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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...

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...

The potential of statin use in castrate resistant prostate cancer treatment

One of the mechanisms by which prostate cancer achieves castrate resistance is through de novo intratumoral production of androgens. Reactivation of androgen receptors results in promotion of cell survival and proliferation pathways despite castrate serum testosterone levels. As androgen synthesis...

Fluoroquinolone resistant rectal colonisation predicts risk of infectious complications after TRPB

Transrectal prostate biopsy (TRPB) has been associated with increased risk of infection between 3.6-5% and sepsis rates of 0.3-3.1% mainly due to fluoroquinolone resistance (FQR). At present, FQ antibiotic prophylaxis is utilised commonly across North America and Europe but due...

The burning issue of urinary tract infections

Urinary tract infections (UTIs) occur when bacteria colonise and proliferate in the urinary tract. These are characterised by specific clinical symptoms (dysuria, suprapubic tenderness, urgency and urinary frequency) which commonly occur alongside the finding of bacteriuria. UTIs are common –...

Performance status may alter outcomes in those treated with abiraterone

The drug therapies available for those with metastatic castrate-resistant prostate cancer have increased over the past few years. Abiraterone, a CYP17 inhibitor, has been proven effective in phase three trials, however those with poor performance status were largely under-represented in...

Radium-223 treatment outcomes after multiple lines of mCRPC therapy in clinical practice: implication of pre-treatment spinal epidural disease

There are a number of treatments now available to patients with metastatic castrate-resistant prostate cancer (mCRPC). However, the optimal timing and order in which they are given is less clear. Radium-223 was FDA-approved for mCRPC patients with symptomatic bone metastases...

Predicting bone scan positivity in non-metastatic CRPC

There is evidence that suggests that early treatment with chemotherapy, immunotherapy or hormone therapy leads to a better response in patients with asymptomatic metastatic castrate resistant prostate cancer (CRPC). This study aimed to predict bone scan positivity in patients with...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...

Rectal swab testing before prostate biopsy

This study explored the real terms value of rectal swab testing and targeted antibiotic prophylaxis in patients undergoing transrectal ultrasound prostate biopsy in view of increasing bacterial resistance to fluoroquinolones (17.6% in North America, 40% in Hong Kong). The authors...

Is surgical antibiotic prophylaxis necessary for paediatric orchiopexy?

With the rise of resistant organisms to most commonly used antibiotics, there is a plea for judicious use of antibiotics, especially for clean surgical procedures. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), clostridium difficile infection,...

Read all about it Nov/Dec 2018

It can be awkward when a patient asks you about a report in their favourite tabloid detailing an amazing research breakthrough or a ‘cutting-edge’ new treatment / test and you don’t know what they are talking about! So this section...