The prevalence of prostate cancer, a common malignancy of urinary system in elderly males, has increased rapidly in China in recent years. Currently most prostate cancer patients are treated with androgen deprivation therapy (ADT). However, ADT-induced metabolic disorders such as metabolic syndrome has remarkably impaired the quality of life and decreased the survival rate.
Androgen Antagonists ; adverse effects ; therapeutic use ; Humans ; Male ; Metabolic Diseases ; chemically induced ; Prostatic Neoplasms ; drug therapy ; metabolism

Studies have investigated the effects of androgen deprivation therapy (ADT) use on the incidence and clinical outcomes of coronavirus disease 2019 (COVID-19); however, the results have been inconsistent. We searched the PubMed, Medline, Cochrane, Scopus, and Web of Science databases from inception to March 2022; 13 studies covering 84 003 prostate cancer (PCa) patients with or without ADT met the eligibility criteria and were included in the meta-analysis. We calculated the pooled risk ratios (RRs) with 95% confidence intervals (CIs) to explore the association between ADT use and the infection risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and severity of COVID-19. After synthesizing the evidence, the pooled RR in the SARS-CoV-2 positive group was equal to 1.17, and the SARS-CoV-2 positive risk in PCa patients using ADT was not significantly different from that in those not using ADT (P = 0.544). Moreover, no significant results concerning the beneficial effect of ADT on the rate of intensive care unit admission (RR = 1.04, P = 0.872) or death risk (RR = 1.23, P = 0.53) were found. However, PCa patients with a history of ADT use had a markedly higher COVID-19 hospitalization rate (RR = 1.31, P = 0.015) than those with no history of ADT use. These findings indicate that ADT use by PCa patients is associated with a high risk of hospitalization during infection with SARS-CoV-2. A large number of high quality studies are needed to confirm these results.
Male ; Humans ; Prostatic Neoplasms/chemically induced* ; Androgen Antagonists/adverse effects* ; COVID-19 ; Androgens/therapeutic use* ; SARS-CoV-2

Epidemiological surveys show that folic acid can prevent prostate cancer, but fortified folic acid may increase the risk of the malignancy. The physician data queries from the National Cancer Institute of the USA describe folate as protective against prostate cancer, whereas its synthetic analog, folic acid, is considered to increase prostate cancer risk when taken at levels easily achievable by eating fortified food or taking over-the-counter supplements. We review the current literature to examine the effects of folate and folic acid on prostate cancer, help interpret previous epidemiologic data, and provide a clarification regarding the apparently opposing roles of folate for patients with prostate cancer. A literature search was conducted in Medline to identify studies investigating the effect of nutrition and specifically folate and folic acid on prostate carcinogenesis and progression. In addition, the National Health and Nutrition Examination Survey database was analyzed for the trends in serum folate levels before and after mandatory fortification. Folate likely plays a dual role in prostate carcinogenesis. There remains some conflicting epidemiologic evidence regarding folate and prostate cancer risk. However, there is growing experimental evidence that higher circulating folate levels can contribute to prostate cancer progression. Further research is needed to clarify these complex relationships.
Dietary Supplements ; adverse effects ; Disease Progression ; Folic Acid ; analogs & derivatives ; blood ; pharmacology ; Food, Fortified ; Humans ; Male ; Nutrition Surveys ; Nutritional Status ; Prostatic Neoplasms ; blood ; chemically induced

OBJECTIVETo study the effect of combined androgen block therapy on hemoglobin (Hb) and hematocrit value (Ht) in patients with prostate cancer.

METHODSOne hundred and thirty-six patients with adenocarcinoma of the prostate were treated with combined androgen block (orchiectomy and flutamide 250 mg, Tid). Complete blood counts were detected before initiation and after 1, 2, 3, 6, 9 and 12 months of therapy.

RESULTSHb level declined significantly in all patients from a mean baseline of (136 +/- 14) g/L to (126 +/- 16) g/L, (121 +/- 14) g/L, (120 +/- 15) g/L, (113 +/- 12) g/L, (121 +/- 13) g/L and (123 +/- 15) g/L at 1, 2, 3, 6, 9 and 12 months. Ht decreased from a mean baseline of 0.424 +/- 0.041 to 0.390 +/- 0.038, 0.381 +/- 0.042, 0.378 +/- 0.038, 0.366 +/- 0.041, 0.384 +/- 0.039 and 0.387 +/- 0.040. The differences between Hb, Ht before and after treatment were significant (P < 0.05).

CONCLUSIONPatients with prostate cancer being treated with combined androgen block would develop a significant degree of anemia. Hemoglobin and hematocrit level should be monitored periodically. This kind of anemia can be treated by recombinant human erythropoietin.

Aged ; Aged, 80 and over ; Androgen Antagonists ; adverse effects ; Anemia ; chemically induced ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms ; blood ; drug therapy

Ethnicity might be associated with treatment outcomes in advanced prostate cancer. This study aimed to evaluate the efficacy and safety of androgen deprivation therapy (ADT) combined with apalutamide in East Asians with metastatic castration-sensitive prostate cancer (mCSPC). The original phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial was conducted at 260 sites in 23 countries. This subgroup analysis included patients enrolled in 62 participating centers in China, Japan, and Korea. Radiographic progression-free survival (PFS), time to prostate-specific antigen (PSA) progression, and PSA changes from baseline were compared between groups in the East Asian population. The intent-to-treat East Asian population included 111 and 110 participants in the apalutamide and placebo groups, respectively. The 24-month radiographic PFS rates were 76.1% and 52.3% in the apalutamide and placebo groups, respectively (apalutamide vs placebo: hazard ratio [HR] = 0.506; 95% confidence interval [CI], 0.302-0.849; P = 0.009). Median time to PSA progression was more favorable with apalutamide than placebo (HR = 0.210; 95% CI, 0.124-0.357; P < 0.001). Median maximum percentages of PSA decline from baseline were 99.0% and 73.9% in the apalutamide and placebo groups, respectively. The most common adverse event (AE) was rash in the apalutamide group, with a higher rate than that in the placebo group (37.3% vs 9.1%). The most common grade 3 or 4 AEs were rash (12 [10.9%]) and hypertension (12 [10.9%]) for apalutamide. The efficacy and safety of apalutamide in the East Asian subgroup of the TITAN trial are consistent with the global results.
Androgen Antagonists/adverse effects* ; Exanthema/chemically induced* ; Far East ; Humans ; Male ; Prostate-Specific Antigen ; Prostatic Neoplasms, Castration-Resistant/pathology* ; Thiohydantoins/adverse effects*

Intraductal carcinoma of the prostate (IDC-P) is characterized by prostatic carcinoma involving ducts and/or acini. The presence of IDC-P is usually associated with a high-grade Gleason score, large tumor volume, and adverse prognostic parameters, including extraprostatic extension and seminal vesicle invasion. When present, IDC-P is associated with worse outcomes, regardless of treatment status. IDC-P is included in a broader diagnostic category of atypical cribriform lesions of the prostate gland. This category of lesions also includes high-grade prostatic intraepithelial neoplasia (HGPIN), urothelial carcinoma involving prostatic ducts or acini, and prostatic ductal adenocarcinoma, amongst other intraductal proliferations. Differentiating between these entities is important as they have differing therapeutic and prognostic implications for patients, although differential diagnosis thereof is not always straightforward. The present review discusses IDC-P in regards to its morphological characteristics, molecular features, and clinical outcomes. Given the current state of knowledge, the presence of IDC-P should be evaluated and documented correctly in both radical prostatectomy and needle biopsy specimens, and the clinical implications thereof should be taken into consideration during treatment and follow up.
Carcinoma, Acinar Cell/chemistry/*diagnosis/pathology ; Carcinoma, Ductal/chemistry/*diagnosis/pathology ; Carcinoma, Transitional Cell/chemistry/*diagnosis/pathology ; Diagnosis, Differential ; Humans ; Male ; Neoplasm Grading ; Prostatic Intraepithelial Neoplasia/chemistry/*diagnosis/pathology ; Prostatic Neoplasms/chemically induced/*diagnosis/*pathology ; Tumor Burden

Aged ; Androgen Antagonists/adverse effects* ; Anticholesteremic Agents/therapeutic use* ; Cholesterol, HDL/blood* ; Cholesterol, LDL/blood* ; Humans ; Hypercholesterolemia/chemically induced* ; Lipids/blood* ; Male ; Middle Aged ; Prostatic Neoplasms/therapy* ; Retrospective Studies ; Testosterone/blood*

Objective: To investigate the correlation of intermittent androgen-deprivation therapy (IADT) and continuous androgen-deprivation therapy (CADT) for advanced prostate cancer (PCa) with the risks of secondary diabetes mellitus (DM) and impaired glucose tolerance (IGT). METHODS: We conducted a retrospective case-control study of the advanced PCa patients treated by IADT or CADT in our hospital from January 2013 to December 2015. Based on the levels fasting blood glucose and 2-hour postprandial blood glucose, results of oral glucose tolerance test, and clinical symptoms of the patients, we statistically analyzed the IADT- or CADT-related risk factors for DM and IGT and the relationship of the body mass index (BMI), hypertension, smoking, and alcohol consumption with secondary DM and IGT. RESULTS: IADT was given to 53 (46.5%) of the patients, aged (69.1 ± 4.3) years, and CADT to 61 (53.5%), aged (70.2 ± 5.7) years. No statistically significant differences were observed in clinical characteristics between the two groups of patients (P > 0.05). BMI, blood pressure, smoking and drinking exhibited no significant influence on the development of DM or IGT either in the IADT (P > 0.05) or the CADT group. The incidence of IGT was significantly lower in the IADT than in the CADT group (P = 0.03), but that of DM showed no statistically significant difference between the two groups (P = 0.64). CONCLUSIONS Compared with CADT, IADT has a lower risk of IGT and a higher safety in the treatment of advanced prostate cancer.
Aged ; Alcohol Drinking ; adverse effects ; Androgen Antagonists ; adverse effects ; therapeutic use ; Blood Glucose ; metabolism ; Body Mass Index ; Case-Control Studies ; Diabetes Mellitus ; chemically induced ; Glucose Intolerance ; chemically induced ; Glucose Tolerance Test ; Humans ; Hypertension ; complications ; Male ; Prostatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

AIMTo study the effect of combined androgen block therapy on hemoglobin and hematocrit values in patients with prostate cancer.

METHODSOne hundred and thirty-six patients with adenocarcinoma of prostate were treated with combined androgen block (orchiectomy and flutamide 250 mg, tid). Complete blood counts were determined before and after 1, 2, 3, 6, 9 and 12 months of therapy.

RESULTSThe hemoglobin and hematocrit levels declined significantly in all patients and at all the time points after treatment (P<0.05).

CONCLUSIONProstate cancer patients treated with combined androgen block would develop obvious anemia. Recombinant human erythropoietin can be used to treat patients with severe anemia.

Adenocarcinoma ; complications ; drug therapy ; therapy ; Adult ; Androgen Antagonists ; adverse effects ; therapeutic use ; Anemia ; chemically induced ; Antineoplastic Agents, Hormonal ; therapeutic use ; Combined Modality Therapy ; Flutamide ; therapeutic use ; Hematocrit ; Hemoglobins ; metabolism ; Humans ; Male ; Orchiectomy ; Prostatic Neoplasms ; complications ; drug therapy ; therapy ; Prostatic Secretory Proteins ; analysis