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Prostate Cancer Diagnosis and Treatment for Patients with Neurogenic Bladder: Does the Literature Support a Different Approach?

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Abstract

Purpose of Review

In this review, the current literature available to patients and providers on the diagnosis and management of prostate cancer in patients with neurogenic bladder will be discussed. Topics include prostate cancer screening and diagnosis, radical prostatectomy and radiotherapy for prostate cancer, as well as surveillance.

Recent Findings

Neurogenic lower urinary tract dysfunction (NLUTD) patients are living longer due to better care, and cancer is becoming more frequent. This is partly due to the aging of this population, as well as intrinsic factors related to the underlying condition or urinary diversion, which poses them a greater risk of developing genitourinary malignancies. Although multiple studies have investigated this patient population, most are derived from large cohorts of spinal cord injury patients.

Summary

Many studies reported how PSA changes for different NGB patients. Few studies have investigated the management of prostate cancer, and good quality evidence for tailoring the care of this population is lacking. Although more evidence is available, improvement is still needed in using biomarkers for early diagnosis, specific screening protocols for different underlying conditions and urinary diversion, and standardized treatment recommendations based on long-term follow-up and surveillance.

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References

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  1. Hartkopp A, et al. Survival and cause of death after traumatic spinal cord injury. A long-term epidemiological survey from Denmark. Spinal Cord. 1997;35(2):76–85.

    Article  CAS  PubMed  Google Scholar 

  2. Brandes SB, et al. Renal cell carcinoma in patients with prior spinal cord injury. J Spinal Cord Med. 2001;24(4):251–6.

    Article  CAS  PubMed  Google Scholar 

  3. Ismail S, et al. Prevalence, management, and prognosis of bladder cancer in patients with neurogenic bladder: a systematic review. Neurourol Urodyn. 2018;37(4):1386–95.

    Article  PubMed  Google Scholar 

  4. Nahm LS, et al. Bladder cancer mortality after spinal cord injury over 4 decades. J Urol. 2015;193(6):1923–8.

    Article  PubMed  Google Scholar 

  5. Siegel RL, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48.

    Article  PubMed  Google Scholar 

  6. Scott PA Sr, et al. Prostate cancer diagnosed in spinal cord-injured patients is more commonly advanced stage than in able-bodied patients. Urology. 2004;63(3):509–12.

    Article  PubMed  Google Scholar 

  7. Strauss DJ, et al. Trends in life expectancy after spinal cord injury. Arch Phys Med Rehabil. 2006;87(8):1079–85.

    Article  PubMed  Google Scholar 

  8. Dennis LK, Lynch CF, Torner JC. Epidemiologic association between prostatitis and prostate cancer. Urology. 2002;60(1):78–83.

    Article  PubMed  Google Scholar 

  9. Frisbie JH, Binard J. Low prevalence of prostatic cancer among myelopathy patients. J Am Paraplegia Soc. 1994;17(3):148–9.

    Article  CAS  PubMed  Google Scholar 

  10. Barbonetti A, et al. Risk of prostate cancer in men with spinal cord injury: a systematic review and meta-analysis. Asian J Androl. 2018;20(6):555–60. Recent Meta-analysis of prostate cancer risk in SCI. Highlights rates of cancer detection, and characteristics of disease staging for this subset of patients. It showed a reduction in prostate cancer risk in SCI than controls.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Bauman WA, et al. Metabolic and endocrine changes in persons aging with spinal cord injury. Assist Technol. 1999;11(2):88–96.

    Article  CAS  PubMed  Google Scholar 

  12. Huang TS, et al. Impaired hypothalamus-pituitary-adrenal axis in men with spinal cord injuries. Am J Phys Med Rehabil. 1998;77(2):108–12.

    Article  CAS  PubMed  Google Scholar 

  13. Safarinejad MR. Level of injury and hormone profiles in spinal cord-injured men. Urology. 2001;58(5):671–6.

    Article  CAS  PubMed  Google Scholar 

  14. Bartoletti R, et al. Prostate growth and prevalence of prostate diseases in early onset spinal cord injuries. Eur Urol. 2009;56(1):142–8.

    Article  PubMed  Google Scholar 

  15. Hvarness H, Jakobsen H, Biering-Sorensen F. Men with spinal cord injury have a smaller prostate than men without. Scand J Urol Nephrol. 2007;41(2):120–3.

    Article  PubMed  Google Scholar 

  16. Lee WY, et al. Risk of prostate and bladder cancers in patients with spinal cord injury: a population-based cohort study. Urol Oncol. 2014;32(1):51-e1-7.

    Article  Google Scholar 

  17. Pannek J, et al. Prostate volume in male patients with spinal cord injury: a question of nerves? BJU Int. 2013;112(4):495–500.

    Article  PubMed  Google Scholar 

  18. Zermann DH, et al. Central nervous system neurons labeled following the injection of pseudorabies virus into the rat prostate gland. Prostate. 2000;44(3):240–7.

    Article  CAS  PubMed  Google Scholar 

  19. Shin YS, et al. Prostate volume and prostate-specific antigen in men with Parkinson’s disease are not different compared to age-matched control group: a prospective, case-controlled multicenter study. Prostate Int. 2015;3(2):62–4.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bowman RM, et al. Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 2001;34(3):114–20.

    Article  CAS  PubMed  Google Scholar 

  21. Shin M, et al. Improved survival among children with spina bifida in the United States. J Pediatr. 2012;161(6):1132–7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Johnston AW, et al. Patterns of inpatient care for prostate cancer in men with spina bifida. Disabil Health J. 2020;13(2):100866. Clinical database analysis of prostate cancer in spina bifida patients, showing the trends of care in the care of SB population (from 1998 to 2014, extracted from National Inpatient Sample from the Healthcare Cost and Utilization Project. 

  23. Wiener JS, Frimberger DC, Wood H. Spina Bifida health-care guidelines for men’s health. Urology. 2018;116:218–26.

    Article  PubMed  Google Scholar 

  24. Eastham JA, et al. Clinically localized prostate cancer: AUA/ASTRO guideline, part II: principles of Active surveillance, principles of surgery, and follow-up. J Urol. 2022;208(1):19–25.

    Article  PubMed  Google Scholar 

  25. Eastham JA, et al. Clinically localized prostate cancer: AUA/ASTRO guideline, part I: introduction, risk assessment, staging, and risk-based management. J Urol. 2022;208(1):10–8.

    Article  PubMed  Google Scholar 

  26. Eastham JA, et al. Clinically localized prostate cancer: AUA/ASTRO guideline. Part III: Principles of radiation and future directions. J Urol. 2022;208(1):26–33.

    Article  PubMed  Google Scholar 

  27. Eastham JA, Boorjian SA, Kirkby E. Clinically localized prostate cancer: AUA/ASTRO guideline. J Urol. 2022;208(3):505–7.

    Article  PubMed  Google Scholar 

  28. Lowrance W, et al. Updates to advanced prostate cancer: AUA/SUO guideline (2023). J Urol. 2023;209(6):1082–90.

    Article  PubMed  Google Scholar 

  29. Schaeffer EM, et al. Prostate cancer, version 42023, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2023;21(10):1067–96. Most recent prostate cancer guidelines for prostate cancer care according to The National Comprehensive Cancer Network.

    Article  CAS  PubMed  Google Scholar 

  30. Wei JT, et al. Early detection of prostate cancer: AUA/SUO guideline part I: prostate cancer screening. J Urol. 2023;210(1):46–53.

    Article  PubMed  Google Scholar 

  31. Wei JT, et al. Early detection of prostate cancer: AUA/SUO guideline part II: considerations for a prostate biopsy. J Urol. 2023;210(1):54–63.

    Article  PubMed  Google Scholar 

  32. Crawford ED, et al. Comorbidity and mortality results from a randomized prostate cancer screening trial. J Clin Oncol. 2011;29(4):355–61.

    Article  PubMed  Google Scholar 

  33. Chen RC, et al. Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer. JAMA. 2017;317(11):1141–50.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Gammon SR, et al. Surgical treatment for prostate cancer in patients with prior spinal cord injury. Ann Surg Oncol. 2005;12(8):674–8.

    Article  PubMed  Google Scholar 

  35. Leach GE, et al. Post-prostatectomy incontinence: urodynamic findings and treatment outcomes. J Urol. 1996;155(4):1256–9.

    Article  CAS  PubMed  Google Scholar 

  36. Smith CP, Chancellor MB. Emerging role of botulinum toxin in the management of voiding dysfunction. J Urol. 2004;171(6 Pt 1):2128–37.

    Article  CAS  PubMed  Google Scholar 

  37. Widmark A, Fransson P, Tavelin B. Self-assessment questionnaire for evaluating urinary and intestinal late side effects after pelvic radiotherapy in patients with prostate cancer compared with an age-matched control population. Cancer. 1994;74(9):2520–32.

    Article  CAS  PubMed  Google Scholar 

  38. Quek ML, et al. Combined radical prostatectomy and bladder augmentation for concomitant prostate cancer and detrusor instability. Urology. 2005;65(5):964–7.

    Article  PubMed  Google Scholar 

  39. Harper ME, Pierrepoint CG, Griffiths K. Carcinoma of the prostate: relationship of pretreatment hormone levels to survival. Eur J Cancer Clin Oncol. 1984;20(4):477–82.

    Article  CAS  PubMed  Google Scholar 

  40. Ribeiro M, Ruff P, Falkson G. Low serum testosterone and a younger age predict for a poor outcome in metastatic prostate cancer. Am J Clin Oncol. 1997;20(6):605–8.

    Article  CAS  PubMed  Google Scholar 

  41. National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. J Spinal Cord Med. 2013:36(1):1-2. https://doi.org/10.1179/1079026813Z.000000000136. Most updated statistics for SCI patients in the US, with median age of presentation, overall survival. This data sheet is a quick reference on demographic and condition status for 36,275 person with tSCI collected through 2022 by 31 federally funded SCI Model Systems

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Authors and Affiliations

  1. Department of Urology, University of WI – Madison, Madison, WI, USA

    M. P. Bigarella & K. A. Richards

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  1. M. P. Bigarella
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MB wrote the main manuscript text. KR provided the outline for the manuscript and the relevance of each topic. MB and KR reviewed the manuscript.

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Correspondence to M. P. Bigarella.

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Bigarella, M.P., Richards, K.A. Prostate Cancer Diagnosis and Treatment for Patients with Neurogenic Bladder: Does the Literature Support a Different Approach?. Curr Bladder Dysfunct Rep (2024). https://doi.org/10.1007/s11884-024-00746-6

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