ABSTRACT
A double-blind study comparing the efficacy of flutamide (SH-13521) and diethylstilbestrol in 15 patients with advanced, previously untreated adenocarcinoma in the prostate in herein presented. Patients receiving diethylstilbestrol, 1 mg. daily, remained stable without evidence of progression of their disease for an average of 25.6 weeks while those receiving either high-or low-dose flutamide showed no objective progression for an average of thirty weeks. There were no complete remissions, and no signficant side effects were seen with either of these agents. In this small series of hormonally untreated Stage D prostatic cancer patients, neither agent displayed significant superiority.
Subject(s)
Anilides/therapeutic use , Diethylstilbestrol/therapeutic use , Flutamide/therapeutic use , Prostatic Neoplasms/drug therapy , Aged , Clinical Trials as Topic , Diethylstilbestrol/administration & dosage , Evaluation Studies as Topic , Flutamide/administration & dosage , Humans , Male , Time FactorsABSTRACT
A patient with Stage B adenocarcinoma of prostate treated with radical prostatectomy and interstitial radioactive gold presented ten years later with liver metastases without evidence of local recurrence. This patient was treated only with massive doses of intravenous diethylstilbestrol diphosphate, with regression of metastases and marked decline of the acid and alkaline phosphatase levels.
Subject(s)
Adenocarcinoma/drug therapy , Diethylstilbestrol/administration & dosage , Liver Neoplasms/drug therapy , Prostatic Neoplasms/pathology , Acid Phosphatase/metabolism , Adenocarcinoma/pathology , Aged , Alkaline Phosphatase/metabolism , Diethylstilbestrol/therapeutic use , Humans , Infusions, Parenteral , Liver Neoplasms/enzymology , Liver Neoplasms/pathology , Male , Neoplasm Metastasis , Radionuclide ImagingABSTRACT
Seven surgical treatments for the management of prostatic cancer are briefly reviewed. A transurethral prostatic resection is of value, not only for the relief of bladder outlet obstruction, but also in the definitive management of Stage A lesions. The long-term survival for patients with Stage C disease treated by radical prostatectomy plus interstitial irradiation demonstrates the efficacy of this mode of therapy. Pelvic lymphadenectomy has yielded valuable information on the stage of the disease; long-term survival was related to the presence of lymph node metastases. Lymphadenectomy may have contributed to the 5-year survival rate of those with regional lymph node involvement, but there is no direct evidence to support this view. The early results in patients treated by cryosurgery indicate that this mode of therapy can be very effective in the ablation of the local lesion and may very well have a useful place in the surgical armamentarium for the management of prostatic cancer.
Subject(s)
Prostatectomy/methods , Prostatic Neoplasms/surgery , Cryosurgery , Gold Radioisotopes/administration & dosage , Humans , Injections , Lymph Node Excision , Lymphatic Metastasis , Male , Prostatic Neoplasms/radiotherapy , Recurrence , UrethraABSTRACT
The diagnosis of urinary tract sepsis is being made more often today because of increased awareness of the condition and improved techniques in the detection and management of genitourinary disorders. Patients developing urinary tract sepsis (bacteremia or septicemia) usually demonstrate certain predisposing factors: underlying chronic disease, advanced age, general debility, or recent urinary tract sepsis is easily made in a patient who has a sudden onset of fever, chills, malaise, nausea, and vomiting, along with tachycardia and a drop in blood pressure. Cultures should be taken from urine and blood samples, but therapy should be instituted immediately rather than after obtaining the results of cultures.
