Prostate-Specific Antigen PSA: its Role in Diagnosis and Screening of Prostate Cancer

PSA revolutionized diagnosis and management of prostate cancer. PSA is diagnostic, clinical and prognostic parameter. It serves for differential diagnosis between BPH and PC (American Urological Association), staging and control of treatment .The value of routine screening is confirmed by the ERSPC study of Erasmus University-Rotterdam - 21% reduction of mortality of PC by regular screening and 11-years follow up. The study includes 182 160 men, 50-74 aged, from 8 countries. Mortality is 0.10/1000, whereas in the controlled group is 1.07/1000, PC is detected in 9.6% against 6% in the controlled group

To Screen or Not to Screen for Prostate Cancer

Golden standard for prostate cancer screening are digital rectal examination, PSA screening and transrectal ultrasound. The recommendations of U.S.Preventive Services Task Force (USPSTF) are based on review of medical literature which conclude that PSA screening leads to unnecessary treatment- related complications which are not justified by the number of the saved lives because:Low specifity of PSA-screening for cancer detectionMedical complications, caused by unnecessary procedures, because of false-positive PSA.Increasing pressure to reduce the rate of growth of health careThe end point of evaluation of the effect of the screening is decreasing of cancer-specific mortality and evaluation of the quality of life of the saved men

PSA Dynamics in Patients with BPH and Patients Treated with 5.Alpha Reductase Inhibitors

Serum PSA gives information about the future increase of prostate volume, deterioration of symptoms and patient`s anxiety, sexual dysfunction, deterioration of urinary flow and risk of urinary retention and prostate surgery. Higher PSA strongly indicates higher risk of future BPH progression. Strong correlation is proven between prostate volume ,,age and PSA-data are from study including 4627 patients with BPH(Roehrborn et al.1999). The results of the studies show that with the increase of PSA-value, increases its sensitivity and specifity. The Curve of PSA for detecting prostate cancer is higher in men receiving dutasteride compared with placebo-group. After 6-months of treatment with 5-alpha reductase inhibitors the value of serum PSA decreases with about 50%

New Activity of a Protein from Canavalia ensiformis

Concanavalin A is a legume lectin which preferentially agglutinates transformed cells and shows antitumor effects on human breast carcinoma cells in vitro and in vivo. It is considered as a new potential antineoplastic agent targeting apoptosis, autophagy, and anti-angiogenesis in preclinical or clinical trials for cancer therapeutics, which has recently become the object of intensive study. In the present investigation, we show the capacity of the lectin to bind manganese, gold, iron, and zinc porphyrins: all potential anticancer agents. The interaction of the legume lectin with the studied compounds has been investigated by tryptophan fluorescence, showing conformational changes within the quaternary and tertiary structures of the protein. The binding of Con A with manganese, gold, and iron porphyrins, as well as adenine, was studied by fluorescence quenching. In contrast, the interaction of Con A with zinc porphyrin caused an increase in Trp fluorescence and a red shift of 10 nm of the emission maximum position. However, the binding of Con A to iron porphyrin was accompanied by a 5 nm blue shift of the emission maximum, and a kD of 0.95 ± 0.13 μM was calculated, respectively. The sigmoidal shape of the curve showed cooperative interactions, which indicated the presence of more than one class of binding site within the Con A molecule for iron porphyrin, confirmed by the Hill slope (h = 1.89±0.46). We have found that the legume lectin interacts with porphyrins and adenine with an affinity (0.14–1.89 μM) similar to that of the non-legume lectin, wheat germ agglutinin. In conclusion, the protein Con A shows new binding activity towards porphyrins with anticancer activities and could find prospective application as a drug delivery molecule that specifically targets cancer cells

Efficacy of triptorelin pamoate 11.25 mg administered subcutaneously for achieving medical castration levels of testosterone in patients with locally advanced or metastatic prostate cancer

Objectives: Gonadotropin-releasing hormone agonists are widely used as androgen deprivation therapy in many men with locally advanced or metastatic prostate cancer. Gonadotropin-releasing hormone agonists are delivered by intramuscular injection every 1, 3 or 6 months, but in some patients subcutaneous injection may be more appropriate. This study assessed the efficacy and safety profile of the gonadotropin-releasing hormone agonist, triptorelin pamoate, when administered by the subcutaneous route. Methods: In this multicentre, open-label, single-arm study, androgen deprivation therapy-naïve men with locally advanced or metastatic prostate cancer received the gonadotropin-releasing hormone agonist triptorelin pamoate 11.25 mg (3-month formulation) by the subcutaneous route twice (at baseline and 13 weeks later). The co-primary efficacy endpoints were the proportion of patients with a castration level of serum testosterone (<50 ng/dl) after 4 weeks, and of these, those still castrated after 26 weeks. Results: Of the 126 treated patients, 123 [97.6%; 95% confidence interval (CI): 93.2–99.5)] were castrated 4 weeks after the first subcutaneous injection, and 115/119 patients (96.6%; 95% CI: 91.6–99.1) castrated at 4 weeks maintained castration at 26 weeks. Median prostate-specific antigen levels were reduced by 64.2 and 96.0% at 4 and 26 weeks, respectively. The probability of maintaining a testosterone level <20 ng/dl up to 26 weeks was 90.0% (95% CI: 85.0–95.0). The most frequently occurring treatment-related adverse events were typical of gonadotropin-releasing hormone agonist treatment (hot flushes, increased weight, erectile dysfunction and hyperhidrosis). Conclusions: This study demonstrates that triptorelin pamoate 11.25 mg administered by the subcutaneous route every 3 months is as efficacious and well tolerated as administration via the intramuscular route in men with locally advanced or metastatic prostate cancer