An interesting summary of the state of the art. Please post on anything they missed or anything you disagree with.
Prostate Cancer: A Journey Through Its History and Recent Developments
by Hamza Mallah, Zania Diabasana, Sina Soultani, Ysia Idoux-Gillet and Thierry Massfelder *
Regenerative NanoMedicine, Centre de Recherche en Biomédecine de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), UMR_S U1260 INSERM and University of Strasbourg, 67085 Strasbourg, France
Thank you for posting this, a nice summary of many hours of scouring I did last year all over reading here and other sources.👍
Key take away for me reconfirms my decision to enjoy life, my comorbidities likely will be my own downfall and outcome, not PCa and family genetics.
"It is incredible how, 150 years later, PC has become a significant health concern [87]."
(Why is it incredible? Can't just be genetics or only better diagnostic tools of today for cancers not just this one.... maybe it just might perhaps be pushing the "easy button" always- fast foods, bad diet eating non plant based, farm animals given hormones, vaccines and chemicals, eating all the packaged processed foods with msg and preservatives, gmo seeds, chemicals in everything, air and water pollution, microplastics, microwave freq radiation transmitted everywhere, societal lifestyle from family farming agro to industrial jobs and desk jobs driving and not walking enough, chemical exposures in air and manufacturing workplace (as my father I suspect died of) lack of aerobic exercise. financial stresses, etc.)
"The majority of PCs are low-grade, low-risk, and rarely aggressive. They also tend to grow slowly. Most of the time, there are no early or beginning symptoms,........Furthermore, a lot of cancers discovered by PSA testing grow so slowly that they probably pose no threat to life "
"tumor heterogeneity complicates accurate diagnosis and grading, as sampling from different areas may yield varying results. It also has prognostic implications, as more genetically heterogeneous tumors are associated with worse disease outcomes.
(So perhaps a 200 needle biopsy might yield accurate results? please.... lol)
"There is no consensus regarding the optimum management of localized disease."
"Patients should be warned that sexual dysfunction, infertility, and bowel and bladder issues can result from PC treatment."
"The PIVOT trial, which involved 731 North American men from 1994 to 2002, indicated that there was no significant advantage to surgery for the 296 patients in the low-risk subgroup, where the 12-year lethality probability was less than 3%. In fact, the findings suggest that surveillance may be more beneficial than surgery, as reflected in both PC-specific and overall mortality rates. Additionally, the overall death rate of about 50% at ten years underscores the presence of significant comorbidities among the recruited patients [110]."
"ProtecT: After 15 years of follow-up, the study found similar prostate-cancer-specific mortality across all groups (3.1% in active monitoring, 2.2% in RP, and 2.9% in RT). However, disease progression differed: metastases occurred in 9.4% of the active monitoring group, compared to 4.7% in RP and 5.0% in RT, while local progression was seen in 25.9% of the active monitoring group, versus 10.5% in RP and 11.0% in RT. Notably, 24.4% of patients in the active monitoring group remained alive without any prostate cancer treatment at the end of the follow-up period [112].
Regarding historical treatments, they could have mentioned that Diethylsilbestrol (DES) oral estrogen treatment was the only successful chemical treatment in the 1950's to 1970's time frame. But, with the invention of Lupron-like LHRH agonist drugs in the 1980's, the use of DES was discontinued because of its higher incidence of blood clots. Also, the authors failed to discuss the very successful results of transdermal estradiol patch ADT for replacing Lupron ADT (aka PATCH Phase-II and 14-year phase-III trials).
I am still surprised there is not more discussion of fever and how it affects cancer given many decades ago patients were given injections to create fever and it improved their cancer such as shrinking tumors. Some went into complete remission. Similarly hyperthermia benefits, especially in conjunction with chemo and radiation.
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247-257, September 2017. | DOI: 10.1097/SPC.0000000000000276
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