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Increased use of active surveillance for men with intermediate risk prostate cancer

The optimal management of men with intermediate risk prostate cancer remains unclear and continues to be debated. The authors interrogate the US National Cancer Database for 176,122 men diagnosed with intermediate risk prostate cancer between 2010 and 2016. Of these...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Demanding cases or nightmares in uro-oncology? Jan/Feb 2023

Radical surgical treatment of prostate cancer has become minimally invasive owing to robotic assisted laparoscopic technology [1]. Patients who undergo robotic assisted radical prostatectomy (RARP) often have lower risk of morbidity compared to an open approach. However, patients with a...

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...

Defining adjuvant, consolidative, and salvage treatment after RP

The most common oncologic outcome following radical prostatectomy (RP) for localised prostate cancer is achieving undetectable prostate-specific antigen (PSA) levels (<0.1 ng/ml), indicating an absence of detectable disease. However, the landscape of RP is shifting as active surveillance becomes the...

Moving pictures

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). Those of you who occasionally wander (virtually of course) into the online Museum...

Management of Prostate Cancer: A Multidisciplinary Approach

This is an excellent textbook which comprehensively covers the vast field of prostate cancer. The editors, who have co-ordinated phase III European Organisation for Research and Treatment of Cancer (EORTC) trials, have brought together a large array of well-known international...

ASAP: is a repeat biopsy necessary?

This study examined the validity of current US and European guidelines on the management of patients diagnosed with atypical small acinar proliferation (ASAP). Current guidance states that these patients should undergo repeat biopsy within three to six months due to...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

Urology in Leeds

In this series of articles, I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). One of the reasons for the creation of the Museum of Urology was...

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...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...