How much do you think you should pay for a radical prostatectomy?

We wish we’d seen this earlier, but apparently in March 2014 an article in Urology gave us an outstanding overview of the wildly different prices that you (but perhaps not your insurance company) might be asked to pay for a radical prostatectomy at 100 hospitals across the USA. … READ MORE …

The SPCG-4 trial: follow-up data after > 23 years

This week’s New England Journal of Medicine contains data from a fifth update to the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial of radical prostatectomy vs. watchful waiting in “early” prostate cancer. … READ MORE …

Does “changing urologists” improve outcomes after surgery?

In what appears to be a fascinating study from a group of researchers at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore come data suggesting that patients who “changed urologists” had better short-term surgical outcomes after radical prostatectomy. So the question has to be, what did the research team mean by “changed urologists”? … READ MORE …

Supplemental testosterone therapy in men treated for prostate cancer

The role of supplemental testosterone therapy in men previously treated for prostate cancer has long been a controversial issue, and the number of patients actually studied for the effects of such therapy (good and bad) is really quite small — at about 600 worldwide. … READ MORE …

“Raising the bar” for outcomes after radical prostatectomy

There is another rather entertaining, 10-minute video today on the Medscape Oncology web site showing a conversation  between Dr. Matt Cooperberg of the University of California, San Francisco and Dr. Andrew Vickers of the Memorial Sloan-Kettering Cancer Center in New York. … READ MORE …

AUA, ASTRO issue new guidance on radiation after radical prostatectomy

So the American Urology Association (AUA) is clearly “on a roll” when it comes to guidance on the detection and management of prostate cancer. This is the third new guidance document issued in a matter of days. … READ MORE …

Patient satisfaction during and after the decision to undergo radical prostatectomy for localized prostate cancer

A paper to be presented at the upcoming AUA annual meeting from what appears to be an ex-US group of clinicians continues to demonstrate the fact that many men get surgical treatment for prostate cancer without anything like a full appreciation of the clinical problem, their treatment options, or the potential consequences. … READ MORE …

Statins in prevention of prostate cancer progression after radical prostatectomy

A detailed review of treatment data from 1,200 patients treated by radical prostatectomy fails to offer any support for the development of a large, prospective trial of the clinical use of statins as adjunct therapy to prevent biochemical progression in men treated surgically for localized prostate cancer. … READ MORE …

TRT after radical prostatectomy for localized prostate cancer in hypogonadal males

A new paper just published in the Journal of Urology addresses (again) the controversial issue of whether the use of testosterone replacement therapy (TRT) is appropriate as a management strategy after first-line treatment for hypogonadal patients. … READ MORE …

Risk for biochemical failure post-surgery among prostate cancer patients > 70 years of age

A new article from the clinical research group at The Cleveland Clinic has suggested that men > 70 years of age are at significantly higher risk for recurrence of their prostate cancer if treated by radical prostatectomy than younger men with comparable diagnostic criteria. … READ MORE …

Immediate, adjuvant ADT after surgery does not significantly affect survival of high-risk men

For many years, physicians at the Mayo Clinic in Rochester, MN, have been offering immediate, adjuvant androgen deprivation therapy (ADT) to some of their surgical patients with more advanced and high-risk forms of prostate cancer. The assumption had been that early use of ADT among such patients might have a significant survival benefit. … READ MORE …

A real decrease in the use of RP in treatment of men with low-risk prostate cancer?

A new paper from clinical research teams at two French hospitals suggests that there has been a significant relative increase (from 2005 to 2010, at their institutions) in the percentage of men found to have pathological T3 as opposed to pathological T2 disease after radical prostatectomy (RP). … READ MORE …

More on age and urinary continence post-radical prostatectomy

We commented on Friday last week on a paper by Wallerstedt et al. addressing factors affecting risk for urinary continence after radical prostatectomy. One reader had asked us whether we could provide more details about the age breakdown and the rates of urinary incontinence in the patients studied by the Swedish research team. … READ MORE …

Albertsen on the problems of screening and active surveillance

A paper just published in European Urology addresses pathologic outcomes among men initially managed with active surveillance and subsequently treated by deferred radical prostatectomy (RP). The paper stimulated an important set of editorial comments by Albertsen, which we strongly recommend to readers (along with the response from the authors of the original paper). … READ MORE …

Delaying surgery for localized prostate cancer … what’s the downside?

A paper published in June this year in the Journal of Sexual Medicine suggests that delaying radical prostatectomy (RP) as a first-line treatment for localized prostate cancer has no significant effects on post-surgical pathology or mortality but may lead to higher risk for incontinence and erectile dysfunction. … READ MORE …

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