Prostate cancer is not uncommon amongst the elderly men. Diagnosis is made using histopathology specimens of Transrectal Ultrasound guided biopsy of the prostate gland. However, prostate cancer presenting as a intra-prostatic cysts are rare. We report a case of elderly gentleman who presented with malignant intra-prostatic cysts.
Prostatic Neoplasms

Prostate cancer, the second most common cancer worldwide in 2012, poses a high public burden prompting the need to develop effective treatment strategies. To determine the progress made through the years, this paper documented the timeline of treatment strategies for advanced prostate cancer as presented in a scientific session held in July 2018. Two treatment strategies for metastatic prostate cancer were emphasized: the addition of docetaxel (chemotherapy) and abiraterone acetate plus prednisone to androgen-deprivation therapy (i.e. standard of care). Related clinical trials including but not limited to the CHAARTED trial, STAMPEDE trial, and LATITUDE trial showed that addition of either DOC or ABI led to a general increase in the overall survival of the patient. Furthermore, treatment strategies for non-metastatic castration resistant prostate cancer were also discussed. Evidence from clinical trials showed that addition of enzalutamide or apalutamide to ADT yielded better outcomes than ADT-placebo. These recent advancements have broadened the physician's options for treatment.

Introduction: 18F-PSMA-1007 is a novel prostate-specific membrane antigen (PSMA)-based radiopharmaceutical for imaging prostate cancer. The recommended imaging time is 60 minutes post-injection of the radiotracer. However, during this time there is a physiologic accumulation of the radiotracer in the urinary bladder which sometimes may obscure lesions adjacent to it. Objective: This study aims to determine if early dynamic imaging in addition to the recommended 60-minute postinjection static imaging can improve the detection of PSMA-avid lesions in the staging and restaging of prostate cancer. Methods: This is a retrospective cross-sectional study of the detection rate of early dynamic and static imaging using 18F-PSMA-1007 PET/CT scan in patients with prostate cancer (PCa) who were referred for initial staging or restaging. The McNemar test was used to compare the detection rate between the two imaging. Spearman correlation was used to determine the correlation of Gleason score (GS), PSA, and SUVmax values. Results: 18F-PSMA-1007 PET/CT scans of 53 patients with prostate cancer, were referred for either staging (22/53) or restaging (31/53), all of whom had undergone both early dynamic and static imaging. Among the 53 patients, 5 had 2 lesions each, for a total of 58 lesions were included in the analysis. There were 48/58 lesions detected on both early dynamic and static imaging, 2/58 lesions were only detected in the early imaging, 1/58 lesions was only detected in the static imaging, and 7/58 were not detected on both imaging. McNemar the test was not statistically significant (p = 1.000) in the detection rate of the two methods. There is a positive correlation between serum PSA levels and SUVmax measurements for all the patients. Only the correlation between the GS and SUVmax in the static imaging of the staging group was statistically significant. Conclusion Early dynamic imaging may be an adjunctive procedure in detecting PSMA-avid lesions, particularly in the basal segment of the prostate gland near the urinary bladder. However, it is not recommended as a standard component of the comprehensive protocol for imaging using 18F-PSMA-1007 PET/CT in patients with PCa.
Prostatic Neoplasms

Introduction: Prostate cancer is the third most common cancer among Filipino males. Ga-68 PSMA PET-CT and Lu-177 PRLT have been introduced in the Philippines for the diagnostics and therapy of prostate cancer. Objective: The aim of this study is to compare treatment outcomes of standard therapy plus Lu-177 PSMA radioligand therapy and standard therapy alone among patients with prostatic cancer status-post castration using Ga-68 PET-CT as an outcome indicator. Methodology: This is an ambispective cohort study on Ga-68 PSMA PET-CT scans performed between January 1, 2018 and July 31, 2021. Serum PSA data taken within one month of the PET-CT scans were also collected when available. The PET-CT images were reviewed by a radiologist for RECIST response, and by a nuclear medicine physician for PERCIST response . Results: A total of 11 participants were included in the study. Six participants (55.5%) received standard therapy, while five participants (45.5%) received Lu-177 PSMA radioligand therapy plus standard therapy. There was no significant difference in the baseline and follow-up CT as shown by all p values > 0.05. A trend towards higher number of participants with non-complete/non-progressive RECIST response was noted in the control group than the treatment group, as well as higher number of participants with progressive or stable disease using the PERCIST response. Conclusion There were no significant differences noted in the clinical outcomes of participants who received Lu-177 PRLT and those with standard therapy alone. A trend towards decreasing serum PSA, CT and PET measurements were noted among patients given Lu-177 PRLT than those with standard therapy.
Prostatic Neoplasms

Introduction: Limited access to the perineum and limited operating room space are just some of the limitations of the standard lithotomy docking for robot-assisted radical prostatectomy (RARP-LD). The side-docking technique (RARP-SD) may address these problems. Methods: Thirty cases of robot-assisted radical prostatectomy were matched to 120 cases of RARP-LD cases by propensity scoring using age, body mass index (BMI), clinical T stage, biopsy Gleason score, and ultrasound prostate volume. Operative and docking time, complications were used to compare peri-operative and safety outcomes. Results: Evaluation of 30 RARP-LD and 30 RARP-SD cases was done after propensity matching. Patient age, BMI, clinical T stage, biopsy Gleason score, and prostate volume were similar between the two groups (p>0.050). The mean docking time of RARP-SD is shorter than that of RARP-LD cases (7.56 vs. 4.12, p <0.001), but this did not translate to a shorter operative time. There were less peri-operative complications in the RARP-SD cases. Conclusions RARP-SD has a docking time and produces less complication than RARP-LD.
Prostatic Neoplasms

Introduction: Prostate cancer is a significant health problem worldwide. Transrectal ultrasound guided biopsy has limitations in the detection of clinically significant disease, hence, new imaging including multiparametric MRI and MRI targeted biopsy is developed. In most centers, reading and contouring of the prostate and identification of significant lesions on MRI are performed by radiologists. In this institution, these steps are performed by a urologist. Objective: To determine the clinically significant cancer detection rate in patients undergoing MRI fusion-targeted and random systematic prostate biopsy where MRI PIRADS scoring, identification of lesions and contouring are performed by a trained urologist in a Philippine tertiary hospital. Methods: This is a cross-sectional study of patients who underwent MRI fusion prostate biopsy in the Philippine General Hospital (PGH) from June 2021 to June 2023. Clinically significant cancer (csCancer) detection rates were calculated for MRI fusion prostate biopsy, random systematic prostate biopsy, and PIRADS scoring. Concordance was also determined between PIRADS scores and histopathological results. Results: Forty six (46) patients who underwent MRI fusion biopsy in PGH were included in the study, representing a total of 90 lesions identified by urologists using mpMRA with PIRADS scores of at least 3. Of the patients, 13 (14.4%) were diagnosed with csCancer, while a large proportion was diagnosed with benign prostatic tissue. The csCancer detection rate of MRI fusion biopsy was 28.3% (13/46) and 8.7% (4/46) for random biopsy. The csCancer detection rate was 11.1%, 14.6%, and 36.4% for PIRADS 3, 4, and 5, respectively. Conclusion The detection rate of clinically significant prostate cancer using MRI fusion-targeted prostate biopsy based on urologist-performed MRI reading and contouring was superior to random systematic approach. The positive predictive value of PIRADS scores when interpreted by urologists was lower compared to reported values in the literature and did not show concordance. This may reflect lowered thresholds for labeling prostate lesions as suspicious in urologists.
Prostatic Neoplasms

In cancer diseases, it is very important to grade histologically because there was close association between histological grades and prognoses. There were many grade systems of prostatic adenocarcinoma, among them the Gleason system was used most widely. In Gleason system, there are 5 grades, with well-differentiated tumors are in grade 1, and the least differentiated tumors in grade 5. The Gleason system is very useful not only in the prognoses, predictions of natural progresses of prostate cancer, but also in the evaluations of recurrence after total prostectomies or radiotherapies
Prostatic Neoplasms ; Neoplasms

No abstract available.
Prostate ; Prostatic Neoplasms ; Urticaria

No abstract available.
Humans ; Prostate* ; Prostatic Neoplasms*

No abstract available.
Diagnosis* ; Prostatic Neoplasms*