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"Aim: to learn the role of docetaxel in non-castrate resistant prostate cancer patient. Methods: literature search was conducted to find relevant study comparing the combination of docetaxel and androgen deprivation therapy (ADT) to ADT alone in non-castrate resistant prostate cancer using PubMed, Cohrane Library, Proquest, EBSCO, and Scopus database. Quality assessment of studies was done using Bond University Rapid Critical Appraisal of a Systematic Review. Results: we found 494 studies from literature search, but only two studies were included in final selection. Based on validity assessment, we chose one study to be discussed further. This study showed that combination of docetaxel and ADT is better than ADT alone in regards of overall survival (HR 0.64; 95% CI 0.55, 0.75; p<0.0001; NNT=3), biochemical progression free survival (HR 0.63; 95% CI 0.57, 0.69; p<0.0001; NNT=2) and clinical progression free survival (HR 0.73; 95% CI 0.64, 0.84; p<0.0001; NNT=2). Benefit of docetaxel and ADT combination was especially seen in high volume disease (HR 0.67; 95% CI 0.54, 0.83; p=0.0003; NNT=3). Conclusion: addition of docetaxel into ADT has beneficial effects in terms of overall survival and progression free survival in patients with non-castrate resistant metastatic prostate cancer."

"Pendahuluan: Kanker prostat merupakan jenis kanker yang paling sering kedua dan penyebab kematian kelima terbanyak di kalangan pria di seluruh dunia. Meskipun ada kemajuan dalam terapi, masalah kekambuhan dan resistensi terhadap pengobatan masih menjadi perhatian, seperti kanker prostat metastasis resisten kastrasi (MCRPC) yang tidak merespons terapi pengurangan androgen tradisional. Penghambat Poly ADP-ribose polymerase (PARP) dianggap sebagai pengobatan yang menjanjikan untuk pasien MCRPC. Oleh karena itu, kombinasi terapi PARP dan antiandrogen perlu dievaluasi.Bahan & Metode: Review sistematis dilakukan dengan mengikuti panduan Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Pencarian literatur dilakukan pada lima basis data yang berbeda dan disaring sesuai dengan kriteria PICO yang ditentukan. Pengambilan data dilakukan untuk membandingkan Kelangsungan Hidup Bebas Progresi (PFS), Kelangsungan Hidup Keseluruhan (OS), Kualitas Hidup Terkait Kesehatan (HRQOL), dan efek samping, dilanjutkan dengan analisis kuantitatif.Hasil & Diskusi: Sebanyak empat RCT yang memenuhi syarat, termasuk dua studi besar, dimasukkan dalam penelitian ini. Analisis PFS menunjukkan penurunan risiko yang signifikan dengan rasio bahaya (HR) sebesar 0.53 (95% CI 0.43-0.66;p<0.001). Hasil serupa juga ditemukan dengan penurunan risiko kematian dengan OS HR sebesar 0.75 (95% CI 0.58-0.97;p=0.03). Analisis HRQOL pada Functional Assessment of Cancer Therapy - Prostate (FACT-P) melaporkan hasil yang tidak signifikan [HR=0.97 (95% CI 0.80-1.17;p=0.72)], dengan hasil serupa pada skor rasa sakit terburuk BPI-SF [HR=0.66 (95% CI 0.32-1.35;p=0.26). Analisis efek samping cukup menarik dengan penurunan risiko pada efek samping ringan dan risiko lebih besar pada kejadian efek samping yang parah, dengan efek kumulatif perbedaan efek samping yang tidak signifikan antara kedua kelompok [HR=1.13 (95% CI 0.79-1.62;p=0.49).Kesimpulan: Penambahan penghambat PAPR pada pengobatan pasien mCRPC secara signifikan meningkatkan PFS dan OS tanpa memberikan dampak negatif pada HRQoL dan efek samping. Studi lanjutan harus dilakukan untuk menentukan manfaatnya dalam berbagai pengaturan.

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ntroduction: Prostate cancer is the second most common cancer and the fifth leading cause of death among men worldwide. Despite the advancement in therapy, recurrence and resistancy after treatment is still a concerning issue, such as metastatic castration-resistant prostate cancer (MCRPC) which is resistant to traditional androgen-deprivation therapy (ADT). Poly ADP-ribose polymerase (PARP) inhibitor is hailed as a promising treatment for MCRPC patients. Thus, combination therapy on PARP and antiandrogen should be evaluated.

Material & Methods: Systematic review was conducted by adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The literature search were conducted on five different databases and screened against the predetermined PICO criteria. Data extraction were completed to compare Progression-Free Survival (PFS), Overall Survival (OS), Health-Related Quality of Life (HRQOL), and adverse effects, continued by quantitative analysis

Results & Discussion: A total of four eligible RCTs, comprising of two large studies were included. The PFS analysis has reported significant risk reduction with hazard ratio (HR) of 0.53 (95% CI 0.43-0.66;p<0.001). Similar results are also found with reduced risk of death with OS HR of 0.75 (95% CI 0.58-0.97;p=0.03). The HRQOL analysis on Functional Assessment of Cancer Therapy - Prostate (FACT-P) reported insignificant results [HR=0.97 (95% CI 0.80-1.17;p=0.72)], with similar results with the BPI-SF worst pain score [HR=0.66 (95% CI 0.32-1.35;p=0.26). The adverse effects analysis was quite interesting with risk reduction on mild adverse effects and

greater risk in severe adverse events, with a cumulative effect of insignificant adverse events difference among the two group [HR=1.13 (95% CI 0.79-1.62;p=0.49).

Conclusion: The addition of PAPR inhibitor to the treatment of mCRPC patients has significantly improved the rPFS and OS with no negative impact on HRQoL and adverse effects. Further studies should be conducted to determine the benefits in various settings.

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"Kanker prostat adalah penyakit progresif yang menghasilkan moribiditas dan mortalitas yng tinggi. Penelitian ini berutujuan untuk menilai ketepatan dari Indonesian Prostate Cancer Risk Calculator IPCRC dalam memprediksi risiko kanker prostate. Data penelitian didapatkan secara retrospektif selama periode Agustus 2014 hingga Desember 2015 dari rekam medis pasien terduga kanker prostat. Pemeriksaan colok dubur, Prostate specific antigen PSA, dan volume prostat digunakan sebagai parameter prediktif dalam IPCRC. Biopsi prostat digunakan sebagai standar baku. Akurasi IPCRC divalidasi dengan menggunakan analisis ROC. Penelitian ini memiliki 127 subjek penelitian dengan median usia pasien BPH dan pasien kanker prostat adalah 66 52-85 dan 69.5 50-100 tahun. Pemeriksaan colok dubur yang tidak normal ditemukan pada 2 pasien 2. Median dari PSA dari pasien BPH dan kanker prostat dalah 10.2 1.6-203.1 dan 74.06 6.94-1412. Volume prostate pasien BPH memiliki median sebesar 47.9 13.774-108 dibandingkan 50.25 19.2-107 pada pasien kanker prostate. Area tersebesar dibawah kurva probabilitas kanker prostat adalah 0.907 95 CI 0.84-0.97. Jika probabilitas kanker prostate lebih dari 15 pada IPCRC, sensitivitas IPCRC mencapai 88.5 dan spesifitas IPCRC mencapai 81.8, dimana bila ditemukan probabilitas kanker prostate lebih dari 20 dengan menggunakan IPCRC, sensitivitasnya mencapai 80.8 dengan spesifitas sebesar 89.9. Dan bila probabilitas kanker prostate lebih dari 25 dalam IPCRC, sensitivitas sebesar 65.4 dan spesifisitas sebesar 89.9. Sehingga, dapat disimpulkan IPCRC merupakn perangkat yang akurat dalam prediksi kanker prosate pada populasi ini. Validasi lebih lanjut masih dibutuhkan pada populasi lain.

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Prostate cancer is a progressive disease resulting in morbidity and mortality. The aim of this study is to assess the accuracy of Indonesian Prostate Cancer Risk Calculator IPCRC in predicting prostate cancer risk. Data were obtained retrospectively during August 2014 to December 2015 from medical records of suspected prostate cancer patients. Digital rectal examination, Prostate Specific Antigen PSA, and prostate volume PV were used as predictive parameters in IPCRC. Prostate biopsy was used as the diagnostic gold standard. The accuracy of IPCRC was validated using the ROC analysis. Our study included 127 subjects. Median age of BPH patients and prostate cancer patients were 66 52-85 and 69.5 50-100. The digital rectal examination was found abnormal in 2 patients 2. Median of PSA of BPH patients and prostate cancer patients were 10.2 1.6-203.1 and 74.06 6.94-1412 respectively. The prostate volume of BPH patients 47.9 13.74-108 median compared to prostate cancer patients 50.25 19.2-107 median. The largest area under the curve of the probability of prostate cancer using IPCRC is 0.907 95 CI 0.84-0.97. If the probability of prostate cancer more than 15 using IPCRC, the sensitivity is 88.5 and specificity is 81.8, besides, if the probability of prostate cancer more than 20 using IPCRC, the sensitivity is 80.8 and specificity is 89.9 and if the probability of prostate cancer more than 25 using IPCRC, the sensitivity is 65.4 and specificity is 89.9 IPCRC is accurate for predicting prostate cancer in our population. Further validation is needed in other population. "

"Pendahuluan: Kanker prostat adalah keganasan terbanyak pada pria, penyebab kematian kedua terbesar akibat keganasan. Colok dubur adalah pemeriksaan dasar dan deteksi dini untuk mendiagnosis kanker prostat. Saat ini pemeriksaan Prostate-Specific Antigen (PSA) dianggap sebagai tumor marker yang paling bermanfaat untuk mendeteksi kanker prostat. The American Cancer Society dan American Urologic Association merekomendasikan penyaringan kanker prostat setiap tahun dengan pemeriksaan colok dubur dan PSA. Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan antara pemeriksaan colok dubur dan nilai PSA pada pasien kanker prostat di RSUP DR Sardjito Yogyakarta periode Januari 2011 sampai Desember 2011. Metode Penelitian: Penelitian ini adalah kasus kontrol. Data dikumpulkan secara retrospektif dari catatan medis RSUP DR Sardjito pada pasien dengan colok dubur yang abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl selama periode Januari 2011 sampai Desember 2011. Hasil pemeriksaan colok dubur dan nilai PSA didapatkan pada saat kunjungan pertama pasien ke rumah sakit. Analisis data nominal menggunakan Chi Square dengan SPSS 18. Hasil: Terdapat 87 pasien yang berhasil dikumpulkan selama periode Januari 2011 sampai Desember 2011 yang memiliki hasil pemeriksaan colok dubur abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl. Pasien memiliki usia rata-rata 70 tahun, nilai median PSA 10,9 ng/dl. Pada pasien ini ditemukan colok dubur abnormal 43 (49,4%), colok dubur normal 44 (50,6%), PSA ≥ 10 ng/dl 69 (79,3%) dan PSA < 10 ng/dl 18 (20,7%). Pemeriksaan colok dubur dan PSA dinilai signifikan secara statistik untuk mendeteksi kanker prostat, hasil secara berurutan 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002. Semua pasien dengan colok dubur abnormal dan PSA ≥ 10 ng/dl terdiagnosis kanker prostat (p < 0,001). Simpulan: Pemeriksaan colok dubur dan Prostate Specific Antigen (PSA) adalah prediktor terbaik untuk kanker prostat.

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Introduction: Prostate cancer is the most frequent form of cancer in males, being also second cause of death by cancer. Digital Rectal Examination (DRE) is the basic examination and early diagnosis for prostate cancer. The Prostate-Specific Antigen (PSA) assay is currently considered the most useful tumor marker for detecting prostate cancer. Both the American Cancer Society and American Urologic Association recommended annual cancer screening with both Digital Rectal Examination (DRE) and PSA.

Objective: The objective of this study is to understand the correlation between DRE and PSA level in prostate cancer at Sardjito General Hospital Yogyakarta during januari 2011 until december 2011.

Research Method: This is a case control study. The data were retrospectively collected from medical record in sardjito general hospital who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl during januari 2011 until December 2011. The DRE and PSA value were examined in the first time they came to the hospital. A chi-square was performed to analyzed the nominal data with SPSS 18.

Result: There are 87 patients were collected during januari 2011 until December 2011 who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl. The median age was 70 years, median PSA level was 10,9 ng/dl. Of these patient, we found abnormal DRE in 43 (49,4%), normal DRE in 44 (50,6%), PSA ≥ 10 ng/dl was 69 (79,3%) and PSA < 10 ng/dl was 18 (20,7%). Digital Rectal Examination and PSA was statistically significant to detected prostate cancer, 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002), respectively. All patient who had abnormal DRE and PSA ≥ 10 ng/dl were diagnosed with prostate cancer (p < 0,001).

Conclusion: Digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) are the best predictor for prostate cancer. "

"Kanker prostat merupakan kanker yang terdiagnosis kedua terbanyak dan mendudukiperingkat keenam dari penyebab kematian pada pria di seluruh dunia. Diperkirakan914.000 kasus ditemukan dan berperan dalam 6% (258.400) dari total angka kematiandi tahun 2008. Telah diciptakan Indonesian Prostate Cancer Risk Calculator (IPCRC)yang diperoleh dari penelitian multisenter sebelumnya, namun masih perlu dilakukanvalidasi eksternal untuk menguji validitas dari kalkulator tersebut. Kami inklusikanseluruh pasien pembesaran prostat jinak (BPH) dan kanker prostat (PCa) yangmenjalani biopsi prostat ataupun prostatektomi di RS Adam Malik Medan pada periode11 Agustus sampai 31 Desember 2014. Dilakukan analisis untuk membandingkanvariabel-variabel yang terkait resiko kanker prostat, termasuk: usia, kadar PSA, volumprostat, dan temuan pemeriksaan colok dubur (DRE). Kemudian resiko kanker prostatpada masing-masing pasien dihitung menggunakan IPCRC dan dianalisis hasilnyamenggunakan kurva receiver operating characteristic (ROC). Kami jugamembandingkan hasilnya dengan luas area di bawah kurva (AUC) untuk PSA. Padastudi ini dijumpai 21 pasien PCa dan 24 pasien BPH. Rata-rata umur, PSA, dan volumprostat secara berturut-turut adalah 66.8±7.3 tahun, 27.3±32.2 ng/ml, dan 64.9±38.1 ml.Temuan DRE abnormal dijumpai pada 6 pasien PCa dan 1 pasien BPH. Seluruhvariabel antara PCa dan BPH tidak berbeda signifikan (p>0.05). AUC dari IPCRCadalah 79.8% (95% IK= 66.2%-93.3%; p=0.001) dalam memprediksi kanker prostat.Analisis ROC IPCRC memiliki sensitivitas 85.7% dan spesifisitas 70.8%. AUC IPCRCini lebih tinggi daripada AUC PSA dengan selisih sebesar 11.4%. Indonesian ProstateCancer Risk Calculator (IPCRC) lebih baik daripada PSA tunggal dalam memprediksikejadian kanker prostat. Validasi dan studi prospective lebih lanjut dengan sampel yanglebih besar perlu dilakukan.

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Prostate cancer is the second most frequently diagnosed cancer and the sixth leadingcause of cancer death in men worldwide. It was estimated 914.000 new cases werefound and responsible for 6% (258.400) of total cancer deaths in men in 2008.Indonesian Prostate Cancer Risk Calculator (IPCRC) was developed from a multicentricstudy to predict the risk of prostate cancer in suspected patient. An externalvalidation is needed to c onfirm the validity of the calculator. We included all benignprostatic hyperplasia (BPH) and prostate cancer (PCa) patients who underwent prostatebiopsy and prostatectomy in Adam Malik Hospital between August 11th and December31st 2014. The relationship between variables affecting the percentage of prostatecancer risk were evaluated, including: age, PSA level, prostate volume, and digitalrectal examination (DRE) findings. We calculated the risk of prostate cancer for eachpatient using IPCRC and analyse the results using the receiver operating characteristic(ROC) curve. We also compared them with the area under curve (AUC) of PSA results.There were 21 PCa and 24 BPH patients in our study. The mean ages, PSA, and prostatevolume were 66.8±7.3 years old; 27.3±32.2 ng/ml and 64.9±38.1 ml, repectively.Abnormal DRE was found in 6 PCa and 1 BPH. Each variable didnt show significantdifference between PCa and BPH groups (p > 0.05). The AUC of IPCRC was 79.8%(CI 95%: 66.2%-93.3%; p=0.001) in predicting prostate cancer. The ROC analysis ofIPCRC had sensitivity of 85.7% and specificity of 70.8%. This AUC of IPCRC washigher than of PSA, with 11.4% difference. The Indonesian Prostate Cancer RiskCaluclator is better than PSA alone in predicting prostate cancer in this population.Further validation and future prospective study in larger population is needed."

"Tujuan: Untuk mengetahui bagaimana upaya diagnosis kanker prostat yang dilakukan oleh spesialis urologidi Indonesia. Metode: Dilakukan pembagian kuesioner yang dirancang sendiri kepada Spesialis Urologi di Indonesia. Kuesioner berisi 11 pertanyaan tentang jenis dan indikasi pemeriksaan yang dilakukan, serta fasilitas yang tersedia di tempat responden dalam penegakan diagnosis kanker prostat. Hasil: Sebanyak 65 (36%) dari 182 (saat penelitian ini dilakukan) spesialis urologi di Indonesia mengembalikan formulir kuesioner. Dari jenis RS primer tempat bekerja terbanyak berasal dari RS swasta (35%), disusul RS pendidikan utama Fakultas Kedokteran (32%). Seluruh responden menjadikan lower urinary tract symptoms (LUTS) sebagai indikasi untuk melakukan pemeriksaan colok dubur. Selain itu 83% responden juga menjawab, peningkatan PSA sebagai salah satu indikasi pemeriksaan colok dubur. Pemeriksaan PSA dilakukan oleh 72% responden pada penderita dengan kecurigaan kanker prostat tanpa melihat usia. Sebanyak 66% responden mengerjakan sendiri pemeriksaan transrectal ultrasonografi (TRUS) dan biopsi, 18% merujuk pada sejawat lain di propinsi yang sama dan 15% tidak memiliki fasilitas TRUS dan biopsi di propinsi tempat bekerja. Sebanyak 75% responden memiliki fasilitas bone scan di Rumah Sakit primer, atau tersedia di RS pada propinsi yang sama. Indikasi tersering melakukan biopsi prostat adalah pada PSA lebih dari 10 ng/ml tanpa melihat usia. Sebanyak 86% responden melakukan biopsi pada kecurigaan kanker prostat melalui colok dubur tanpa melihat usia. Sembilan puluh persen responden menggunakan antibiotik profilaksis golongan Kuinolon untuk biopsi prostat. Sebanyak 46% menggunakan analgesia oral atau suppositoria atau kombinasi keduanya sebagai analgesia dalam biopsi prostat. Kesimpulan: Dalam mendiagnosis kanker prostat, spesialis urologi di Indonesia melakukan pemeriksaan colok dubur, PSA dan TRUS biopsi prostat, namun masih terdapat perbedaan pendapat tentang indikasi dan waktu dilakukannya masing-masing pemeriksaan. Ketersediaan fasilitas diagnostik juga berpengaruh dalam diagnostik kanker prostat di Indonesia. Belum tersedianya guideline Nasional pada saat penelitian ini dilakukandiduga menyebabkan perbedaan pendapat tersebut.

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Purpose: To get information on diagnosis of prostate cancer conducted by urologist in Indonesia.

Method: A self-constructed questionnare of 11 questions about the type and indication of the tests, as well as the available facilities at the place of the respondents to diagnose prostate cancer distributed to Indonesian Urologist.

Result: As much as 65 (36%) from 182 (when the survey was conducted) Indonesian Urologist returned the questionnare. Most of them worked in Private Hospital (35%), followed by Medical School Hospital (32%). All respondents performed DRE in patients with Lower Urinary Tract Symptoms (LUTS). Elevated PSA was also indication for conducting DRE in 83% respondents. PSA level was tested by 72% respondents in patients with suspicion of prostate cancer regardless of age. As much as 66% respondents did Trans Rectal Ultrasound (TRUS) and prostate biopsy by themselves, 18% referred to other urologists in the same province and 15% didn?t have TRUS and prostate biopsy facilities in their province. Bone scan was available in the Primary Hospital or another hospital in the province of 75% respondents. Main indication to perform prostate biopsy was elevated PSA level above 10ng/ml regardless of the age. Meanwhile, 86% respondents did prostate biopsy in suspiciousness of prostate cancer by DRE regardless of age. Most respondents (90%) chose Quinolon as prophylaxis antibiotic in prostate biopsy and 46% respondents used oral analgesia or suppository or both in prostate biopsy.

Conclusions: In diagnosing prostate cancer, Indonesian Urologists performed DRE, PSA serum analysis and TRUS biopsy of the prostate. But the Indonesian Urologists still had different opinions about the indications and timing of the procedure. The availability of diagnostic equipment and unavailability of National Guideline of Prostate Cancer when this study was conducted played a role of how the prostate cancer diagnosed in Indonesia."

"Kematian yang disebabkan oleh kanker diperkirakan akan terus meningkat, terutama untuk kanker prostat. Penyakit ini adalah jenis kanker yang paling umum untuk pria di dunia. Jumlah kematian dapat dikurangi dengan deteksi dini menggunakan machine learning. Salah satunya adalah klasifikasi data kanker prostat. Data kanker yang digunakan memiliki berbagai fitur, tetapi tidak semua fitur adalah fitur penting. Dalam penelitian ini, kami menggunakan Support Vector Machine-Recursive Feature Elimination (SVM-RFE) dan One Dimensional Naïve Bayes Classifier (1-DBC) sebagai metode seleksi fitur. Dalam kedua metode itu akan mendapatkan peringkat untuk setiap fitur. Penggunaan kedua metode ini dalam klasifikasi data kanker prostat menghasilkan tingkat evaluasi yang tinggi. Kedua metode ini dapat menghasilkan tingkat akurasi 100%, precision 100%, dan recall 100% pada metode klasifikasi Random Forest. Dan menghasilkan tingkat akurasi 95%, precision 100%, dan recall 94,11% pada metode klasifikasi SVM. Dalam evaluasi tambahan, SVM-RFE memiliki running time lebih rendah dari 1-DBC.

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Death caused by cancer is expected to continue to increase, especially for prostate cancer. This disease is the most common type of cancer for men in the world. The number of deaths can be reduced by early detection using machine learning. One of them is the classification of prostate cancer data. Cancer data used has various features, but not all features are essential features. In this study, we use Support Vector Machine-Recursive Feature Elimination (SVM-RFE) and One Dimensional Naïve Bayes Classifier (1-DBC) as a feature selection method. In both methods, it will get a rating for each feature. The use of these two methods in the classification of prostate cancer data produces a high level of evaluation. Both of these methods can produce 100% accuracy, 100% precision, and 100% recall in the Random Forest classification method. And it produces 95% accuracy, 100% precision, and 94.11% recall in the SVM classification method. In the additional evaluation, SVM-RFE has a running time lower than 1-DBC."

"Kanker prostat diketahui berhubungan dengan pekerjaan yang melibatkan kerja shift. Pada tahun 2007, International Agency for Research on Cancer (IARC) menyatakan bahwa kerja shift dengan disrupsi sirkadian menyebabkan kemungkinan kanker pada manusia. Pajanan terhadap LAN (Light at Night) menekan sekresei melatonin pineal dan menstimulasi peningkatan hormon sex yang pada gilirannya dapat meningkatkan kerentanan terhadap kanker yang bergantung pada hormon. Kasus disini akan menilai bagaimana hubungan antara pekerja shift suatu manufaktur yang telah bekerja 30 tahun dengan peningkatan risiko kanker prostat melalui beberapa telaah jurnal kritis untuk menilai validitas dan aplikabilitasnya. Dari ketiga jurnal yang ditelaah adalah valid dan aplikatif. Sebuah systematic review dan meta-analysis oleh Mancio J.dkk tahun 2018 adanya peningkatan yang signifikan antara kanker prostat dengan rotasi kerja gilir. Begitu pula dengan Behrens T.dkk tahun 2017. Namun, studi kohort Torbjrn A.dkk tahun 2017 menilai tidak ada hubungan kanker prostat dengan durasi kerja malam. Perbedaan ini mungkin karena kurangnya pengukuran pajanan, dan perbedaan dalam jenis kovariat yang disesuaikan untuk kelompok pekerjaan heterogen yang terlibat.

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Prostate cancer has been associated with jobs that involve some degree of work at night. In 2007, the International Agency for Research on Cancer (IARC) concluded that shift work involving circadian disruption was probably carcinogenic in humans. Exposure to artificial LAN (Light at Night) suppresses pineal melatonin secretion and subsequently leads to an increase of sex hormones, which in turn could increase the susceptibility to hormone-dependent cancers. In this case, the authors assessed the relationship between workers in a manufacture company who had worked shift work for 30 years and an increased risk of prostate cancer. This case takes evidence base from several journals that support this hypothesis while doing a critical appraisal to determine its validity and applicability. The three journals appraised were valid and applicable. From A systematic review and meta-analysis by Mancio J. et al. in 2018, there was a significantly increased risk of prostate cancer with rotating shift work. Behrens T. et al. (2017) observed a twofold increased HR among shift workers and night workers working in industries. However, cohort studies by Torbjrn A. et al (2017) with no association with duration of night work was seen, this discrepancy may be due to a lack of a common exposure measurement, differences in the type of covariates adjusted for or heterogeneous occupational group involved, and selection into and out of night work occurs continously."

"This book provides an exhaustive review of the current state of the art in the management of prostate cancer, from screening to treatment. A particular feature is the emphasis placed on the value of a multidisciplinary approach. The opening chapters address basic aspects including epidemiology, biology, and chemoprevention. The role of individual and mass screening is carefully appraised, and diagnosis, clinical work-up, and the role of active surveillance are discussed in detail. Subsequent chapters are devoted to each of the therapies that may be employed, including open and robotic laparoscopic radical prostatectomy, the various forms of radiation therapy, high-intensity focused ultrasound, cryotherapy, hormonal therapy, and targeted therapies and vaccination. Up-to-date data from clinical trials are included."

"The volume provides an introduction to the concept of active surveillance in oncology in general and prostate cancer specifically. The primary focus is to provide a comprehensive guide to the management of patients on surveillance. The volume covers the many complexities and nuances to this approach including, patient selection, risk assessment, how to overcome 'cancer hysteria' when counseling patients, identifying appropriate triggers for intervention, use of PSA kinetics and MR imaging information, technique and frequency of biopsies, secondary prevention interventions, and the relative roles of surveillance and focal therapy."