Prostate Cancer: Nursing Assessment ... - Google Book Search

Prostate Cancer: Nursing Assessment ... - Google Book Search

Bilateral orchiectomy with or without flutamide fo...[N Engl J Med. 1998] - PubMed Result

Bilateral orchiectomy with or without flutamide fo...[N Engl J Med. 1998] - PubMed Result\

Bilateral orchiectomy with or without flutamide for metastatic prostate cancer.

Eisenberger MA, Blumenstein BA, Crawford ED, Miller G, McLeod DG, Loehrer PJ, Wilding G, Sears K, Culkin DJ, Thompson IM Jr, Bueschen AJ, Lowe BA.

Johns Hopkins Hospital, Baltimore, MD, USA.

BACKGROUND: Combined androgen blockade for the treatment of metastatic prostate cancer consists of an antiandrogen drug plus castration. In a previous trial, we found that adding the antiandrogen flutamide to leuprolide acetate (a synthetic gonadotropin-releasing hormone that results in medical ablation of testicular function) significantly improved survival as compared with that achieved with placebo plus leuprolide acetate. In the current trial, we compared flutamide plus bilateral orchiectomy with placebo plus orchiectomy. METHODS: We randomly assigned patients who had never received antiandrogen therapy and who had distant metastases from adenocarcinoma of the prostate to treatment with bilateral orchiectomy and either flutamide or placebo. Patients were stratified according to the extent of disease and according to performance status. RESULTS: Of the 1387 patients who were enrolled in the trial, 700 were randomly assigned to the flutamide group and 687 to the placebo group. Overall, the incidence of toxic effects was minimal; the only notable differences between the groups were the greater rates of diarrhea and anemia with flutamide. There was no significant difference between the two groups in overall survival (P=0.14). The estimated risk of death (hazard ratio) for flutamide as compared with placebo was 0.91 (90 percent confidence interval, 0.81 to 1.01). Flutamide was not associated with enhanced benefit in patients with minimal disease. CONCLUSIONS: The addition of flutamide to bilateral orchiectomy does not result in a clinically meaningful improvement in survival among patients with metastatic prostate cancer.

PMID: 9761805 [PubMed - indexed for MEDLINE]

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Test Reports

History & PSA monitoring:

12.07.07 USG abdomen revealed slight enlargement of prostrate (14gms)

14.07.07 Tested PSA blood test-Value reported 92.19n.g/mL.
18.0707 Bone scan done at Madras Medical Mission revealed hotspots with metastatic deposits?
19.07.07 Trucut needle biopsy done by Prof.R.P.Rajan at PHC.
24.07.07 Apollo hospital HPE report confirmed Acinar Adenocarcinoma (Gleasons score 3+4) Prostate. (4th.stage)
27.07.07 Prof.R.P.Rajan performed bilateral orchidectomy at J.V.Hospital to arrest Androgen activity(90%).

01.08.07 HPE report revealed section showing seminiferous tubules showing hypospermatogenesisus/ no evidence of malignancy in the testicular parenchyma seen.

18.08.07 –Prescribed Calutide-50 for 100% androgen blockade.

04.01.08 -*Calcium-shellcal-1000mg/day suggested.

Calutide-50 temporarily stopped from 08.1.08 & my urologist suggested that if PSA level goes up calutide may be re administered.

Test reports

Normal Range 0.0-4.0 8.4-11.0

Date	Lab	PSA	LFT	S.Cal	H.globin	Creati	Uricacid	Bloodurea	Pl.Glucose	TC	Neu	Lym	Eos	Mono	Bas	AS	RA
14.07.07	Bha	92.19	Normal	N	15.6	0.9
17.08.07	Vsh		N		13.7	1.0
06.09.07	Vsh		N		12.4	1.0
01.10.07	Bha	0.30	N
04.01.08	Bha	0.17	N	7.6 *
27.02.08	Eliza								84(F)121(PP)
29.02.08	Lis	0.20			14.3
15.04.08	Bha			9.5	13.8	1.1	5.3	23	86(F)	7,800	56	44	00	00	00	<25-ve	<20-ve

10.06.08

JVH

0.2ng

N

10.4

13.8

1.3

Urine S-Nil

22

79F 94PP

5,900

48

46

02

00

LDL-170mg Tonmt tab

20.07.08

Bone Density report: T-Score: -1.22 Osteopenic Medi:Adtrol plus/Osteonuron

05.09.08

Bha

0.208

8.2