Prostatic Neoplasms: Montie JE

Montie JE, Clark PE, Eisenberger MA, El-Galley R, Greenberg RE, Herr HW, Hudes GR, Kuban DA, Kuzel TM, Lange PH, Lele SM, Michalski J, Patterson A, Pohar KS, Richie JP, Sexton WJ, Shipley WU, Small EJ, Trump DL, Walther PJ, Wilson TG, Anonymous00046. · University of Michigan Comprehensive Cancer Center. · J Natl Compr Canc Netw. · Pubmed #19176203 No free full text.

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Montie JE, Abrahams NA, Bahnson RR, Eisenberger MA, El-Galley R, Herr HW, Hudes GR, Kuzel TM, Lange PH, Patterson A, Pollack A, Richie JP, Sexton WJ, Shipley WU, Small EJ, Trump DL, Walther PJ, Wilson TG, Anonymous00097. · No affiliation provided · J Natl Compr Canc Netw. · Pubmed #17112448 No free full text.

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Rubin MA, Montie JE. · No affiliation provided · Urology. · Pubmed #15708026 No free full text.

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Wei JT, Montie JE. · No affiliation provided · Cancer. · Pubmed #10918148 links to  free full text

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Wittmann D, Northouse L, Foley S, Gilbert S, Wood DP, Balon R, Montie JE. · Department of Urology, University of Michigan, Ann Arbor, MI 48109-5330, USA. · Int J Impot Res. · Pubmed #19158798 No free full text.

Abstract: Prostate cancer affects one in six American men. Erectile and sexual dysfunctions are long-term side effects of prostate cancer treatment. PubMed database was searched for papers on prostate cancer-related sexual recovery for men and couples. The search yielded articles on (1) the treatment of erectile dysfunction, (2) men's psychological and culturally diverse adaptation to the sexual side effects; (3) the impact of prostate cancer on couples' relationships; and (4) interventions to promote sexual function. Erectile dysfunction after prostate cancer treatment has been widely studied. Research on the sexual recovery of men and couples or understanding it in a cultural context is scarce. Greater focus on the impact of sexual sequelae of prostate cancer treatment on men as well as couples in diverse groups is needed. Clinical implications for treating sexual dysfunction and promoting sexual recovery for prostate cancer survivors and their partners are discussed. Recommendations for future research are provided.

Montie JE. · Department of Urology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA. · Urol Oncol. · Pubmed #18774465 No free full text.

Abstract: There has been a significant increase in prostate cancer identification due to current detection methods, especially in the proportion of men with low volume, often potentially clinically indolent disease (<0.5 ml). Physicians are struggling to find an appropriate balance between undertreatment and overtreatment for men with low volume prostate cancer. Both physicians and patients alike face tough treatment decisions about the appropriate balance between the risks and benefits of therapy. Treatment decisions regarding either active surveillance or targeted focal therapy must be made with as much information as can be garnered safely. As active surveillance or targeted focal therapy protocols are developed, it would seem prudent to prospectively employ a more stringent biopsy sampling strategy. Without better tumor sampling methodologies, physicians may occasionally underestimate the extent of a patient's disease and potentially make ill-advised treatment recommendations. In the future, intraprostatic imaging models with high sensitivity could improve treatment management and outcomes. Currently, periodic PSA values and biopsies are key components of monitoring disease progression, which will likely continue into the foreseeable future. Both PSA velocity and PSA doubling time are diagnostic tools that have proven to be useful for prostate cancer detection and provide prognostic information for both localized and metastatic disease. Our goal should be to use all of these treatment tools to improve patient life expectancy and quality of life no matter what the burden level of disease happens to be.

Morris DS, Tomlins SA, Montie JE, Chinnaiyan AM. · Department of Urology, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA. · BJU Int. · Pubmed #18422767 No free full text.

Abstract: Chromosomal rearrangements play a causal role in haematological and mesenchymal malignancies. Importantly, the resulting gene fusions can serve as specific therapeutic targets, as exemplified by the development of imatinib (Gleevec), which specifically inhibits the BCR-ABL gene fusion product that defines chronic myeloid leukaemia. Recently, gene fusions involving the prostate-specific gene transmembrane protease, serine 2 (TMPRSS2) and members of the erythroblastosis virus E26 transforming sequence (ETS) family of transcription factors were identified in most of PSA-screened prostate cancers. In this review, we summarize the identification, characterization and detection of TMPRSS2:ETS gene fusions and their role in prostate cancer development. We also discuss the discovery of additional 5' partners that define distinct classes of ETS gene fusions based on the prostate specificity and androgen responsiveness of the 5' partner. Additionally, we also summarize conflicting reports about associations between gene fusion status and patient outcome. The specificity of ETS gene fusions in prostate cancer suggests that they may have causal roles in prostate cancer and suggest utility in prostate cancer detection, stratification and treatment.

Montie JE. · Department of Urology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. · J Urol. · Pubmed #17084162 No free full text.

Abstract: PURPOSE: This study provides a perspective on initial treatment in select patients with high risk, localized prostate cancer. MATERIALS AND METHODS: A select literature review was done with commentary on the philosophy of initial surgery followed by adjuvant or salvage therapies. RESULTS: Early detection and associated stage migration identify a cadre of men with unfavorable but apparently localized prostate cancer who historically would not have been viewed as appropriate candidates for radical prostatectomy. Decreased morbidity from radical prostatectomy and data demonstrating improved outcomes in some patients treated with multimodal therapy protocols provide a rationale for including radical prostatectomy as part of an aggressive treatment plan to achieve optimal local elimination of cancer. Data suggest that radical prostatectomy and adjuvant or possibly even salvage radiation therapy may provide the best elimination of large local cancers. Whether such an approach provides results that are better than or even as good as those of the common standard of radiation therapy plus androgen deprivation therapy remains to be seen and, if so, at what cost to the patient in terms of adverse effects. However, it is likely that optimal elimination of local disease is needed to achieve the maximum benefit from adjuvant systemic endocrine, chemotherapy or targeted treatments. In other words optimal local therapy may be necessary but not sufficient. CONCLUSIONS: Initial radical prostatectomy may have a role for treating high risk localized prostate cancer.

Bradford TJ, Montie JE, Hafez KS. · Department of Urology, University of Michigan Medical Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0330, USA. · Urol Clin North Am. · Pubmed #16829272 No free full text.

Abstract: Urologic malignancies are common, accounting for approximately 25% of all new cancer cases in the United States. Patients with urologic malignancies require long-term surveillance to detect progression or recurrence as early as possible. The urologist is faced with the task of balancing patient safety and cost-effectiveness, while finding the most practical follow-up regimen. For each urologic malignancy, this article reviews the commonly used radiologic techniques for surveillance and offers recommended follow-up schedules.

Montie JE, Wei JT. · Section of Urology, The University of Michigan, Ann Arbor, Michigan 48109-0330, USA. · Cancer. · Pubmed #11309763 links to  free full text

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Cooney KA, Strawderman MS, Wojno KJ, Doerr KM, Taylor A, Alcser KH, Heeringa SG, Taylor JM, Wei JT, Montie JE, Schottenfeld D. · Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA. · Urology. · Pubmed #11164150 No free full text.

Abstract: OBJECTIVES: Previous studies have observed higher age-specific serum prostate-specific antigen (PSA) values in African-American (AA) men without prostate cancer compared to white men, leading some to recommend race-specific PSA reference ranges for the early detection of prostate cancer. The primary objective of the Flint Men's Health Study was to determine age-specific PSA reference values in a community-based sample of AA men, aged 40 to 79 years. METHODS: A probability sample of 943 AA men was selected from households in Genesee County, Michigan. Men without a prior history of prostate cancer/surgery were invited to participate in a prostate cancer screening protocol, consisting of measurement of serum total PSA, free/total PSA ratio, and digital rectal examination. Sextant biopsies were recommended, based on total PSA greater than 4.0 ng/mL and/or an abnormal digital rectal examination. RESULTS: From the sample of 943 men, 732 were eligible, 432 had blood drawn for PSA testing, and 374 completed all phases of the clinical examination. The 95th percentile PSA values were estimated to range from 2.36 ng/mL for men in the fifth decade to 5.59 ng/mL for men in the eighth decade. The 95th percentile values for age-specific PSA were comparable to those observed in a similar study of white men in Olmsted County, Minnesota. The median and 5th percentile values for free/total PSA did not vary significantly across age. CONCLUSIONS: The minor differences in PSA reference ranges between AA and white men may not be of sufficient magnitude to recommend the use of race-specific PSA reference ranges for screening.

Montie JE, Wei JT. · Section of Urology, The University of Michigan, Ann Arbor 48109-0330, USA. · Cancer. · Pubmed #10870046 links to  free full text

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Northouse LL, Mood DW, Schafenacker A, Montie JE, Sandler HM, Forman JD, Hussain M, Pienta KJ, Smith DC, Kershaw T. · School of Nursing, University of Michigan, Ann Arbor, Michigan 48109-5482, USA. · Cancer. · Pubmed #17999405 links to  free full text

Abstract: BACKGROUND: Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life. The objective of this study was to determine whether a family-based intervention could improve appraisal variables (appraisal of illness or caregiving, uncertainty, hopelessness), coping resources (coping strategies, self-efficacy, communication), symptom distress, and quality of life in men with prostate cancer and their spouses. METHODS: For this clinical trial, 263 patient-spouse dyads were stratified by research site, phase of illness, and treatment; then, they were randomized to the control group (standard care) or the experimental group (standard care plus a 5-session family intervention). The intervention targeted couples' communication, hope, coping, uncertainty, and symptom management. The final sample consisted of 235 couples: 123 couples in the control group and 112 couples in the experimental group. Data collection occurred at baseline before randomization and at 4 months, 8 months, and 12 months. RESULTS: At 4-month follow-up, intervention patients reported less uncertainty and better communication with spouses than control patients, but they reported no other effects. Intervention spouses reported higher quality of life, more self-efficacy, better communication, and less negative appraisal of caregiving, uncertainty, hopelessness, and symptom distress at 4 months compared with controls, and some effects were sustained to 8 months and 12 months. CONCLUSIONS: Men with prostate cancer and their spouses reported positive outcomes from a family intervention that offered them information and support. Programs of care need to be extended to spouses who likely will experience multiple benefits from intervention.

Montie JE. · Department of Urology, University of Michigan Medical Center, Ann Arbor, Michigan, USA. · Urology. · Pubmed #19394485 No free full text.

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Helgeson BE, Tomlins SA, Shah N, Laxman B, Cao Q, Prensner JR, Cao X, Singla N, Montie JE, Varambally S, Mehra R, Chinnaiyan AM. · Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109-0602, USA. · Cancer Res. · Pubmed #18172298 links to  free full text

Abstract: Recurrent gene fusions involving oncogenic ETS transcription factors (including ERG, ETV1, and ETV4) have been identified in a large fraction of prostate cancers. The most common fusions contain the 5' untranslated region of TMPRSS2 fused to ERG. Recently, we identified additional 5' partners in ETV1 fusions, including TMPRSS2, SLC45A3, HERV-K_22q11.23, C15ORF21, and HNRPA2B1. Here, we identify ETV5 as the fourth ETS family member involved in recurrent gene rearrangements in prostate cancer. Characterization of two cases with ETV5 outlier expression by RNA ligase-mediated rapid amplification of cDNA ends identified one case with a TMPRSS2:ETV5 fusion and one case with a SLC45A3:ETV5 fusion. We confirmed the presence of these fusions by quantitative PCR and fluorescence in situ hybridization. In vitro recapitulation of ETV5 overexpression induced invasion in RWPE cells, a benign immortalized prostatic epithelial cell line. Expression profiling and an integrative molecular concepts analysis of RWPE-ETV5 cells also revealed the induction of an invasive transcriptional program, consistent with ERG and ETV1 overexpression in RWPE cells, emphasizing the functional redundancy of ETS rearrangements. Together, our results suggest that the family of 5' partners previously identified in ETV1 gene fusions can fuse with other ETS family members, suggesting numerous rare gene fusion permutations in prostate cancer.

Weizer AZ, Shah RB, Lee CT, Gilbert SM, Daignault S, Montie JE, Wood DP. · Department of Urology, University of Michigan, Ann Arbor, MI 48109-0330, USA. · Urol Oncol. · Pubmed #18047952 No free full text.

Abstract: OBJECTIVES: Prostate capsule sparing cystectomy has been performed in conjunction with orthotopic diversion to preserve sexual function and improve urinary control. Because concerns remain regarding incomplete surgical resection, we evaluated the risk of urothelial and prostate cancer in a series of patients undergoing radical cystoprostatectomy. METHODS: A total of 35 men undergoing radical cystoprostatectomy (August 2003-August 2005) had separate submission of the prostate peripheral zone/capsule from the prostate adenoma and bladder after surgery. These specimens were evaluated for bladder and prostate cancer grade, stage, and largest diameter of prostate cancer. Patient records were reviewed for demographic and medical information. Clinical variables were compared between patients with and without carcinoma involving the prostate using standard statistical software. RESULTS: Of patients, 57% had cancer involving the prostate at radical cystoprostatectomy. There were 9 patients (26%) who had urothelial carcinoma involving the prostate; only prostatic urethral biopsy identified these patients before radical cystoprostatectomy. Prostate adenocarcinoma was evident in 16 of 35 (47%) patients, with a majority involving the prostate peripheral zone/capsule (43%). There were 4 patients (11%) who had clinically significant prostate cancer (Gleason sum >6 or tumor volume >0.5 cm(3)). Patients with prostate cancer were significantly older than patients without prostate cancer (P = 0.01). CONCLUSIONS: No clinical variable can confidently predict patients with prostate cancer involving the prostate. Because a majority of patients undergoing radical cystoprostatectomy have cancer involving their prostate, preoperative evaluation with prostatic urethral and prostate biopsy may be useful to guide patient selection for prostate capsule sparing cystectomy.

Wood DP, Schulte R, Dunn RL, Hollenbeck BK, Saur R, Wolf JS, Montie JE. · Department of Urology, Michigan Urology Center, University of Michigan Medical School, Ann Arbor, Michigan 48109-0330, USA. · Urology. · Pubmed #17919694 No free full text.

Abstract: OBJECTIVES: To prospectively compare the relevant in-hospital and postdischarge short-term health outcomes in a contemporary group of patients undergoing either robotic or conventional radical prostatectomy. METHODS: A total of 117 robotic and 89 conventional radical prostatectomy patients participated in a prospective study evaluating short-term postoperative recovery. A validated short-term health outcomes questionnaire was self-administered at 2 and 6 weeks postoperatively. All patients were given the same preoperative and postoperative instructions. RESULTS: The significant differences in short-term health outcome measures between the two groups were that robotic patients had less mean narcotic use during the first 24 hours of admission (32 versus 52 mg morphine sulfate equivalents, P = 0.001) and a shorter mean length of hospital stay (1.2 versus 1.3 days, P = 0.048). No difference was found between the robotic and conventional radical prostatectomy groups regarding the median time to normal activity, 100% activity, and time to driving (9 and 8, 21 and 28, and 13 and 14 days, respectively). No difference was found in the postdischarge pain levels at 2 and 6 weeks, as reflected in the equivalent time of narcotic use between the two groups (10.6 and 9 days for the robotic and conventional radical prostatectomy groups, respectively). CONCLUSIONS: The results of this prospective study have shown that both robotic and conventional radical prostatectomy provide comparable short-term postdischarge recovery, including time to normal and full activity, driving, and postdischarge narcotic use.

Kim JH, Dhanasekaran SM, Mehra R, Tomlins SA, Gu W, Yu J, Kumar-Sinha C, Cao X, Dash A, Wang L, Ghosh D, Shedden K, Montie JE, Rubin MA, Pienta KJ, Shah RB, Chinnaiyan AM. · Michigan Center for Translational Pathology, Department of Pathology, Department of Urology, Program of Bioinformatics, and Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109-0940, USA. · Cancer Res. · Pubmed #17804737 links to  free full text

Abstract: Integrative analysis of genomic aberrations in the context of trancriptomic alterations will lead to a more comprehensive perspective on prostate cancer progression. Genome-wide copy number changes were monitored using array comparative genomic hybridization of laser-capture microdissected prostate cancer samples spanning stages of prostate cancer progression, including precursor lesions, clinically localized disease, and metastatic disease. A total of 62 specific cell populations from 38 patients were profiled. Minimal common regions (MCR) of alterations were defined for each sample type, and metastatic samples displayed the most number of alterations. Clinically localized prostate cancer samples with high Gleason grade resembled metastatic samples with respect to the size of altered regions and number of affected genes. A total of 9 out of 13 MCRs in the putative precursor lesion, high-grade prostatic intraepithelial neoplasia (PIN), showed an overlap with prostate cancer cases (amplifications in 3q29, 5q31.3-q32, 6q27, and 8q24.3 and deletions in 6q22.31, 16p12.2, 17q21.2, and 17q21.31), whereas postatrophic hyperplasia (PAH) did not exhibit this overlap. Interestingly, prostate cancers that do not overexpress ETS family members (i.e., gene fusion-negative prostate cancers) harbor differential aberrations in 1q23, 6q16, 6q21, 10q23, and 10q24. Integrative analysis with matched mRNA profiles identified genetic alterations in several proposed candidate genes implicated in prostate cancer progression.

Mehra R, Han B, Tomlins SA, Wang L, Menon A, Wasco MJ, Shen R, Montie JE, Chinnaiyan AM, Shah RB. · Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA. · Cancer Res. · Pubmed #17804708 links to  free full text

Abstract: Recurrent gene fusions between the androgen-regulated gene TMPRSS2 and the ETS family transcription factors ERG, ETV1, and ETV4 have been identified in the majority of prostate adenocarcinomas (PCA). PCA is often multifocal with histologic heterogeneity of different tumor foci. As TMPRSS2 is a common 5' partner of ETS gene fusions, we monitored TMPRSS2 rearrangement by fluorescence in situ hybridization (FISH) to study the origin and molecular basis of multifocal PCA heterogeneity. TMPRSS2 rearrangement was evaluated by FISH on a tissue microarray representing 93 multifocal PCAs from 43 radical prostatectomy resections. Overall, 70% (30 of 43) of the cases showed TMPRSS2 rearrangement, including 63% through deletion (loss of the 3' TMPRSS2 signal), 27% through translocation (split of 5' and 3' TMPRSS2 signals), and 10% through both mechanisms in different tumor foci. Of the 30 TMPRSS2 rearranged cases, 30% showed concordance in all tumor foci, whereas 70% were discordant in at least one focus. In TMPRSS2 rearranged cases, the largest (index) tumor was rearranged 83% of the time. Pathologic stage, size, or Gleason grade of the multifocal PCA did not correlate with overall TMPRSS2 rearrangement. Our results suggest that multifocal PCA is a heterogeneous group of diseases arising from multiple, independent clonal expansions. Understanding this molecular heterogeneity is critical to the future development and utility of diagnostic and prognostic PCA biomarkers.

Tomlins SA, Laxman B, Dhanasekaran SM, Helgeson BE, Cao X, Morris DS, Menon A, Jing X, Cao Q, Han B, Yu J, Wang L, Montie JE, Rubin MA, Pienta KJ, Roulston D, Shah RB, Varambally S, Mehra R, Chinnaiyan AM. · Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. · Nature. · Pubmed #17671502 No free full text.

Abstract: Recently, we identified recurrent gene fusions involving the 5' untranslated region of the androgen-regulated gene TMPRSS2 and the ETS (E26 transformation-specific) family genes ERG, ETV1 or ETV4 in most prostate cancers. Whereas TMPRSS2-ERG fusions are predominant, fewer TMPRSS2-ETV1 cases have been identified than expected on the basis of the frequency of high (outlier) expression of ETV1 (refs 3-13). Here we explore the mechanism of ETV1 outlier expression in human prostate tumours and prostate cancer cell lines. We identified previously unknown 5' fusion partners in prostate tumours with ETV1 outlier expression, including untranslated regions from a prostate-specific androgen-induced gene (SLC45A3) and an endogenous retroviral element (HERV-K_22q11.23), a prostate-specific androgen-repressed gene (C15orf21), and a strongly expressed housekeeping gene (HNRPA2B1). To study aberrant activation of ETV1, we identified two prostate cancer cell lines, LNCaP and MDA-PCa 2B, that had ETV1 outlier expression. Through distinct mechanisms, the entire ETV1 locus (7p21) is rearranged to a 1.5-megabase prostate-specific region at 14q13.3-14q21.1 in both LNCaP cells (cryptic insertion) and MDA-PCa 2B cells (balanced translocation). Because the common factor of these rearrangements is aberrant ETV1 overexpression, we recapitulated this event in vitro and in vivo, demonstrating that ETV1 overexpression in benign prostate cells and in the mouse prostate confers neoplastic phenotypes. Identification of distinct classes of ETS gene rearrangements demonstrates that dormant oncogenes can be activated in prostate cancer by juxtaposition to tissue-specific or ubiquitously active genomic loci. Subversion of active genomic regulatory elements may serve as a more generalized mechanism for carcinoma development. Furthermore, the identification of androgen-repressed and insensitive 5' fusion partners may have implications for the anti-androgen treatment of advanced prostate cancer.

Weizer AZ, Ye Z, Hollingsworth JM, Dunn RL, Shah RB, Wolf JS, Wei JT, Montie JE, Hollenbeck BK. · Department of Urology, University of Michigan, Ann Arbor, Michigan 48109, USA. · Urology. · Pubmed #17656216 No free full text.

Abstract: OBJECTIVES: To study the evolution of surgical margins in robotic prostatectomy (DVP), to ascertain the surgical volume necessary to provide quality cancer care. METHODS: Clinicopathologic data on consecutive DVP patients were abstracted from our institutional database. The primary outcome evaluated was the presence of any positive surgical margin. Surgeon DVP volume was the unit of exposure. A logistic model was fit to measure the association of volume and margin status, adjusting for patient differences. RESULTS: Between November 2001 and August 2005, 193 consecutive patients underwent DVP. Disease and patient characteristics were similar across the levels of surgeon volume. Overall, surgical margins did not dramatically decline over time (first 15 cases, 26% versus cases 81 and beyond, 22%; P = 0.82). However, extensive margins were largely eliminated (first 15 cases, 12% versus cases 81 and beyond, 2%; P = 0.05). After adjusting for preoperative patient differences, the odds of any positive margin among those treated by a surgeon in the highest-volume group was 0.99 (95% confidence interval 0.36 to 2.72) compared with those treated during a surgeon's first 15 cases. CONCLUSIONS: Although extensive surgical margins decline with increasing volume, overall positive margin rates after DVP respond slowly. It seems that cumulative surgeon volume beyond that which can be obtained in the typical urology practice may be needed to obtain ideal margin rates with this new technology.

Northouse LL, Mood DW, Montie JE, Sandler HM, Forman JD, Hussain M, Pienta KJ, Smith DC, Sanda MG, Kershaw T. · School of Nursing and the Division of Hematology/Oncology, Department of Urology, University of Michigan, Ann Arbor 48109-0482, USA. · J Clin Oncol. · Pubmed #17635953 No free full text.

Abstract: PURPOSE: Despite the high prevalence of prostate cancer, little information is available on the quality of life of men and their spouses during the phases of illness. This study assessed patients' and spouses' quality of life, appraisal of illness, resources, symptoms, and risk for distress across three phases of prostate cancer: newly diagnosed, biochemical recurrence, and advanced. PATIENTS AND METHODS: The sample consisted of 263 patient/spouse dyads. A stress-appraisal conceptual model guided the selection of variables which were then assessed with established instruments. Study variables were examined for phase effects (differences in dyads across three phases), role effects (patients v spouses), and phase-by-role interactions (differences within dyads across phases) using analysis of variance (ANOVA). RESULTS: More phase effects than role effects were found, indicating that the psychosocial experiences of patients and their spouses were similar, but differed from dyads in other phases. Dyads in the advanced phase were at highest risk for distress. These patients had the lowest physical quality of life, and their spouses had the lowest emotional quality of life of all participants. Dyads in the biochemical recurrence and advanced phases had more negative appraisals of illness and caregiving, greater uncertainty, and more hopelessness compared with dyads in the newly diagnosed phase. Spouses, in contrast to patients, had less confidence in their ability to manage the illness and perceived less support across all phases of illness. CONCLUSION: Phase-specific programs of care are needed to assist both men with prostate cancer and their spouses to manage the effects of illness.

Montie JE, Hussain M. · The University of Michigan Medical Center, Ann Arbor, MI, USA. · BJU Int. · Pubmed #17608823 No free full text.

This publication has no abstract.

Beebe-Dimmer JL, Dunn RL, Sarma AV, Montie JE, Cooney KA. · Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, USA. · Cancer. · Pubmed #17265528 links to  free full text

Abstract: BACKGROUND: Metabolic syndrome refers to a cluster of conditions that includes hypertension, dyslipidemia, central adiposity, and high blood glucose levels. Over the past decade, a growing body of literature suggests that metabolic syndrome may be associated with several different forms of cancer. Because prostate cancer risk is highest among African Americans, and these men, similarly, are more prone to developing specific features of the metabolic syndrome, including hypertension and type-2 diabetes, any relationships would have a significant impact on developing strategies for the primary prevention of prostate cancer. METHODS: The Flint Men's Health Study is a community-based, case-control study of prostate cancer conducted exclusively among African Americans. Prostate cancer cases and controls completed an interviewer-administered questionnaire that asked about the respondent's history of high blood pressure and diabetes. All men also participated in a physical examination in which several measures of body composition, including waist circumference, were collected. RESULTS: Hypertension was reported more commonly among men with prostate cancer (cases) compared with men in the control group (odds ratio [OR]. 2.4; 95% confidence interval [95% CI], 1.5-3.7), and cases were more likely to have a waist circumference >102 cm (OR, 1.8; 95% CI, 1.2-2.9). However, self-reported diabetes was not associated with prostate cancer risk. The men with prostate cancer also were more likely than controls to exhibit multiple syndrome characteristics (OR, 1.9; 95% CI, 1.2-3.0). CONCLUSIONS: The current results indicated that features of the metabolic syndrome, specifically abdominal obesity and hypertension, are associated with prostate cancer in African-American men. This relationship, if it is proved causal, suggests that prevention or control of these conditions eventually may lead to a reduction in the incidence of prostate cancer in this high-risk minority group.

Beebe-Dimmer JL, Drake EA, Dunn RL, Bock CH, Montie JE, Cooney KA. · Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-0946, USA. · Urology. · Pubmed #17095075 No free full text.

Abstract: OBJECTIVES: To explore the familial aggregation of prostate and breast cancer using data from a population-based case-control study of African-American men participating in the Flint Men's Health Study. METHODS: A detailed family history questionnaire was administered to 121 African-American men with prostate cancer and 179 African-American male controls. The family history data of prostate and breast cancer in first-degree relatives were compared between men with and without prostate cancer using standard statistical methods. RESULTS: In the Flint Men's Health Study, men with prostate cancer were more likely than controls to report having a brother with prostate cancer (age-adjusted odds ratio 4.80, 95% confidence interval 2.01 to 11.44) or a sister with breast cancer (age-adjusted odds ratio 3.80, 95% confidence interval 1.57 to 9.22). CONCLUSIONS: Although a family history of prostate cancer is a recognized prostate cancer risk factor consistent across different races, few studies have examined the co-clustering of breast and prostate cancer within African-American families. Future studies should focus on racially heterogeneous populations to further explore the observation from the Flint Men's Health Study that having a brother with prostate cancer or a sister with breast cancer may be associated with prostate cancer occurrence. This research may have implications for both gene identification and early detection strategies.