Approach to management of clinically localized prostate cancer in patients with human immunodeficiency virus.
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.
Levinson
Adam
A
Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Nagler
Eli A
EA
Lowe
Franklin C
FC
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
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