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"The treatment of prostate cancer continues to be problematic owing to serious side-effects, including erectile dysfunction and urinary incontinence. Robotic radiosurgery offers a novel, rapid, non-invasive outpatient treatment option that combines robotics, advanced image-guided spatial positioning, and motion detection with submillimeter precision. This book examines all aspects of the treatment of prostate cancer with robotic radiosurgery. It explains how image-guided robotic radiosurgery overcomes the problem of patient motion during radiation therapy by continuously identifying the precise location of the prostate tumor throughout the course of treatment. Hypofractionated radiation delivery by means of robotic radiosurgery systems is also discussed in detail. The book closes by examining other emerging genitourinary applications of robotic radiosurgery. All of the authors are experts in their field who present a persuasive case for this fascinating technique."

"This book provides an exhaustive review of the current state of the art in the management of prostate cancer, from screening to treatment. A particular feature is the emphasis placed on the value of a multidisciplinary approach. The opening chapters address basic aspects including epidemiology, biology, and chemoprevention. The role of individual and mass screening is carefully appraised, and diagnosis, clinical work-up, and the role of active surveillance are discussed in detail. Subsequent chapters are devoted to each of the therapies that may be employed, including open and robotic laparoscopic radical prostatectomy, the various forms of radiation therapy, high-intensity focused ultrasound, cryotherapy, hormonal therapy, and targeted therapies and vaccination. Up-to-date data from clinical trials are included."

"Kanker prostat diketahui berhubungan dengan pekerjaan yang melibatkan kerja shift. Pada tahun 2007, International Agency for Research on Cancer (IARC) menyatakan bahwa kerja shift dengan disrupsi sirkadian menyebabkan kemungkinan kanker pada manusia. Pajanan terhadap LAN (Light at Night) menekan sekresei melatonin pineal dan menstimulasi peningkatan hormon sex yang pada gilirannya dapat meningkatkan kerentanan terhadap kanker yang bergantung pada hormon. Kasus disini akan menilai bagaimana hubungan antara pekerja shift suatu manufaktur yang telah bekerja 30 tahun dengan peningkatan risiko kanker prostat melalui beberapa telaah jurnal kritis untuk menilai validitas dan aplikabilitasnya. Dari ketiga jurnal yang ditelaah adalah valid dan aplikatif. Sebuah systematic review dan meta-analysis oleh Mancio J.dkk tahun 2018 adanya peningkatan yang signifikan antara kanker prostat dengan rotasi kerja gilir. Begitu pula dengan Behrens T.dkk tahun 2017. Namun, studi kohort Torbjrn A.dkk tahun 2017 menilai tidak ada hubungan kanker prostat dengan durasi kerja malam. Perbedaan ini mungkin karena kurangnya pengukuran pajanan, dan perbedaan dalam jenis kovariat yang disesuaikan untuk kelompok pekerjaan heterogen yang terlibat.

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Prostate cancer has been associated with jobs that involve some degree of work at night. In 2007, the International Agency for Research on Cancer (IARC) concluded that shift work involving circadian disruption was probably carcinogenic in humans. Exposure to artificial LAN (Light at Night) suppresses pineal melatonin secretion and subsequently leads to an increase of sex hormones, which in turn could increase the susceptibility to hormone-dependent cancers. In this case, the authors assessed the relationship between workers in a manufacture company who had worked shift work for 30 years and an increased risk of prostate cancer. This case takes evidence base from several journals that support this hypothesis while doing a critical appraisal to determine its validity and applicability. The three journals appraised were valid and applicable. From A systematic review and meta-analysis by Mancio J. et al. in 2018, there was a significantly increased risk of prostate cancer with rotating shift work. Behrens T. et al. (2017) observed a twofold increased HR among shift workers and night workers working in industries. However, cohort studies by Torbjrn A. et al (2017) with no association with duration of night work was seen, this discrepancy may be due to a lack of a common exposure measurement, differences in the type of covariates adjusted for or heterogeneous occupational group involved, and selection into and out of night work occurs continously."

"Latar Belakang: Penyakit keganasan urogenital merupakan spektrum penyakit yang luas, dengan penatalaksanaan mulai dari observasi dan pemantauan ketat hingga pembedahan ekstirpatif mayor. Risiko malnutrisi praoperatif akibat kanker dan pascaoperatif akibat stres pembedahan akan meningkatkan risiko morbiditas dan mortalitas. Terapi nutrisi perioperatif yang adekuat bertujuan untuk menunjang perbaikan klinis dan status nutrisi, mendukung proses pemulihan, menurunkan risiko komplikasi pascaoperasi, serta menurunkan lama rawat di rumah sakit. Metode: Laporan serial kasus ini menyajikan empat kasus kanker urogenital, terdiri dari dua kasus kanker buli, satu kasus kanker ginjal, dan satu kasus kanker penis. Tiga kasus termasuk kaheksia kanker, dan satu kasus termasuk pra-kaheksia. Seluruh pasien menjalani pembedahan urologi mayor dengan anestesi umum dan epidural. Terapi nutrisi perioperatif yang diberikan antara lain carbohydrate loading, nutrisi enteral dini pascaoperasi, serta pemberian nutrisi secara bertahap berdasarkan kondisi klinis. Dilakukan pemantauan yang meliputi keluhan klinis, antropometri, pemeriksaan fisik, hasil laboratorium, dan analisis asupan. Hasil: Dua pasien mengalami ileus paralitik pascaoperasi dengan satu pasien di antaranya membutuhkan nutrisi parenteral total, dan dapat teratasi dalam 7 hari pascaoperasi. Satu pasien mengalami hiperglikemia reaktif dan diberikan terapi insulin, dapat teratasi dalam 7 hari pascaoperasi. Satu pasien mengalami perlambatan penyembuhan luka dan memiliki masa rawat pascaoperasi paling lama. Pasien yang mengalami ileus paralitik membutuhkan waktu lebih lama untuk mencapai target kalori 80 , namun seluruh pasien telah dapat mencapai target tersebut dalam 7 hari pascaoperasi. Lama perawatan pascaoperasi bervariasi, sekitar 10-27 hari. Kesimpulan: Terapi nutrisi perioperatif yang diberikan pada keempat pasien menunjang perbaikan klinis dan status nutrisi, mendukung proses pemulihan, menurunkan risiko komplikasi pascaoperasi, serta menurunkan lama rawat di rumah sakit.

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Background: Genitourinary malignancy represents a broad spectrum of disease, with treatments ranging from watchful waiting to major extirpative surgery. The risk of preoperative malnutrition due to cancer and postoperatively due to surgical stress will increase the risk of morbidity and mortality. An adequate perioperative nutrition therapy aims to support clinical and nutritional status improvement, hasten the recovery process, reduce the risk of postoperative complications, and decrease the length of hospital stay.

Method This case series report presents four cases of genitourinary cancers, consist of two cases of bladder cancer, one case of kidney cancer, and one case of penile cancer. Three cases are classified into cancer cachexia, and one case of pre cachexia. All patients had undergone major urological surgery under general and epidural anesthesia. Perioperative nutrition therapy provides carbohydrate loading, postoperative early enteral nutrition, as well as gradual nutrition based on clinical conditions. The monitoring given included clinical complaints, anthropometric measurement, physical examination, laboratory test results, and intake analysis.

Result Two patients had postoperative paralytic ileus with one patient requires total parenteral nutrition, and resolved within 7 days after surgery. One patient had reactive hyperglycemia and treated with insulin therapy, resolved in 7 days postoperative. One patient experienced impaired wound healing and had the longest postoperative care period. Patients with paralytic ileus may take more days to achieve 80 calorie target, yet all patients have been able to achieve the target in 7 days postoperative. The length of hospital stay after surgery was varied between 10 to 27 days.

Conclusion Perioperative nutrition therapy given to four patients in this case series leads to the clinical and nutritional status improvement, supports the recovery process, decreases the risk of postoperative complications, and shortens the hospital stays."

"Tujuan penelitian ini adalah untuk melihat hubungan antara serum Prostate Specific Antigen ( PSA ), stadium klinis lokal, grading tumor dengan hasil bone scan dalam usaha mengevaluasi kemampuan serum PSA untuk memprediksi hasil bone scan pada penderita baru kanker prostat. Suatu penelitian retrospektif dilaksanakan terhadap data penderita kanker prostat yang didiagnosis di institusi penulis antara Januari 1995 hingga Desember 2003. Subyek penelitian ditolak apabila nilai PSA diperoleh setelah dilakukan manipulasi uretra atau sesudah penderita mendapatkan terapi. Hubungan antara hasil bone scan dengan serum PSA, stadium klinis lokal dan grading tumor dianalisis. Hasil penelitian menunjukkan dari 103 penderita yang termasuk dalam penelitian ini, 61 penderita ( 59,2% ) mempunyai hasil bone scan positif dengan rerata nilai PSA 471,13 ± 853,34 ng/ml, sedangkan 42 penderita (40,8% ) mempunyai hasil bone scan negatif dengan rerata nilai PSA 61,00 ± 124,47 ng/ml ( p < 0,05 ). Resiko untuk mendapatkan hasil bone scan positif bertambah besar dengan meningkatnya nilai PSA, stadium klinis lokal dan grading tumor ( p < 0,05 ). Dengan menggunakan kurva Receiver Operating Characteristic ( ROC ), terbukti bahwa PSA mempunyai korelasi terbaik dengan hasil bone scan ( Area Under Curve = 0,812 ). Kombinasi serum PSA, stadium klinis lokal dan grading tumor mempunyai kemampuan terbaik dalam memprediksi hasil bone scan. Dari 19 penderita dengan serum PSA < 10 ng/ml, terdapat 5 penderita yang mempunyai hasil bone scan positif; sedangkan dari 8 penderita dengan serum PSA < 10 ng/ml, stadium klinis T1 atau T2 dan grading tumor derajat 1 atau 2, tidak satupun menunjukkan metastasis tulang. Dari penelitian ini dapat disimpulkan bahwa pemeriksaan rutin bone scan tidak diperlukan bagi penderita baru kanker prostat dengan serum PSA < 10 ng/ml, stadium klinis T1 atau 2 dan grading tumor 1 atau 2. (Med J Indones 2004; 13: 151-5)

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The objective of this study is to assess the relation between serum Prostate Specific Antigen ( PSA ), clinical tumor stage, tumor grade and bone scan result in an attempt to seek the ability of serum PSA to predict bone metastases in newly diagnosed prostate cancer patients. A retrospective analysis was conducted on clinical files of prostate cancer patients which were diagnosed in our institutions between January 1995 and December 2003. Patients on which initial serum PSA were obtained after urethral manipulation or after receiving therapy were excluded. The results of bone scans were related to levels of serum PSA, clinical tumor stage and tumor grade. Of 103 patients who were included in this investigation, 61 patients ( 59.2% ) had a positive bone scan and 42 patients ( 40.8% ) had a negative bone scan with mean PSA value 471.13 ± 853.34 ng/ml and 61.00 ± 124.47 ng/ml respectively ( p < 0.05 ). The risk of having a positive bone scan increased with advancing serum PSA levels, clinical tumor stage and tumor grade ( p < 0.05 ). Using Receiver Operating Characteristic curves, PSA had the best correlation with bone scan results ( the area under curve was 0.812 ). Bone scan results were predicted best by the combination of serum PSA, clinical tumor stage and tumor grade. Bone scans were positive in 5 of 19 patients with PSA level < 10 ng/ml. None of 8 patients with PSA levels < 10 ng/ml, clinical tumor stage T1 or 2 and tumor grade 1 or 2 had a positive bone scan. In conclusion, we suggest that routine bone scan examination may not be necessary in patients with newly diagnosed, untreated prostate cancer, who have serum PSA level < 10 ng/ml with clinical tumor stage T1 or 2 and tumor grade 1 or 2 (Med J Indones 2004; 13: 151-5)."

"Tujuan Untuk menyusun konstruksi tissue microarrays (TMAs) dan mengevaluasi level reseptor androgen pada perkembangan kanker prostat dengan pemeriksaan imunohistokimia pada jaringan prostat tikus model the transgenic adenocarcinoma of mouse prostate (TRAMP) dan tikus non transgenik. Metode Konstruksi tissue microarrays (TMAs) dilakukan terhadap sampel yang berasal dari lobus dorso-lateral tikus kelompok kontrol (non-transgenic), kelompok tanpa kastrasi (intact TRAMP) dan kelompok kastrasi (castrated TRAMP) yang di pulas dengan haematoxylin eosin (H&E). Ekspresi reseptor androgen dievaluasi pada sampel TMAs dengan video image anlysis (VIA). Hasil Ekspresi reseptor androgen dijumpai pada jaringan prostat normal maupun patologis baik pada lesi non-neoplastik maupun neoplastik sampai lesi ganas, sedangkan pada kanker prostat stadium lanjut ekspresi menurun atau menghilang. Ekspresi reseptor androgen meningkat pada kelompok kastrasi (kondisi pelucutan androgen) dibanding pada kelompok tanpa kastrasi. Kesimpulan Sama seperti pada manusia, pada tikus TRAMP kanker prostat menunjukkan variasi ekspresi AR sampai kondisi castrate resistant, yang menunjukkan bahwa AR turut memfasilitasi pertumbuhan tumor lebih lanjut.

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AbstractAim To construct tissue microarrays (TMAs) that consisted of prostate tumours from the transgenic adenocarcinoma of mouse prostate (TRAMP) mice and non-transgenic murine prostates and to assess androgen receptor (AR) levels during progression of prostate cancer in TRAMP mice by immunohistochemistry. Methods Haematoxylin and eosin (H&E) sections from the ventral and dorso-lateral prostate lobes of non-transgenic, intact TRAMP and castrated TRAMP were used to demarcate regions of interest for TMAs construction. The samples on TMAs were used to evaluate AR expression using video image analysis (VIA). Results AR was expressed during cancer progression, but AR levels were reduced or absent in late stage disease. Furthermore, when AR levels were compared in tumours from intact and castrate animals, a significant increase in AR levels was observed following androgen ablation. Conclusion Similar to clinical prostate cancer, in the TRAMP model, prostate tumours evolve mechanisms to maintain AR expression and AR responsive gene pathways following castration to facilitate continued tumour growth."

"This book reviews the use of theranostic nanoparticles for cancer applications over the past decade. First, it briefly discusses the challenges and limitations of conventional cancer treatments, and presents an overview of the use of nanotechnology in treating cancer. These introductory chapters are followed by those exploring cancer diagnosis and a myriad of delivery methods for nanotherapeutics. The book also addresses multifunctional platforms, treatment monitoring, and regulatory considerations. As a whole, the book aims to briefly summarize the development and clinical potential of various nanotheranostics for cancer applications, and to delineate the challenges that must be overcome for successful clinical development and implementation of such cancer theranostics."

"The volume provides an introduction to the concept of active surveillance in oncology in general and prostate cancer specifically. The primary focus is to provide a comprehensive guide to the management of patients on surveillance. The volume covers the many complexities and nuances to this approach including, patient selection, risk assessment, how to overcome 'cancer hysteria' when counseling patients, identifying appropriate triggers for intervention, use of PSA kinetics and MR imaging information, technique and frequency of biopsies, secondary prevention interventions, and the relative roles of surveillance and focal therapy."

"This introduction to genitourinary and pelvic radiology is a further volume in the learning imaging series. Written in a case-based format, the book is subdivided into ten chapters, kidney, adrenal gland, urinary bladder, collecting system and urethra, prostate and seminal vesicles, scrotum, obstetrics, uterus, cervix and vagina, adnexa and retroperitoneum. Genitourinary radiology has undergone a tremendous change owing to advances in ultrasound, CT and MRI that have redefined our understanding of genitourinary and pelvic pathology. Each chapter includes an introduction and ten case studies with illustrations and comments from anatomical, physiopathological and radiological standpoints and with bibliographic recommendations."