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Contiform – is available on prescription

Despite the rumours of Contiform’s demise that have been greatly exaggerated, and that...

Prognostic impact of preoperative neutrophil-to-lymphocyte ratio after radical prostatectomy

Neutrophil-to-lymphocyte ratio has been shown to be a prognostic factor in a number of different cancers. This is one of the largest studies to date to evaluate its effect on overall survival in patients who have undergone radical prostatectomy (RP)...

PET imaging of prostate-specific membrane antigen in prostate cancer

Molecular imaging utilising prostate-specific membrane antigen (PSMA) as a target has increasingly been mentioned at key conferences and meetings. PSMA is a membrane metalloenzyme that is overexpressed in prostate cancer, with the degree of expression appears to correlate with tumour...

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...

The natural history of prostate cancer on MRI

Multiparametric MRI features heavily on a number of active surveillance protocols. This study looked at 86 men on active surveillance who had an mpMRI prior to 2013 to assess how lesions changed over time. Two blinded radiologists examined all the...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Prostate cancer series: diagnostics 2

- Click here for Part 1 - A 68-year-old male was referred to the two-week wait prostatic clinic with a serum prostate specific antigen (PSA) of 17. He had no bothersome lower urinary tract symptoms, relevant past medical history or...

Indeterminate renal lesions – a pragmatic imaging approach

The incidence of renal cell carcinoma (RCC) in the UK has increased steadily over the last two decades, largely driven by the increasing use of abdominal imaging and the incidental detection of small renal lesions [1]. The majority of incidental...

Rare and Complex Urology

Diseases that are rare or of low prevalence pose challenges to provision of high-quality care because of limited available knowledge and sparse good-quality evidence regarding uncommon presentations, mechanisms of disease, and optimal treatments. Approximately 80% of rare diseases are of...

Demanding cases or nightmares in uro-oncology? May/Jun 2022

Delayed diagnosis of testicular cancer Testicular cancer is considered rare in the general population but is the most common cancer affecting males between 24 and 49 years. The diagnosis of testicular cancer depends on physical examination, ultrasound findings and tumour...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

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...