In an issue of ONCOLOGY, there was a review of the literature provides us with a comprehensive review of the limited literature on management of men with prostate cancer who have pelvic lymph node involvement but no known distant metastatic disease at diagnosis. Common folklore has been that these men, with limited pelvic lymph node [...]
It is generally accepted that a complete biochemical response (BR) of a man’s PSA immediately after surgery is an indicator of optimal cancer control. Does this also hold true for men with lymph node invasion (LNI)? Researchers performed a single institution study of 319 men with prostate cancer and LNI who were treated with surgery [...]
I have often had men recently diagnosed with advanced, metastatic prostate cancer call me and ask if surgery makes any sense for them to consider. I have never been sure how to respond given that their cancer is known to be already out of their gland. In response to this common question, researchers from the [...]
In an analysis of outcomes reported in the Journal of Clinical Oncology, men who were diagnosed with lymph node-positive prostate cancer (no bone involvement) who went on to receive targeted radiation (adjuvant radiotherapy) enjoyed a survival benefit over those individuals who did not have this therapy. This finding was specifically for men with both low-volume [...]
In the normal course of events node-positive prostate cancer has typically been excluded from clinical trials. This leaves our oncologists with little evidence to guide the management for those of us who have this flavor of prostate cancer. A recent anaylisis presented at the European Society for Medical Oncology (ESMO) 2014 Congress begins to shed [...]
The standard of treatment for men who have a localized recurrence in lymph nodes (LN) after surgery is intensity modulated radiation therapy (IMRT) as well as with men who have high-risk prostate cancer which includes cancer in both the prostate and seminal vesicles (SV). As with all treatments the use of IMRT comes with many [...]
At a recent meeting that I attended it was reported by a nurse that one of her patients with advanced prostate cancer with only a PSA recurrence and lymph node involvement on a scan was rejected by their insurance company for reimbursement for Provenge. The insurance company indicated that to pay for the treatment they [...]
Diagnosed with lymph-node positive prostate cancer, what are the best treatment options? Should you add surgery to hormone therapy? These are important questions which have not yet been adequately answered. To help to begin to answer this question, researchers at Department of Urologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. and [...]
The prognosis of patients with advanced prostate cancer who have lymph node metastasis depends on the number of positive lymph nodes removed and Gleason score of the primary tumor. Bilateral pelvic lymph node dissection should be performed in intermediate- and high-risk patients to identify those with minimal nodal burden who may benefit the most from [...]
In many places it is a common practice to stop a radical prostatectomy (prostate gland removal) if the surgeon finds that the patient has positive lymph nodes. Since positive nodes are considered systemic disease as opposed to a localized disease, many physicians have felt there is no reason to complete the surgery and subject the [...]
