Journal Reviews
Prostate cancer screening
This editorial is from the University of Minnesota in the USA. The present evidence suggests that prostate specific antigen (PSA) testing provides a small reduction in prostate cancer (CaP) mortality and no reduction in all-causes mortality. The downside is of...
Urologists beware!
This article recounts the story of a Californian urologist who was shot dead two decades later by a patient who was diagnosed with stricture of the urethra. The patient underwent surgery for urethral stricture in 1992 by a team (ironically,...
When partial nephrectomy is unsuccessful
With increasing use of partial nephrectomy (PN) to treat complex T1 tumours, the risk of conversion to radical nephrectomy (RN) increases. In this study the authors look at the incidence of conversion of robotic PN (RPN) to RN and analysed...
MRI targeted transperineal prostate biopsy: a local anaesthetic approach
Transperineal template biopsy remains the gold standard investigation in diagnosis of prostate cancer. Data from the PROMIS study demonstrated the low sensitivity of transrectal ultrasound (TRUS) biopsy as a diagnostic tool, and highlighted the need for a better diagnostic pathway....
Prostate biopsy and survival
Talk to many urologists and the axiom is “you are more likely to die with prostate cancer than from it”. This study was conducted on Danish men between 1995 and 2011. The observations are: 1) Cumulative prostate cancer – specific...
Active surveillance for intermediate-risk prostate cancer
In this review, Klotz and Dall’Era summarise available data from the Toronto, UCSF, ERSPC, PASS and Royal Marsden active surveillance cohorts, looking specifically at outcomes of patients classed as intermediate risk. Cancer specific survival in men managed initially with active...
Abiraterone acetate in men with castration-resistant prostate cancer
With emerging results from the Stampede and Latitude studies, abiraterone has taken the forefront in the management of metastatic prostate cancer while researchers try to identify the ideal timing for administration. It is a potent inhibitor of CYP17 which results...
Morbidity and mortality after surgery for LUTS
The market for bladder outflow obstruction surgery is currently wide open with new technologies such as Urolift® emerging. One of the key selling points of new technologies is the comparative safety and efficacy compared to traditional techniques such as transurethral...
Is AS in SRM more convincing than in prostate cancer?
This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...
Radium-223 treatment outcomes after multiple lines of mCRPC therapy in clinical practice: implication of pre-treatment spinal epidural disease
There are a number of treatments now available to patients with metastatic castrate-resistant prostate cancer (mCRPC). However, the optimal timing and order in which they are given is less clear. Radium-223 was FDA-approved for mCRPC patients with symptomatic bone metastases...
Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer
Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...
Long-term oncologic outcomes of salvage cryoablation for rrPC
Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...
