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Michel MS, Gschwend JE, Wullich B, Krege S, Bolenz C, Merseburger AS, Krabbe LM, Schultz-Lampel D, König F, Haferkamp A, Hadaschik B. [Risk-adapted early detection program for prostate cancer 2.0-position paper of the German Society of Urology 2024]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:893-898. [PMID: 39134785 DOI: 10.1007/s00120-024-02437-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND AND OBJECTIVE Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed a concept for risk-adapted prostate cancer early detection. MATERIALS AND METHODS Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed. RESULTS Risk-adapted prostate cancer screening involves PSA testing in the age group of 45-70 years, followed by PSA-based individual risk stratification and stepwise expansion of diagnostics through magnetic resonance imaging (MRI) to biopsy. While initially up to 2.6 million men will undergo PSA testing, a reduction in these initial examinations to fewer than 200,000 men per year will occur from year four onwards. CONCLUSIONS The presented algorithm provides clear recommendations for risk-adapted PSA-based early detection for prostate cancer for urologists and patients. The goal is to improve diagnosis of clinically significant prostate cancer, while reducing overdiagnosis and overtreatment.
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Affiliation(s)
- Maurice Stephan Michel
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland.
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - Jürgen E Gschwend
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Bernd Wullich
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Susanne Krege
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Christian Bolenz
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Axel S Merseburger
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Laura-Maria Krabbe
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Daniela Schultz-Lampel
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Frank König
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Axel Haferkamp
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
| | - Boris Hadaschik
- Deutsche Gesellschaft für Urologie, Geschäftsstelle Berlin, Martin-Buber-Straße 10, 14163, Berlin, Deutschland
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Claaßen K, Karpinski M, Kajüter H, Hüsing J, Möller L, Wellmann I, Grünwald V, Hadaschik B, Albers P, Stang A. Mortality from prostate cancer in the years 2007-2021 in North Rhine-Westphalia, Germany. BMC Urol 2024; 24:181. [PMID: 39192311 DOI: 10.1186/s12894-024-01564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 08/12/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The crude mortality rate and the lifetime mortality risk from prostate cancer in Germany are above international average. However age-standardised mortality and years of life lost per capita from prostate cancer are declining. This study analyses the mortality-related measures for the federal state of North Rhine-Westphalia (NRW) in Germany. METHODS Based on the cause of death statistics and data from the NRW State Cancer Registry on 45,300 deaths in the years 2007-2021, mortality rates, the lifetime mortality risk from prostate cancer, median age at death and years of life lost are presented. Additionally, the 15 most frequent causes of death of 95,013 patients diagnosed with prostate cancer are reported. RESULTS With a stable lifetime mortality risk from prostate cancer, age-standardised mortality and years of life lost per capita are decreasing while crude mortality and median age at death are increasing in NRW. Less than half of the patients die from their prostate cancer. Cancers of the urinary bladder and other urinary organs also occur more frequently as a cause of death than it would be expected based on the age-specific risk in the total population. CONCLUSIONS More people in North Rhine-Westphalia are dying of prostate cancer over time due to demographic ageing alone. At the same time, the age-specific mortality risk has not increased and when patients die of prostate cancer, it is at an increasingly older age. However, there is a statistical association with deaths from cancers of the lower urinary tract in patients diagnosed with prostate cancer, which demands further evaluation.
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Affiliation(s)
- Kevin Claaßen
- State Cancer Registry North-Rhine Westphalia, Bochum, Germany.
- Department of Medical Statistics and Epidemiology, Medical School Hamburg, Hamburg, Germany.
| | - Madeleine Karpinski
- State Cancer Registry North-Rhine Westphalia, Bochum, Germany
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | | | - Johannes Hüsing
- State Cancer Registry North-Rhine Westphalia, Bochum, Germany
| | - Lennart Möller
- State Cancer Registry North-Rhine Westphalia, Bochum, Germany
| | - Ina Wellmann
- State Cancer Registry North-Rhine Westphalia, Bochum, Germany
| | - Viktor Grünwald
- Department of Urology, University Hospital Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, Essen, Germany
| | - Peter Albers
- Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Andreas Stang
- State Cancer Registry North-Rhine Westphalia, Bochum, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
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3
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Leenen RCA, Venderbos LDF, Helleman J, Gómez Rivas J, Vynckier P, Annemans L, Chloupková R, Májek O, Briers E, Vasilyeva V, Remmers S, van Harten MJ, Denijs FB, de Vos II, Chandran A, Basu P, van den Bergh RCN, Collen S, Van Poppel H, Roobol MJ, Beyer K. Prostate Cancer Early Detection in the European Union and UK. Eur Urol 2024:S0302-2838(24)02502-8. [PMID: 39183092 DOI: 10.1016/j.eururo.2024.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND AND OBJECTIVE While prostate cancer (PCa) incidence and mortality rates continue to rise, early detection of PCa remains highly controversial, and the research landscape is rapidly evolving. Existing systematic reviews (SRs) and meta-analyses (MAs) provide valuable insights, but often focus on single aspects of early detection, hindering a comprehensive understanding of the topic. We aim to fill this gap by providing a comprehensive SR of contemporary SRs covering different aspects of early detection of PCa in the European Union (EU) and the UK. METHODS On June 1, 2023, we searched four databases (Medline ALL via Ovid, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) and Google Scholar. To avoid repetition of previous studies, only SRs (qualitative, quantitative, and/or MAs) were considered eligible. In the data, common themes were identified to present the evidence systematically. KEY FINDINGS AND LIMITATIONS We identified 1358 citations, resulting in 26 SRs eligible for inclusion. Six themes were identified: (1) invitation: men at general risk should be invited at >50 yr of age, and testing should be discontinued at >70 yr or with <10 yr of life expectancy; (2) decision-making: most health authorities discourage population-based screening and instead recommend a shared decision-making (SDM) approach, but implementation of SDM in clinical practice varies widely; decision aids help men make more informed and value-consistent screening decisions and decrease men's intention to attempt screening, but these do not affect screening uptake; (3) acceptance: facilitators for men considering screening include social prompting by partners and clinician recommendations, while barriers include a lack of knowledge, low-risk perception, and masculinity attributes; (4) screening test and algorithm: prostate-specific antigen-based screening reduces PCa-specific mortality and metastatic disease in men aged 55-69 yr at randomisation if screened at least twice; (5) harms and benefits: these benefits come at the cost of unnecessary biopsies, overdiagnosis, and subsequent overtreatment; and (6) future of screening: risk-adapted screening including (prebiopsy) risk calculators, magnetic resonance imaging, and blood- and urine-based biomarkers could reduce these harms. To enable a comprehensive overview, we focused on SRs. These do not include the most recent prospective studies, which were therefore incorporated in the discussion. CONCLUSIONS AND CLINICAL IMPLICATIONS By identifying consistent and conflicting evidence, this review highlights the evidence-based foundations that can be built upon, as well as areas requiring further research and improvement to reduce the burden of PCa in the EU and UK. PATIENT SUMMARY This review of 26 reviews covers various aspects of prostate cancer screening such as invitation, decision-making, screening tests, harms, and benefits. This review provides insights into existing evidence, highlighting the areas of consensus and discrepancies, to guide future research and improve prostate cancer screening strategies in Europe.
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Affiliation(s)
- Renée C A Leenen
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands.
| | - Lionne D F Venderbos
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Jozien Helleman
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Juan Gómez Rivas
- Department of Urology, Clínico San Carlos University Hospital, Madrid, Spain
| | - Pieter Vynckier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Lieven Annemans
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Renata Chloupková
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ondřej Májek
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | | | - Vera Vasilyeva
- European Association of Urology, Policy Office, Arnhem, The Netherlands
| | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Meike J van Harten
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Frederique B Denijs
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Ivo I de Vos
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Arunah Chandran
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Partha Basu
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Roderick C N van den Bergh
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Sarah Collen
- European Association of Urology, Policy Office, Arnhem, The Netherlands
| | - Hein Van Poppel
- European Association of Urology, Policy Office, Arnhem, The Netherlands; Department of Urology, KU Leuven, Leuven, Belgium
| | - Monique J Roobol
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
| | - Katharina Beyer
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, The Netherlands
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Matsukawa A, Yanagisawa T, Bekku K, Kardoust Parizi M, Laukhtina E, Klemm J, Chiujdea S, Mori K, Kimura S, Fazekas T, Miszczyk M, Miki J, Kimura T, Karakiewicz PI, Rajwa P, Shariat SF. Comparing the Performance of Digital Rectal Examination and Prostate-specific Antigen as a Screening Test for Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol Oncol 2024; 7:697-704. [PMID: 38182488 DOI: 10.1016/j.euo.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND AND OBJECTIVE Although digital rectal examination (DRE) is recommended in combination with prostate-specific antigen (PSA) for detection of prostate cancer (PCa), there are limited data to support its use as a screening/early detection test. Our objective was to assess the diagnostic value of DRE in screening for early detection of PCa. METHODS In August 2023, we queried the PubMed, Scopus, and Web of Science databases to identify prospective studies simultaneously investigating the diagnostic performance of DRE and PSA for PCa screening. The primary endpoints were the positive predictive value (PPV) and cancer detection rate (CDR) of DRE. Secondary endpoints included the PPV and CDR of both PSA alone and in combination with DRE. We conducted meta-regression analysis to compare the CDR and PPV of different screening strategies. This meta-analysis is registered on PROSPERO (CRD42023446940). KEY FINDINGS AND LIMITATIONS We identified eight studies involving 85,798 participants, of which three were randomized controlled trials and five were prospective diagnostic studies, that reported the PPV and CDR of both DRE and PSA for the same cohort. Our analysis revealed a pooled PPV of 0.21 (95% confidence interval [CI] 0.13-0.33) for DRE, which is similar to the PPV of PSA (0.22, 95% CI 0.15-0.30; p = 0.9), with no benefit from combining DRE and PSA (PPV 0.19, 95% CI 0.13-0.26; p = 0.5). However, the CDR of DRE (0.01, 95% CI: 0.01-0.02) was significantly lower than that of PSA (0.03, 95% CI 0.02-0.03; p < 0.05) and the combination of DRE and PSA (0.03, 95% CI 0.02-0.04; p < 0.05). The screening strategy combining DRE and PSA was not different to that of PSA alone in terms of CDR (p = 0.5) and PPV (p = 0.5). CONCLUSIONS AND CLINICAL IMPLICATIONS Our comprehensive review and meta-analysis indicates that both as an independent test and as a supplementary measure to PSA for PCa detection, DRE exhibits a notably low diagnostic value. The collective findings from the included studies suggest that, in the absence of clinical symptoms and signs, DRE could be potentially omitted from PCa screening and early detection strategies. PATIENT SUMMARY Our review shows that the screening performance of digital rectal examination for detection of prostate cancer is not particularly impressive, suggesting that it might not be necessary to conduct this examination routinely.
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Affiliation(s)
- Akihiro Matsukawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kensuke Bekku
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mehdi Kardoust Parizi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Jakob Klemm
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sever Chiujdea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Spitalul Clinic Judetean Murures, University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Mures, Romania
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shoji Kimura
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tamas Fazekas
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Marcin Miszczyk
- Third Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
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5
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Shish L, Zabell J. Digital Rectal Exam in Prostate Cancer Screening and Elevated PSA Work-up-Is there a role anymore? Curr Urol Rep 2024; 25:193-199. [PMID: 38869693 DOI: 10.1007/s11934-024-01218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE OF REVIEW Prostate cancer (PCa) screening tools, particularly digital rectal examination (DRE), are under scrutiny. This review assesses the utility of DRE in PCa screening. RECENT FINDINGS Recent studies reaffirm the DRE's sensitivity and specificity, a higher PCa detection rate with PSA in conjunction with DRE, and a slightly elevated risk of clinically significant PCa (CSPC) in those with elevated PSA and suspicious DRE. Studies confirm high accuracy of MRI in identifying CSPC, with ongoing research exploring its screening potential. DRE alone lacks accuracy for PCa screening, often resulting in missed diagnoses and unnecessary biopsies. Its supplementary use with PSA marginally increases detection rates of identifying a small percentage of CSPC, but the benefit remains questionable. Emerging evidence suggests MRI has the potential as a superior screening tool compared to DRE, although direct comparative studies are lacking. Overall, the DRE has a limited role in current PCa screening.
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Affiliation(s)
- Lane Shish
- Department of Urology, University of Minnesota, 420 Delaware St. SE, MMC 394, Minneapolis, MN, 55455, USA
| | - Joseph Zabell
- Department of Urology, University of Minnesota, 420 Delaware St. SE, MMC 394, Minneapolis, MN, 55455, USA.
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6
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De Vrieze M, Al-Monajjed R, Boschheidgen M, Albers P. Prostate Cancer Screening in Young Men. J Pers Med 2024; 14:818. [PMID: 39202010 PMCID: PMC11355119 DOI: 10.3390/jpm14080818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/10/2024] [Accepted: 07/30/2024] [Indexed: 09/03/2024] Open
Abstract
Background: Prostate cancer (PCa) screening strategies are being developed and evaluated in several countries. However, most of the evidence regarding PCa screening has been generated in study populations aged 50 and older. Aims: This study summarizes findings of a screening trial in younger men and discuss those findings in the context of other screening trials. Methods: Non-systematic review. Results: Screening of 45-year-old men resulted in a low PCa detection rate. Nonetheless, almost 70% of screen-detected PCa at this age was clinically significant. In young men ISUP GG 1 screen-detected cancers warrant rigorous follow-up. A baseline, midlife prostate-specific antigen (PSA) value at age 45 may safely exclude the vast majority of men from further screening investigations for at least 5 years. At age 45, a confirmatory PSA value reduces the number of subsequent tests almost by half. Sequential magnetic resonance imaging (MRI) as a reflex test subsequent to an elevated PSA ≥ 3 ng/mL needs further investigation in young men. Conclusions: Screening in young men needs to be carefully investigated in order to avoid overscreening and overdiagnosis.
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Affiliation(s)
- Maxime De Vrieze
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany
| | - Rouvier Al-Monajjed
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany
- Department of Urology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
| | - Matthias Boschheidgen
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
| | - Peter Albers
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany
- Department of Urology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
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7
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Lavi Arab F, Hoseinzadeh A, Hafezi F, Sadat Mohammadi F, Zeynali F, Hadad Tehran M, Rostami A. Mesenchymal stem cell-derived exosomes for management of prostate cancer: An updated view. Int Immunopharmacol 2024; 134:112171. [PMID: 38701539 DOI: 10.1016/j.intimp.2024.112171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/16/2024] [Accepted: 04/27/2024] [Indexed: 05/05/2024]
Abstract
Prostate cancer represents the second most prevalent form of cancer found in males, and stands as the fifth primary contributor to cancer-induced mortality on a global scale. Research has shown that transplanted mesenchymal stem cells (MSCs) can migrate by homing to tumor sites in the body. In prostate cancer, researchers have explored the fact that MSC-based therapies (including genetically modified delivery vehicles or vectors) and MSC-derived exosomes are emerging as attractive options to improve the efficacy and safety of traditional cancer therapies. In addition, researchers have reported new insights into the application of extracellular vesicle (EV)-MSC therapy as a novel treatment option that could provide a more effective and targeted approach to prostate cancer treatment. Moreover, the new generation of exosomes, which contain biologically functional molecules as signal transducers between cells, can simultaneously deliver different therapeutic agents and induce an anti-tumor phenotype in immune cells and their recruitment to the tumor site. The results of the current research on the use of MSCs in the treatment of prostate cancer may be helpful to researchers and clinicians working in this field. Nevertheless, it is crucial to emphasize that although dual-role MSCs show promise as a therapeutic modality for managing prostate cancer, further investigation is imperative to comprehensively grasp their safety and effectiveness. Ongoing clinical trials are being conducted to assess the viability of MSCs in the management of prostate cancer. The results of these trials will help determine the viability of this approach. Based on the current literature, engineered MSCs-EV offer great potential for application in targeted tumor therapy.
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Affiliation(s)
- Fahimeh Lavi Arab
- Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Akram Hoseinzadeh
- Department of Immunology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.; Cancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Hafezi
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadat Mohammadi
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farid Zeynali
- Department of Urology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Hadad Tehran
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Amirreza Rostami
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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8
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Kirby M, Merriel SW, Olajide O, Norman A, Vasdev N, Hanchanale V, Cain M, Wilkinson M, Stephens H, Victor D, Kinnaird W, Tree A, Challapalli A, Rylance A. Is the digital rectal exam any good as a prostate cancer screening test? Br J Gen Pract 2024; 74:137-139. [PMID: 39222422 DOI: 10.3399/bjgp24x736677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Affiliation(s)
- Mike Kirby
- Trends in Urology and Men's Health; president elect, British Society of Sexual Medicine
| | - Samuel Wd Merriel
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester
| | | | - Alexander Norman
- Cobham Health Centre, Cobham; co-medical director, Surrey and Sussex Cancer Alliance
| | - Nikhil Vasdev
- Lister Hospital, Stevenage; professor and chair of robotic surgery, University of Hertfordshire
| | | | - Michelle Cain
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - Malcolm Wilkinson
- Macmillan urology consultant radiographer, Western Health and Social Care Trust, Londonderry
| | - Harley Stephens
- SABR and IGRT specialist therapy radiographer, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol
| | | | - William Kinnaird
- University College London Hospitals NHS Foundation Trust, London
| | - Alison Tree
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London
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9
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Kumar A, Prakash A, Kumar Upadhyay A, Kumar B, Mitra S. A Rare Case of Neuroendocrine Prostate Cancer Detected on 68Ga - DOTANOC Positron Emission Tomography/Computed Tomography (PET/CT). Cureus 2024; 16:e52375. [PMID: 38361734 PMCID: PMC10868628 DOI: 10.7759/cureus.52375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/17/2024] Open
Abstract
Prostate cancer is one of the most common malignancies affecting elderly men worldwide and the fifth leading cause of cancer death in men. Prostate cancer includes many histological variants with the prostatic acinar adenocarcinoma variant accounting for the majority of the diagnosed cases. Other less common histological variants are broadly classified as non-acinar carcinomas. One of the non-acinar carcinoma variants is neuroendocrine prostate cancer (NEPC). NEPC can emerge as a mechanism of treatment resistance in castration-resistant conventional prostate cancer and can also rarely be seen as a primary histological form at the time of initial diagnosis. Like other non-acinar carcinoma variants of prostate cancer, NEPC is also an aggressive variant with associated poor prognosis. Neuroendocrine tumors (NETs) are characterized by the expression of somatostatin receptors (SSTRs). Positron emission tomography/computed tomography (PET/CT) using radiolabeled somatostatin analogs like DOTANOC have been used to detect and stage these NETs. These radiolabeled somatostatin analogs also provide the option of treatment of these tumors and have been used in peptide receptor radionuclide therapy of these tumors. NEPC being a neuroendocrine malignancy also expresses SSTRs and hence can be detected with PET/CT radiotracers like 68Gallium-labeled somatostatin analogs. We here report a case of metastatic treatment-emergent NEPC detected on 68Ga - DOTANOC PET/CT.
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Affiliation(s)
| | | | | | - Bhola Kumar
- Nuclear Medicine, Tata Main Hospital, Jamshedpur, IND
| | - Sujata Mitra
- Nuclear Medicine, Tata Main Hospital, Jamshedpur, IND
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