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April 11, 2008

Managing Prostate Cancer No Different in HIV

HIV-positive men with prostate cancer appear to respond as well to standard prostate cancer treatment as HIV-negative men do, according to an article to be published in a future issue of BJU International, a British urological journal.

There are reasons for concern about prostate cancer among HIV-positive men. First, many forms of cancer are either more common in people living with HIV, respond less favorably to treatment, or both. Second, many HIV-positive men are living longer due to the use of antiretroviral therapy, putting them at risk for typical age-related health problems.

Liron Pantanowitz, MD, from the Department of Pathology at Tufts University School of Medicine in Springfield, Massachusetts, and his colleagues examined the medical records of HIV-positive men diagnosed with prostate cancer from several institutions. Pantanowitz’s team found 17 patients averaging 59 years of age, with an average CD4 count of 336 cells and a viral load of 17,319 copies. Most of the men had been living with HIV for many years, and the majority of them were diagnosed with cancer after receiving an elevated prostate-specific antigen (PSA) reading.

One of the men remained untreated, while the rest were treated with hormone therapy, radiation treatment or surgical removal of their prostates. All of the patients treated had a complete response to therapy, defined as an undetectable PSA level. Pantanowitz’s team found that the men responded to treatment as well as HIV-negative men being treated for prostate cancer, and recommend that HIV-positive men with prostate cancer be managed according to standard guidelines.

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