Cancers of the prostate, penis, and testicles: epidemiology, prevention, and treatment

Men's Achilles' heel: prostate cancer and the reconstruction of masculinity

The aim of this study was to investigate how Swedish men diagnosed with prostate cancer understand the effects of their treatment in relation to sexual health and masculinity. Utilising a phenomenological and sociologically informed approach, the study involved interviews with 21 Swedish men who experienced problems following treatment. The results showed that participants' initial response post-treatment, involved the development of new bodily understandings and socially informed strategies to handle incontinence and sexual dysfunction. Due to impotence and the loss of ejaculatory ability following treatments such as surgery, participants re-articulated the meaning of intimacy, as well as their understanding of masculinity and themselves as ageing men. Unlike in previous research, such a re-articulation of masculinity and sexual health is understood as taking place within rather than in opposition to hegemonic masculinity.

Polymeric Chloroquine as an Effective Antimigration Agent in the Treatment of Pancreatic Cancer

Hydroxychloroquine (HCQ) has been the subject of multiple recent preclinical and clinical studies for its beneficial use in the combination treatments of different types of cancers. Polymeric HCQ (PCQ), a macromolecular multivalent version of HCQ, has been shown to be effective in various cancer models both in vitro and in vivo as an inhibitor of cancer cell migration and experimental lung metastasis. Here, we present detailed in vitro studies that show that low concentrations of PCQ can efficiently inhibit cancer cell migration and colony formation orders of magnitude more effectively compared to HCQ. After intraperitoneal administration of PCQ in vivo, high levels of tumor accumulation and penetration are observed, combined with strong antimetastatic activity in an orthotopic pancreatic cancer model. These studies support the idea that PCQ may be effectively used at low doses as an adjuvant in the therapy of pancreatic cancer. In conjunction with previously published literature, these studies further undergird the potential of PCQ as an anticancer agent.

A Comparative study of two types of organ-sparing surgeries for early stage penile cancer: Wide local excision vs partial penectomy

INTRODUCTION

Till date, there have been few reports of comparative studies on the outcomes of these different treatment modalities. In this study, we have aimed to comparatively evaluate the quality-of-life parameters, including sexual function, urinary function, and health-related quality of life (HRQOL), in patients with early stage penile cancers who underwent two different organ-sparing surgeries.

MATERIAL AND METHODS

From March 2012 to March 2015, we enrolled 15 patients with early stage penile cancers who underwent either wide local excision or partial penectomy as organ-sparing surgical treatments. We assessed their sexual and urinary functions and their HRQOL, using the International Index of Erectile Function (IIEF-15), Self-Esteem and Relationship (SEAR), and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires and urodynamic determinations, and comparatively analyzed the outcomes of these patients who underwent either type of surgery.

RESULTS

All patients who underwent these two types of surgeries experienced satisfactory outcomes. The patients who underwent wide local excision performed relatively better, in terms of their sexual functions, urinary functions, and HRQOL, but no statistically significant differences were observed in the data collected via the IIEF-15, SEAR, EDITS, and EORTC-QLQ-C30 questionnaires and urodynamic determinations (p > 0.05), except in the data corresponding to the orgasmic function (p = 0.033).

CONCLUSION

Both types of organ-sparing surgeries assessed in this study achieved good outcomes, in terms of the aesthetics, sexual functions, urinary functions, and HRQOL in patients, without compromising the therapeutic effects of these surgeries. However, the observed decreases in orgasmic function will need to be addressed further.

Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

Penile cancer is an uncommon malignancy. Surgical treatment is inevitably mutilating. Considering the strong impact on patients' sexual life we want to evaluate sexual function and satisfaction after partial penectomy. The patients in this study (n = 25) represented all those who attended our institutions and were diagnosed and treated for penile cancer from October 2011 to November 2013. All patients underwent partial penectomy and followed-up (mean: 14 months; range: 12-25). Sexual presurgical baseline was estimated using the International Index of Erectile Dysfunction 15 (IIEF-15). Sexual outcomes of each patient were estimated considering four standardized and validated questionnaires. We analyzed the means and ranges of IIEF-15 including erectile function (IIEF-1-5 and -15), orgasmic function (IIEF-9 and -10), sexual desire (IIEF-11 and -12), intercourse satisfaction (IIEF-6-8), and overall satisfaction (IIEF-13 and -14). Then, we also used Quality of Erection Questionnaire (QEQ), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and Self-Esteem and Relationship (SEAR) to evaluate the sexual function and satisfaction of our patients. The final results showed that penile cancer leads to several sexual and psychosexual dysfunctions. Nevertheless, patients who undergo partial penectomy for penile cancer can maintain the sexual outcomes at levels slightly lower to those that existed in the period before surgery.

Associations of serum vitamin A and carotenoid levels with markers of prostate cancer detection among US men

Associations of serum vitamin A and carotenoid levels with markers of prostate cancer detection were evaluated among 3,927 US men, 40-85 years of age, who participated in the 2001-2006 National Health and Nutrition Examination Surveys. Five recommended definitions of prostate cancer detection were adopted using total and free prostate-specific antigen (tPSA and fPSA) laboratory measurements. Men were identified as high risk based on alternative cutoffs, namely tPSA > 10 ng/ml, tPSA > 4 ng/ml, tPSA > 2.5 ng/ml, %fPSA < 25%, and %fPSA < 15%. %fPSA was defined as (fPSA÷tPSA)× 100%. Serum levels of vitamin A (retinol and retinyl esters) and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein + zeaxanthin, lycopene) were defined as quartiles and examined as risk/protective factors for PSA biomarkers. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using binary logistic models. After adjustment for known demographic, socioeconomic, and lifestyle confounders, high serum levels of retinyl esters (tPSA > 10 ng/ml: Q4 vs. Q1 → OR = 0.38, 95% CI: 0.14-1.00) and α-carotene (%fPSA < 15%: Q4 vs. Q1 → OR = 0.49, 95% CI: 0.32-0.76) were associated with a lower odds, whereas high serum level of lycopene (tPSA > 2.5 ng/ml: Q4 vs. Q1 → OR = 1.49, 95% CI: 1.01-2.14) was associated with a greater odds of prostate cancer detection. Apart from the three significant associations observed, no other exposure-outcome association was significant. Monitoring specific antioxidant levels may be helpful in the early detection of prostate cancer.

[Prevention strategies for testicular and penile cancer: an integrative review]

Testicular and penile cancers are genital disorders that affect a small part of population, but are generally aggressive mainly because of the dramatic psychological effect they impose over patients. The purpose of this study was to identify evidence concerning preventing strategies for the referred types of cancer. An integrative literature review was performed on the COCHRANE, PubMed/MEDLINE, LILACS, BDENF and CINAHL databases using the following controlled descriptors: health promotion, risk factors, primary prevention, and urogenital neoplasms; and uncontrolled descriptors: prevention, penile cancer, testicle cancer. The studies were unanimous in concluding that self-examination of testicles is the best way to identify a possible event of testicular cancer. Circumcision, prevention for sexual transmission diseases and adequate hygiene were the most important manners for penile cancer prevention. Nurses should assume the role for general and specific health promotion, considering the major impact it would have for prevention of diseases, especially for the urogenital cancers studied in this review.

Looking past the obvious: experiences of altered masculinity in penile cancer

OBJECTIVES

Penile cancer, although statistically rare in Western countries (1:100 000 per year), results in considerable physical and psychological morbidity. The treatment of choice for penile cancer is either partial or total amputation of the penis. Metastatic spread into the surrounding lymphatic system may require additional surgery. To date, little is known of the lived experiences of men with penile cancer regarding the impact of the disease and its treatment on dimensions of masculinity.

METHODS

A small-scale qualitative study using Interpretative Phenomenological Analysis (IPA). IPA aims at exploring the experience of life events and the meaning and implications for the person living through them. A purposive sample of men with penile cancer who were within a minimum of 18 months post-surgery were recruited via a specialist urology clinic (n = 9). Participants were interviewed by a male researcher using a pre-agreed semi-structured interview schedule; interviews were audio recorded for transcription with detailed analyses of main and sub-themes conducted independently by three researchers. To maintain analytical rigour, constant comparisons of main and sub-themes were made between the individual transcripts and across the emergent themes within the research group.

RESULTS

Central themes were (1) grappling with reality; (2) learning to cope and (3) changes to self.

CONCLUSIONS

That men should have an altered sense of masculine identity following penile cancer surgery is not unexpected. However, the ways in which altered masculinity manifested itself were both subtle and insidious. The results have implications for clinical practice and demonstrated the need for further research.

A review of the psychosocial issues for nurses in male genitalia-related care

AIM

This literature review aimed to highlight psychosocial issues for nurses in the practice of male genitalia-related care so as to guide the improvement of the teaching and practice of male genitalia-related care.

BACKGROUND

Male genitalia-related care is common in hospitals and in the community. In several conditions, e.g. incontinence, postradiotherapy or following operation for cancer of genitalia, bladder, colon or rectum, patients will require male genitalia-related care. Patients who require male genitalia-related care may encounter psychosocial and/or sexual dysfunction. In the holistic approach to men's health, nurses are expected to meet patients' psychosocial and sexual needs, while the literature suggests that nurses' perceptions and attitudes in providing certain male genitalia-related care, e.g. genital hygiene, sexual counselling, are negative.

METHOD

Systematic literature review.

CONCLUSION

Issues surrounding male genitalia-related care for nurses are complicated and may be related to privacy, intimacy, sexuality, dirty work and emotional discomfort. Age, gender, race and social class could compound these issues. Relevance to clinical practice. Nurses' negative perceptions, responses and attitudes towards male genitalia-related care may exacerbate patients' conditions under which male genitalia-related care is required. Appropriate strategies should be developed to overcome these problems.

Prostate-specific antigen levels in relation to cadmium exposure and zinc intake: results from the 2001-2002 National Health and Nutrition Examination Survey

BACKGROUND

Cadmium exposure has been suggested as a risk factor for prostate cancer, and experimental literature suggests that the carcinogenic effect of cadmium is modified by the presence of zinc. We evaluated total prostate-specific antigen (PSA) levels in relation to urinary cadmium concentrations and dietary zinc intake.

METHODS

PSA levels were determined in 1,320 men over the age of 40 in the 2001-2002 National Health and Nutrition Examination Survey (NHANES). Urinary cadmium concentrations were measured in about one-third of the sample population, whereas dietary zinc intake was based on participants' 24-hr recall. Information on all three variables was available for 422 men in the 2001-2002 NHANES survey. We performed linear regressions to evaluate the relationships these factors after accounting for age and other covariates.

RESULTS

Little evidence for an association between cadmium and elevated PSA level was observed. However, the data provide suggestive evidence for an interaction between zinc intake and cadmium exposure (P for interaction=0.09). Among men with zinc intake less than the median level of 12.67 mg/day, an increase in 1 microg/g creatinine cadmium exposure was associated with a 35% increase in PSA level. In contrast, among men with greater than median zinc intake, little evidence for an association between cadmium and PSA was found.

CONCLUSIONS

These findings suggest a protective effect of zinc intake on cadmium-induced prostatic injury, and may provide further rationale for investigating the impact of these factors individually and jointly on the etiology of prostate cancer.

Normal and prostate cancer cells display distinct molecular profiles of alpha-tubulin posttranslational modifications

BACKGROUND

Multiple diverse posttranslational modifications of alpha-tubulin such as detyrosination, further cleavage of the penultimate glutamate residue (Delta2-tubulin), acetylation, and polyglutamylation increase the structural and functional diversity of microtubules.

METHODS

Herein, we characterized the molecular profile of alpha-tubulin posttranslational modifications in normal human prostate epithelial cells (PrEC), immortalized normal prostate epithelial cells (PZ-HPV-7), androgen-dependent prostate cancer cells (LNCaP), transitional androgen-independent prostate cancer cells (LNCaP-cds and CWR22Rv1), and androgen-independent prostate cancer cells (PC3).

RESULTS

Compared to PrEC and PZ-HPV-7 cells, all cancer cells exhibited elevated levels of detyrosinated and polyglutamylated alpha-tubulin, that was paralleled by decreased protein levels of tubulin tyrosine ligase (TTL). In contrast, PrEC and PZ-HPV-7 cells expressed markedly higher levels of Delta2-tubulin. Whereas alpha-tubulin acetylation levels were generally equivalent in all the cell lines, PC3 cells did not display detectable levels of Ac-tubulin.

CONCLUSION

These data may reveal novel biomarkers of prostate cancer and new therapeutic targets.