A case of prostate cancer metastasized to the breast is presented, the latter being prostate-specific antigen (PSA) positive. This is the first of such cases reported in Hong Kong and China in the English literature. As PSA expression also can be found in primary breast cancer, prostatic acid phosphatase staining was employed to confirm the diagnosis. The relationship of PSA and non-prostatic tissues is reviewed. The differential diagnosis of breast enlargement in patients known to have prostate malignancy also is discussed.
Background : Despite the lack of evidence, using normal saline for inflating the balloon of a Foley urethral catheter is frequently regarded as a cause for deflation failure. We have investigated the issue by comparing the rate of deflation failure of Foley catheter balloon, using either sterile water or normal saline as the filling solution.Methods : Four thousand latex Foley urethral catheters (14 Fr) were randomly assigned to one of two groups: sterile water or normal saline. Each of the catheter balloons would then be inflated with 10 mL of the corresponding fluid. They were subsequently put in water baths at 37 ∞ C for 4 weeks. At the end of 4 weeks, all the balloons were deflated by people who were blind to the assignment of fluid inflated. Failure of deflation was defined as the balloon not being able to be deflated completely. The number of deflation failures was recorded and the amount of fluid aspirated from each balloon was also noted. Results : Of the 4000 catheters, 17 (0.43%) were found to be defective and could not be used for the study. The remaining 3983 catheters were randomly allocated into the sterile water (2011) and normal saline (1972) groups. The failure rate of deflation for the sterile water group and normal saline group were 185 (9.2%) and 157 (8.0%), respectively, which was not statistically significant ( P = 0.162). Conclusion : There was no difference in the rate of deflation failure of latex Foley balloons by using either sterile water or normal saline as the filling solution.
Prostate cancer is mainly an androgen sensitive disease. The use of androgen ablation can be dated back to Huggins in 1941. Currently patients with localized prostate cancer are managed aggressively and hormonal manipulations are reserved for locally advanced or metastatic disease. When androgen independence has emerged, treatment options are essentially palliative; with the aim of controlling symptoms and maintaining quality of life, and if possible prolonging survival. Following the failure of primary androgen ablation, a number of treatment strategies are available. Exploitation of the anti-androgen withdrawal syndrome and using second or third line hormonal therapies are well established treatments. Interest in chemotherapy has been revived owing to demonstrable benefits in prostate-specific antigen response and pain palliation, albeit without definite improvements in survival. An increased understanding of the molecular biology of prostate cancer has led to the identification of novel agents that may prolong survival while maintaining quality of life. Ongoing clinical trials are designed for assessment of these agents, with the view of adding them to our armamentarium against prostate cancer.
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