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An inconvenient truth: reflections on the NHS
“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...
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...How do we tackle social injustice in urological cancer?
Socioeconomic status as an established determinant of health and associated injustices is well recognised. Confronting these injustices and creating a fairer healthcare system is an ongoing challenge for many governments. In Scotland, the devolved government has created the Scottish Index...
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...
PSA screening in limbo: how low should we go?
One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...
Importance of PSA variation – an analysis of PLCO trial data
This study looks specifically at the group of patients in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial (PLCO), to investigate variations in prostate specific antigen (PSA) level. They have specifically included only patients who...
Evaluation of the learning curve for learning MRI-US fusion prostate biopsies
With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be implementing MRI-US transrectal or transperineal fusion biopsies to their clinical practice. This prospective cohort study evaluated 779 consecutive...Inpatient care of patients with established spinal cord injury - what a general urologist needs to know
Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...Demanding cases or nightmares in uro-oncology? Sep/Oct 2021
Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...
Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?
Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...
Fast Facts: Prostate Cancer
I have read this book since my SHO days, when the first edition was published in 1996, and still enjoy reading every new edition. This is a concise, pocket-sized book which is designed to provide a rapid update on what...
