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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...

Prostate Cancer Diagnosis – PSA, Biopsy and Beyond

The danger of many of the texts which deal with this rapidly changing field is that by the time the texts are published they are out of date. This book however remains fresh, in part because it acknowledges that there...

Recent advances in the management of castration resistant prostate cancer

Castrate resistant prostate cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy lowering testosterone to castrate levels. It may present as a rise in serum levels of prostate specific antigen (PSA), progression of pre-existing disease, or the appearance of...

Prostate cancer survivorship: a new path for uro-oncology

Over two million people in England have a diagnosis of cancer [1]. Of this figure, over 250,000 have been diagnosed with prostate cancer [2]. However, during the next decade, a rapid increase in the number of new cancer diagnoses, as...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

COVID-19 cuts prostate cancer referrals in half

Charity warns that 3500 men risk being diagnosed with incurable cancer as referrals drop to lowest in 10 years Urgent referrals for urological cancers have dropped by half in England (49.5%) compared to the same period last year as the...

Use of MRI in the evaluation of prostate cancer: part 1

Introduction Prostate cancer remains the most commonly diagnosed cancer in males and the second leading cause of cancer related deaths in UK men, after lung cancer [1]. The incidence of prostate cancer in the UK has shown a rapid increase...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

Sexual dysfunction following prostate cancer treatment

Prostate cancer is common with over 52,300 new cases diagnosed annually in the UK; this is expected to rise by 15% between 2023-2025 and 2038-2040 [1]. Radical prostatectomy continues to be the most common form of radical treatment for men...

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...

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...