title: Approach to management of clinically localized prostate cancer in patients with human immunodeficiency virus.
abstract: OBJECTIVE
  To evaluate the approach to management of localized prostate cancer (PCa) in patients with human immunodeficiency virus (HIV) in the highly active antiretroviral therapy era.
  
  
  METHODS
  A retrospective analysis was performed on 10 HIV-positive patients who recently presented with elevated prostate-specific antigen levels and clinically localized PCa.
  
  
  RESULTS
  At the diagnosis of PCa, the average patient was 54.0 years old, had been HIV positive for 8.75 years, had a CD4 count of 417, a prostate-specific antigen level of 9.2 ng/mL, and a Gleason score of 6. Eight of the patients had risk factors for PCa--either African-American descent (n = 6) or a positive family history (n = 2). The treatment was laparoscopic radical prostatectomy in 1, potency-preserving androgen deprivation in 1, cryosurgery in 1, brachytherapy in 2, observation in 2, and external beam radiotherapy in 3.
  
  
  CONCLUSIONS
  Screening of all HIV-positive men should be initiated at age 40 if they have either a positive family history of prostate cancer or are of African-American descent. Asymptomatic HIV-positive patients should be offered all therapeutic PCa treatment options.
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Levinson
authors.forename: Eli A
authors.initials: EA
authors.lastname: Nagler
authors.forename: Franklin C
authors.initials: FC
authors.lastname: Lowe
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000150:complications / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000813:Anilides / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D014408:Biomarkers, Tumor / Q000097:blood; D001918:Brachytherapy; D019090:Case Management; D003131:Combined Modality Therapy; D003452:Cryosurgery; D018120:Finasteride / Q000627:therapeutic use; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009363:Neoplasm Proteins / Q000097:blood; D009570:Nitriles; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications / Q000473:pathology / Q000628:therapy*; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D014105:Tosyl Compounds
chemical_list: D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D009570:Nitriles; D014105:Tosyl Compounds; D018120:Finasteride; C053541:bicalutamide; D017430:Prostate-Specific Antigen; D016729:Leuprolide