rejse gennem pca - propa · 2020-04-15 · ahmed h. zedan h-læge, onkologisk afd., vs phd...
TRANSCRIPT
![Page 1: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/1.jpg)
Rejse gennem PCa
Ahmed H. Zedan
H-læge, onkologisk afd., VS
PhD studerende, urologisk afd., VS
07-11-2017 Propa Master Class 2017,Middelfart.
![Page 2: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/2.jpg)
![Page 3: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/3.jpg)
165 år tilbage
Adams, J. The case of scirrhous of the prostate gland with corresponding affliction of the lymphatic glands in the lumbar region and in the pelvis. Lancet 1, 393 (1853).
![Page 4: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/4.jpg)
2016
![Page 5: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/5.jpg)
Hele vesten
![Page 6: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/6.jpg)
Hvad var der sket!
![Page 7: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/7.jpg)
1786-1893
1941
1960s
1970s-1980s
1980-1995
1995-2004
2004-2017
1904
1931
1945
1966
1962
1983
1988
Medicinisk kirurgisk, Stråle
![Page 8: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/8.jpg)
Medicinisk
![Page 9: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/9.jpg)
1780’er-1890’er
Palmer, J. F. (ed.) The Works of John Hunter F. R. S. with Notes (Longman, London, 1786
White, W. J. Surgical removal of the hypertrophied prostate. Ann. Surg. 152 (1893)
![Page 10: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/10.jpg)
1941
11/7/2017
Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res 1: 293 297
![Page 11: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/11.jpg)
1960s
Anderson, K. M. & Liao, S. Selective retention of dihydrotestosterone by prostatic nuclei. Nature 219,277–279 (1968).
![Page 12: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/12.jpg)
1970s-1980s
Schally, A. V., Kastin, A. J. & Arimura, A. Hypothalamic FSH and LH-regulating hormone. Structure, physiology and clinical studies. Fertil. Steril. 22, 703–721 (1971).
Liao, S., Howell, D. K. & Chang, T. M. Action of a nonsteroidal antiandrogen, flutamide, on the receptor binding and nuclear retention of 5 α-dihydrotestosterone in rat ventral prostate. Endocrinology 94, 1205–1209 (1974).
Tolis, G. et al. Tumor growth inhibition in patients with prostatic carcinoma treated with lutenizing hormonereleasing hormone agonists. Proc. Natl Acad. Sci. 79, 1658–1662 (1982).
![Page 13: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/13.jpg)
1980-1995
![Page 14: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/14.jpg)
1995-2000s
![Page 15: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/15.jpg)
2014-2017
![Page 16: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/16.jpg)
Kirurgisk og strålebehandling
![Page 17: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/17.jpg)
1900---nu
• 1904 Først prostatektomi
• 1931 Først brachyterapi
• 1945 retropubic prostatektomi
• 1962 Ekstern radioterapi
• 1966 GS
• 1983 Nerve- bevarende prostatektomi
• 1988 TRUS
• 2001 laparoskopisk prostatektomi.
![Page 18: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/18.jpg)
2017
![Page 19: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/19.jpg)
11/7/2017
år
ADTLokal terapi
Recidiv
PSA
![Page 20: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/20.jpg)
11/7/2017
år
ADTLokal terapi
Recidiv
DOCDOC
Tidlig/upfront
Radium-223
ENZ
ABI
ENZ
CBZ
ABIABI
PSA
![Page 21: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/21.jpg)
Udfordringer
• Diagnostisk
• prognostisk
• Prædiktiv
• mPC
![Page 22: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/22.jpg)
Biomarkører og PCa
![Page 23: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/23.jpg)
Diagnostisk
![Page 24: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/24.jpg)
Diagnostisk
![Page 25: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/25.jpg)
Diagnostisk
![Page 26: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/26.jpg)
mPCa
Oligometastaser Immunterapi Genetiske
![Page 27: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/27.jpg)
Oligometastaser
![Page 28: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/28.jpg)
Immunterapi
• Vaccination
• PDL-1
• Programmeret immune system
![Page 29: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/29.jpg)
BRCA and PARPI
Mateo J, Carreira S, Sandhu S, et al. DNA-repair defects and olaparib in metastatic prostate cancer. N Engl J Med 2015;373: 1697–708.
![Page 30: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/30.jpg)
Andre områder
• Livskvalitet
• Livsstil
• Kost
![Page 31: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/31.jpg)
Muligheder i DK
• 25 studier
• EMBARK (M0CSPC) (hele DK)
• ENZ i mCSPC (hele DK)
• PROfound (PARPI) (Odense)
• PRO-TEST (KBH)
• Biobanker
![Page 32: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/32.jpg)
PerPros
![Page 33: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/33.jpg)
PerPros
• Personaliseret behandling af PCa
• Sygehus Lillebælt, Sydvestjysk Sygehus, og Sygehus Sønderjylland
• Blod og urin
• Opbevares på VS
• 5 år
• Palle Osther, Urologisk afd. VS.
![Page 34: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/34.jpg)
Hvem kan være med…
• Alle mænd der mistænkes for prostatakræft og indkaldes til TRUS med biopsi
• Samtykke, blodprøver og urinprøve FØR biopsi
![Page 35: Rejse gennem PCa - PROPA · 2020-04-15 · Ahmed H. Zedan H-læge, onkologisk afd., VS PhD studerende, ... Huggins, C. and Hodges, C.V. (1941) Studies on prostatic cancer I the effect](https://reader033.vdocuments.pub/reader033/viewer/2022050601/5fa87812bd246139ec3fab6a/html5/thumbnails/35.jpg)
Tak