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Criteria for active surveillance are gradually improving
Being diagnosed with low-risk prostate cancer is a good reason to consider management under active surveillance (as opposed to immediate, early intervention) … but active surveillance won’t be right...
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New prostate cancer “vaccine” in Phase II trial prior to ADT
According to a media release we saw this morning, a company called Madison Vaccines has started a Phase II clinical trial of a new form of immunotherapy for treatment of men with non-metastatic...
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“Five golden rules” for prostate cancer screening and treatment today
In a very simple and straightforward article in European Urology, Vickers et al. have clearly laid out a series of five “golden rules” that, in their opinion, all physicians should be following today...
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New NCCN guidelines on prostate cancer are not an all-around success!
Alas, the latest revisions to the National Comprehensive Cancer Network (NCCN) guidelines on early detection of prostate cancer seem to have instigated more furore than they have clarity (although the...
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Evaluation of the real utility of new biomarkers for prostate cancer risk
There is a fascinating comment by Kattan scheduled for publication in a forthcoming issue of the new journal Urology Practice. It makes a truly critical point about whether any of the new biomarkers...
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Shared and emotion-free decision-making with respect to PSA-based screening
The following is (slightly edited) report by Jeffrey J. Tomaszewski, MD, on behalf of UroToday.com, of a state-of-the-art lecture by David Penson, MD, presented at the annual meeting of the American...
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Old and newer tests and risks for prostate cancer; can you avoid...
We now have five approved tests that can (at least in theory) help a man — and his doctors — to decide whether he is at sufficient risk for clinically significant prostate cancer that he should go get...
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“A plea for individualized prostate cancer screening”
For some years, Vickers, Lilja, and their associates have been arguing that baseline PSA level is able to predict long-term risk for prostate cancer, and now a new paper in European Urology seems to...
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Maybe this time … a real answer to the value of PSA screening?
We have frequently referred to an ongoing trial in the UK known as the ProtecT trial. That trial is comparing the effectiveness and safety of surgery, radiation therapy, active surveillance as...
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USPSTF on PSA screening … a current update …
The U.S. Preventive Services Task Force (USPSTF) has just issued its “Guide to Clinical Preventive Services” for 2014. The publication (which is available on line) includes summary information about...
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One size doesn’t fit all when it comes to prostate cancer risk assessment
A newly published article in the journal Cancer is probably going to drive a number of readers of this blog to distraction — and for any number of good reasons, starting with the idea that all prostate...
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ERSPC mortality data at 13 years of follow-up published
The Lancet has just published previously reported data from the European Randomized Study of Screening for Prostate Cancer (the ERSPC trial) at 13 years of follow-up. These data were first reported...
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To quest and test (or not to quest at all)
On The New York Times‘s “Well” blog site today. Dr. Barak Gaster takes on the complex issue of how doctors need to get better at talking to patients about the pros and cons of PSA testing. And there...
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D’Amico on the individualization of prostate cancer risk management
In an interesting article in the September 2014 issue of The ASCO Post, Dr. Anthony D’Amico argues in favor of a future in which individualized approaches to risk will replace PSA screening alone as a...
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What a young primary care opinion leader thinks about screening for prostate...
In a guest blog post, published yesterday on the MedPage Today web site, Dr. Andrew Buelt, a co-producer of the “Questioning Medicine” podcast for physicians, takes on the issue of screening for...
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Which patients with a PSM post-surgery need early adjuvant therapy?
Could more intensive monitoring of PSA levels in the first few months after a radical prostatectomy help to determine which patients who have a positive surgical margin (PSM) need adjuvant radiation...
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The Prostate Health Cocktail in management of biochemically recurrent...
A newly published paper by some highly regarded researchers provides data from a small, Phase II trial of Prostate Health Cocktail (PHC) — an “over-the-counter” combination herbal supplement — in the...
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MRI/TRUS fusion biopsies in men with PSA values < 5.2 ng/ml
There is a distinctly “odd” paper in the December 2014 issue of the Journal of Urology on optimization of the use of MRI/TRUS fusion-guided biopsies in men suspected of having prostate cancer. This...
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PSA doubling time, seminal vesicle invasion, and efficacy of salvage...
A small study from one hospital in Norway has suggested that PSA doubling times after surgery may predict the value of salvage radiation therapy alone as a second line form of therapy. Servoll et al....
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Prostvac-type vaccine therapy in progressive prostate cancer after first-line...
A study just published in European Urology has suggested that early therapy with Prostvac-type vaccines might have value in the management of men with a rising PSA after first-line therapy. The key...
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