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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...

Incidence and risk factors of suicide after a prostate cancer diagnosis

This is an observational study looking at 1,281,393 men diagnosed with prostate cancer and 842,294 matched prostate cancer-free men. There was an overall increased relative risk of suicide of 2.01 in men diagnosed with prostate cancer compared to those without,...

The potential of statin use in castrate resistant prostate cancer treatment

One of the mechanisms by which prostate cancer achieves castrate resistance is through de novo intratumoral production of androgens. Reactivation of androgen receptors results in promotion of cell survival and proliferation pathways despite castrate serum testosterone levels. As androgen synthesis...

The role of embolisation in urology

Case 1 An 86–year–old male presented with visible haematuria and suprapubic pain. He had a history of diabetes, heart failure, benign prostatic hypertrophy, aortic valve replacement, deep vein thrombosis (DVT) and atrial fibrillation (AF) and was anticoagulated on a non-VKA...

Surgical treatment of LUTS secondary to BPH

For the vast majority of patients an initial trial of medical therapy for the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is indicated [1]. In a substantial minority of cases however, a surgical intervention...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...

Smith’s Textbook of Endourology, 2 Volume Set, 4th Edition

Since the founding fathers of endourology first published this textbook in 1996, the surgical vista has been changed unrecognisably by technological advances. Laparoscopic approaches have become commonplace for renal, ureteric, bladder and prostatic surgery, and robotic-assisted techniques have developed with...

Prostate cancer detection rate of MRI-TRUS fusion vs. systematic biopsy

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be considering introducing the technique of magnetic resonance imaging transrectal ultrasound (MRI-TRUS) fusion biopsies to their practice. A retrospective...

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...

Post prostatectomy outcomes of patients with high-risk prostate cancer treated with neoadjuvant androgen blockade

This is an interesting paper reporting on the use of neoadjuvant androgen blockage in patients with high-risk prostate cancer undergoing radical prostatectomy. Previous work in the literature has shown an improvement in the rate of organ-confined disease and decreased positive...

Rectal swab testing before prostate biopsy

This study explored the real terms value of rectal swab testing and targeted antibiotic prophylaxis in patients undergoing transrectal ultrasound prostate biopsy in view of increasing bacterial resistance to fluoroquinolones (17.6% in North America, 40% in Hong Kong). The authors...

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...