Management
of HIV Positive Men with Prostate Cancer in the HAART Era Because HIV
positive men being treated with HAART
are living longer, they are increasingly likely to develop malignancies such as
prostate cancer. The objective of the present study, published in the April 2,
2008 online edition of the British Journal
of Urology, was to characterize clinical and pathological findings and outcomes of HIV positive patients diagnosed and treated
for prostate cancer. Researchers at Baystate Medical Center,
Tufts University School of Medicine, in Springfield,
MA, performed a retrospective, multi-institution
study involving HIV positive men with concomitant carcinoma of the prostate. The investigators collected data regarding patient demographics (age, race/ethnicity),
HIV status (CD4 cell count, HIV viral load, use of HAART), prostate-specific antigen
(PSA) level at cancer diagnosis, signs and symptoms, radiological findings, pathology
(Gleason score, stage), cancer treatment (type, side-effects), and outcomes
(response, survival). Data were analyzed using descriptive statistics.  Results
•
17 patients (mean age
59 years) with HIV-associated prostate adenocarcinoma were identified.
•
The mean
CD4 count was 336 cells/mm3 and the mean HIV viral load was 17 319
copies/mL.
•
14 (82%)
of these men were receiving HAART.
•
ost patients were diagnosed
with carcinoma after an abnormal PSA screening (mean level 30 ng/mL).
•
Only 6
men (35%) had an abnormal prostate on examination.
•
The mean
Gleason score was 6.8.
•
In most
cases, the cancer was confined to the prostate gland.
•
ost patients were amenable
to curative treatment with hormonal therapy, radiation, and/or prostatectomy (prostate
removal).
•
1 individual
remained untreated.
•
No serious treatment-related
side-effects were observed.
•
All treated
patients experienced a complete response
(undetectable PSA).
•
Most patients
were long-term survivors.
•
Documented
death in 5 cases was unrelated to prostate cancer.
Based on their findings, the study authors concluded, “The management of
HIV-positive men with prostate carcinoma in the HAART era is becoming increasingly important.” “Our data shows that in men receiving HAART, their age, PSA levels, clinical
presentation, management, and outcome
from treated prostate carcinoma does not appear to be significantly altered by
HIV status,” they added. As a result, the researchers recommended
that patients with prostate cancer and well-controlled HIV should be managed similarly
to their HIV-negative counterparts. Department
of Pathology, Baystate Medical Center,
Tufts University
School of Medicine, Springfield, MA.
4/11/08 Reference
Pantanowitz, G Bohac, TP Cooley, and others. Human immunodeficiency virus-associated
prostate cancer: clinico-pathological findings and outcome in a multi-institutional study. British Journal of Urology. April 2, 2008.
[Epub ahead of print]. | 
