to 53 over the same time. Sexual potency also increased after TRT initiation from 50% to 68%, 7 or more months after TRT. Conclusions: For patients diagnosed with hypogonadism who were previously treated for prostate cancer, cautious use of testosterone replacement therapy does not appear to increase the risk of biochemical failure or increase PSA. Sexual function may improve to approximate pre-radiation levels in some cases. A prospective trial with long-term follow up is required to better support our findings.

A Little Can Go a Long Way: The Impact of Advertising Services on Program Take-Up

2018 ◽  
Vol 40 (3) ◽  
pp. 382-398 ◽  
Author(s):  
Oded Gurantz
Keyword(s):  
High Schools ◽  
Low Income ◽  
Effective Means ◽  
Cost Effective ◽  
State Aid ◽  
Private Funding ◽  
Postsecondary Enrollment ◽  
Policy Interventions ◽  
Marginal Students ◽  
The Impact

The success of policy interventions is frequently stymied by the inability to induce take-up in target populations. In this article, I show that local advertising in combination with small financial lotteries increases the likelihood that low-income students apply for and receive state aid. I isolate causal impacts by estimating the change in completed aid applications in high schools where the advertising program was canceled due to the expiration of private funding compared with high schools that never participated in the advertising program. Using this differences-in-differences framework, I find that state aid applications declined by approximately 3% to 4% (or roughly four to six applications per high school). Furthermore, postsecondary enrollment in 4-year public colleges declined by about one-half to one percentage point in impacted high schools. These results suggest that small incentives may be a cost-effective means of promoting program take-up for marginal students.

Sign in / Sign up

Export Citation Format

Share Document