Clinicopathological Analysis On Small Cell Carcinoma Of The Prostate In Chinese Patients
Aitao Guo1,2, Shuang Wen3, Yaqi Ma1, Lixin Wei1, Aijun Liu1
1. Department of Pathology, Chinese PLA General Hospital, Beijing, China 100853.2. Department of Pathology, Hainan Branch of PLA General Hospital, Sanya, China 572014.3. Department of Pathology, Dalian Friendship Hospital of Liaoning Province, Dalian, China 116001.
Citation:J Cancer
Ongoing Work To Learn More
Dr. Aggarwal and his colleagues are investigating how the t-SCNC subtype develops in men with metastatic castrate-resistant prostate cancer.
We think it arises from adenocarcinoma,” Dr. Aggarwal said. “The cancer cells transform into this subtype of prostate cancer through genetic reprogramming.
Some aspects of this reprogramming event are understood, such as specific factors that control the transition. However, he added, more studies still need to be done to understand how and when it happens.
Potent hormone therapies such as abiraterone and enzalutamide may push prostate cancer toward this transformation, said Dr. Dahut. That may be why this subtype is more prevalent in men who have received treatment than in men with newly diagnosed prostate cancer, noted Dr. Aggarwal.
The research teams ultimate goal is to find therapies for t-SCNC. Master regulator proteins are opportune drug targets, Dr. Aggarwal explained, because they control many pathways that contribute to cancer growth and survival.
Several of the master regulators that they identified in t-SCNC tumors can be targeted directly or indirectly by drugs that are in development, and the team hopes to be able to test these in clinical trials of men with this subtype of prostate cancer.
Dr. Dahut also speculated that a better understanding of the genetic reprogramming event that creates t-SCNC could potentially lead to the discovery of drugs that prevent the development of this hard-to-treat subtype.
Research And Clinical Trials
Doctors are always trying to improve the diagnosis and treatment of cancer. But small cell prostate cancer is very rare, so it is harder to research than other more common types of prostate cancer.
Researchers are looking into immunotherapy for small cell prostate cancer. This is early stage research and it’s not clear whether these treatments will work well for small cell prostate cancer.
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Correlation Between Serum Psa Levels And Pathological Type
Among the 21 patients with pure SmCC, serum PSA levels in 18 cases were normal and only elevated in three cases. For the five mixed cases, three had an elevation, and the other two had serum PSA levels in the normal range. However, the results of the chi-square tests revealed no significant differences .
Coping With Small Cell Prostate Cancer
Coping with a rare condition can be difficult, both practically and emotionally. Being well informed about the cancer and its treatment can help you to make decisions and cope with what happens. It can also help to talk to other people who have the same condition.
You can visit Cancer Chat Cancer Research UK’s discussion forum. It is a place for anyone affected by cancer to share experiences, stories and information with other people who know what you are going through.
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Clinical And Pathological Information Of The Cases From Plagh
In total, 1,002 cases of prostate cancer were diagnosed pathologically at the Chinese PLA General Hospital from 1999 to 2011, and seven of them were suspected of SmCC. All pathologic sections from these seven cases were reviewed by three pathologists. Immunohistochemical staining for prostate-specific antigen , CD56, synaptophysin , chromogranin A , and cytokeratin was performed. Four cases were excluded because of the negative staining for CD56, Syn, and CgA, which were suspected to be poorly differentiated acinar adenocarcinomas with Gleason scores 9-10. The remaining three cases were confirmed as SmCC. Detailed clinical and pathological information is presented below.
Case 1. Mixed SmCC. Components of SmCC. Components of acinar adenocarcinoma. Gleason scores were 3+3=6 combined with bilateral lung and liver metastases.
Case 2. A 65-year-old patient was referred to our hospital with symptoms of dysuria and frequent urination. The serum PSA level was 20.67ng/mL . DRE indicated the prostate was homogeneously enlarged and the central sulcus disappeared. MRI showed a mass in the prostate, combined with pelvic lymph node metastasis. He underwent an ultrasound-guided prostate biopsy. Combined SmCC and acinar adenocarcinoma were confirmed pathologically. The patient received endocrine therapy. The 4-month follow-up showed tumor-bearing survival, and the general condition of the patient was poor.
What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of lung cancer is 60%, it means that people who have that cancer are, on average, about 60% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.
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Patient And Disease Variables
In our study cohort, the median age at diagnosis was 70 6276) . Survival data were available for 197 patients with a median follow-up time of 14 months and a total of 158 deaths. A majority of patients were white , lived in a metropolitan area and received treatment at a comprehensive cancer program . The year of diagnosis and region of diagnosis were evenly distributed across the study period. For patients with known CCI, the majority had CCI of 0 . Of the patients diagnosed after 2003, the median PSA was 4.9ngml1 and 61% presented with elevated measurements . Among men with recorded clinical T stage, 73% were staged cT12.
Table 1 Patient, hospital and clinical characteristics
Clinical Features And Imaging
The presentation of small cell prostate carcinoma is similar to that of prostatic adenocarcinoma. Localized tumors produce few, if any, symptoms. Symptomatic patients usually have locally advanced or metastatic disease. Some patients notice a change in their urine stream with trouble starting or stopping. Patients may also have a feeling of urgency, hematuria, hematospermia, or trouble defecating. Bone pain or fracture is associated with bone metastasis. A firm nodule may be detected by digital rectal examination.
Unlike patients with prostatic adenocarcinoma, in most patients with small cell carcinoma of the prostate, the serum prostate-specific antigen level is not elevated. About 10% of prostatic small cell carcinomas secrete hormones, such as ACTH or ADH, and these patients may present with paraneoplastic syndromes.
Small cell carcinomas tend to invade outside of the prostate and more commonly involve the surrounding organs, regional lymph nodes, and distant organs than conventional prostatic adenocarcinoma. The findings of atypical metastatic spread or paraneoplastic syndromes should raise the suspicion of a small cell carcinoma.
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Pure Small Cell Carcinoma Of Prostate In A Patient Presenting With Acute Urinary Retention: A Rare Case Report
1Ministry of Health, Nevehir State Hospital, Urology Department, Nevehir, Turkey
2Ministry of Health, Nevehir State Hospital, Pathology Department, Nevehir, Turkey
3Ministry of Health, Nevehir State Hospital, Nephrology Department, Nevehir, Turkey
4University of Health Sciences, Sultan Abdulhamid Han Education and Research Hospital, Biochemistry Department, stanbul, Turkey
Working To Treat A Deadly Form Of Prostate Cancer
– July 11, 2018
A deadly form of advanced prostate cancer is more common than experts previously thought.
A new study looked at about 200 men with prostate cancer that had spread and were resistant to standard treatment. It found that about 17 percent of the men had developed a deadlier subtype of prostate cancer called treatment-emergent small cell neuroendocrine prostate cancer.
Clinical recognition of the emergence of small cell carcinoma during the usual progression of prostate cancer is increasing, said Moffitt pathologist Dr. Jasreman Dhillon. The increase is largely attributed to the use of more effective androgen deprivation therapies in recent years. This type of prostate cancer progresses rapidly and combinational chemotherapy is the only treatment option at this time.
The studys findings suggest the deadly cancer subtype could also be successfully treated with targeted therapy, a type of treatment that is tailored to individual tumors.
Moffitt is already using a type of individualized treatment called adaptive therapy. It utilizes mathematical models to analyze a patients response to treatment to create a unique and constantly evolving treatment strategy.
Dr. Jingsong Zhang, a medical oncologist in Moffitts Genitourinary Oncology Program, is currently conducting a clinical trial of adaptive therapy for prostate cancer patients.
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Lung Cancer Survival Rates
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
Does Atezolizumab Boost Survival With Chemotherapy In Small Cell Or Neuroendocrine Carcinoma Of The Prostate
A correlation between small cell or neuroendocrine carcinoma of the prostate and poor survival outcomes was revealed, despite treatment with the combination of the immunotherapy agent atezolizumab and chemotherapy, according to an institutional study conducted within the Mayo Clinic.
A correlation between small cell or neuroendocrine carcinoma of the prostate and poor survival outcomes was revealed, despite treatment with the combination of the immunotherapy agent atezolizumab and chemotherapy, according to an institutional study conducted within the Mayo Clinics Division of Medical Oncology.
The exploration of this combination in prostate cancer was influenced by the survival benefit observed with atezolizumab and chemotherapy in patients with extensive-stage small cell lung cancer . It is a common clinical practice to use regimens from the SCLC space to treat rare extrapulmonary small cell carcinoma, therefore oncologists at the Mayo Clinic sought to test the treatment strategy in their institution.
Recent introduction of checkpoint inhibitor therapy for SCC of the prostate was based on extrapolation from studies in small-cell lung cancer. We wanted to review the outcomes for such patients who had received chemo-immunotherapy treatment at Mayo Clinic, the study lead Lance C. Pagliaro, MD, professor of oncology, Division of Medical Oncology, Department of Oncology at Mayo Clinic, told Targeted Oncology in an interview.
Reference:
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Its Time To Get Your Life Back
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Stage Iv Prostate Cancer Prognosis
Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.
How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
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Retrieval Method Of The Related Literature
All literature reports relating to SmCC of the prostate were accessed from the China Hospital Knowledge Database , the Chinese Medical Journal Database , the Chinese Medical Citation Index , and the Wanfang Database using the keywords small cell carcinoma, prostate, and neuroendocrine. The search located 29 cases in 19 reports -. The contents of these reports were then reviewed. Two cases were found to be duplicated and were eliminated -. Another case was also eliminated due to incomplete clinical and pathological data . In total, 26 cases were eligible -. Data on age, clinical symptoms and signs, serum PSA levels, DRE findings, ultrasound scans and MRI, surgical approach, postoperative therapy, follow-up time, and survival were collected.
Metastatic Small Cell Carcinoma Of The Prostate In An Octogenarian With Significant Response To First
Anthony Wood
Division of Hematology & Medical Oncology – Melvin & Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
E-mail :
Nabil Adra
Division of Hematology & Medical Oncology – Melvin & Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
Liang Cheng
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Roberto Pili
Division of Hematology & Medical Oncology – Melvin & Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
DOI: 10.15761/HMO.1000120
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for non-small cell lung cancer and small cell lung cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the lung.
- Regional: The cancer has spread outside the lung to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body, such as the brain, bones, liver, or the other lung.
Deadly Form Of Advanced Prostate Cancer Is Common Calls For Distinct Treatment
- Date:
- University of California – San Francisco
- Summary:
- A new study of prostate cancer in 202 men, whose cancers had spread and were resistant to standard treatment, found that a surprisingly large number of these cancers — about 17 percent — belong to a deadlier subtype of metastatic prostate cancer.
A new study of prostate cancer in 202 men, whose cancers had spread and were resistant to standard treatment, found that a surprisingly large number of these cancers — about 17 percent — belong to a deadlier subtype of metastatic prostate cancer.
Previously, it was thought that these cancers constituted less than 1 percent of all prostate cancers.
The study, which was led by researchers at UC San Francisco and published online July 9 in the Journal of Clinical Oncology, suggests that this prostate cancer subtype, called treatment-emergent small cell neuroendocrine prostate cancer , might in the future be routinely and more successfully treated with targeted drugs that already are being developed or tested in clinical trials.
The research team identified specific genetic mutations and patterns of gene expression that are found in t-SCNC, but are distinct from the more common type of prostate cancer known as adenocarcinoma. Among the patterns identified in t-SCNC was higher activity of specific “transcription factor” proteins — proteins that switch on production of other proteins that drive cancer growth.
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Prostate Cancer With A Normal Psa: Small Cell Carcinoma Of The Prostate A Rare Entity
Pure small cell carcinoma of the prostate is extremely rare. When it does occur, it is usually in concordance with prostatic adenocarcinoma. Early diagnosis is difficult as the carcinoma tends to spread early to visceral organs without concordant elevation of prostate-specific antigen . Because this condition is rare, no standard treatment regimen has been established, and the overall prognosis remains poor.
This case report describes clinical characteristics of a 67-year-old man with pure small cell carcinoma of the prostate. The unique clinical and biological features of this histologic type of prostate cancer are discussed.
Clinical Information Of The Patients Reported In Literatures
The 26 cases were aged from 21 to 82 years . Because the median age was 61 years, patients were divided into two groups: < 59 years old and 60 years old. There were 15 cases in the 60 group . Most cases suffered from difficulty urinating, and 20 cases showed normal serum PSA levels. DRE indicated grade III prostate enlargement and hardening. Space-occupying lesions were detected by imaging examinations. Among them, 11 cases underwent prostate biopsies eight underwent transurethral resection of the prostate and seven underwent radical prostatectomy. For postoperative treatment, 13 cases received chemotherapy, two received radiotherapy, and 13 had a history of endocrine therapy .
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Recalcitrant Cancer Research Act
In 2013, the US Congress passed the Recalcitrant Cancer Research Act, which mandated increased attention to certain recalcitrant cancers, including small cell lung cancer. That led to the National Cancer Institute supporting small cellspecific research through a consortium.
As a result, new experimental drugs for small cell lung cancer are currently being tested, including Iadademstat and Keytruda .