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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...

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...

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...

Prostate cancer screening

This editorial is from the University of Minnesota in the USA. The present evidence suggests that prostate specific antigen (PSA) testing provides a small reduction in prostate cancer (CaP) mortality and no reduction in all-causes mortality. The downside is of...

What is the significance of prostatic calcification?

This prospective study on men undergoing transrectal ultrasonography (TRUS) biopsies was performed to evaluate the prevalence and to classify prostatic calcification (PCalc) on TRUS and correlate the findings with histology. Images of the prostate were saved at three defined regions:...

Indication to pelvic lymph nodes dissection for prostate cancer

This paper explored the role of multiparametric MRI (mpMRI) in predicting the likelihood of lymph node invasion in patients with a risk of <5% according to the Briganti nomogram. Three hundred and ten patients who underwent a preoperative mpMRI and...

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...

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...

Impact of MetS on prostate cancer (PCa)

Metabolic syndrome is associated with an increased risk of finding prostate cancer (PCa) overall and high-grade disease on biopsy. The first objective was to determine if MetS is associated with higher final PCa stage and grade on radical prostatectomy (RP)...

Adjuvant radiotherapy versus wait-and-see after radical prostatectomy

Optimum treatment modalities in prostate cancer continue to evolve, with debates at each stage of the evolution process, from focal therapy to radical treatment. In this randomised study, Wiegel et al. investigated the role of adjuvant radiotherapy following open radical...

Testosterone supplementation after prostatectomy – journey from bad to good

The role of androgens in the pathogenesis of prostate cancer is quite complex and is not entirely clear yet. Despite several reports suggesting testosterone use is safe in patients diagnosed with prostate cancer, many clinicians are still reluctant to use...