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 very definitely are pros and cons! I kid you not.

Your acne’s not preventing your risk for prostate cancer

Even though we don’t remember ever coming across this suggestion before, a few studies have apparently suggested that having acne is associated with a decreased risk for a diagnosis of prostate cancer — and aggressive forms of prostate cancer in particular. … READ MORE …

Over-use of PSA testing in men > 65 with short life expectancies?

Why is it that we seem to be so focused on testing for risk of prostate cancer in older men with life expectancies of < 10 years, i.e., men who are almost certainly at very low risk for clinically significant disease? … READ MORE …

Early identification of androgen receptor gene amplification and prostate cancer risk

Historically, it has generally been assumed that androgen receptor gene amplification was a result of androgen deprivation therapy (ADT) and occurred in some 20 to 30 percent of men with castration-resistant prostate cancer (CRPC). However, … READ MORE …

Sleep disruption, melatonin levels, and risk for prostate cancer

There have been a number of studies in the past suggesting that men who work night-shifts have a higher risk for prostate cancer than those of us who work during normal “day time” hours. … READ MORE …

Data from two large cohorts of Austalian patients on active surveillance

A new paper in BJU International reports on data from a total of 650 Australian patients managed on active surveillance for low-risk, localized prostate cancer. … READ MORE …

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 earlier this year at the annual meeting of the EAU, and we commented then on the significance of these data. … READ MORE …

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 cancer screening either should be or might be discontinued (as suggested by the USPSTF). … READ MORE …

“Extreme apical sampling” and prostate cancer diagnosis

A new article in the September issue of Prostate addresses the potential benefits of “extreme apical sampling” during the initial biopsies of men at risk for prostate cancer based on such standard parameters as PSA level, positive/negative DRE, and related factors. … READ MORE …

Is baseline free serum T a factor in appropriate management on active surveillance?

Analysis of data from a cohort of 154 Chilean men with prostate cancer, all being monitored on active surveillance, suggests that free serum testosterone levels (but not total testosterone levels) may be able to help to predict which of these men will go on to need active treatment. … READ MORE …

ART or SRT in high-risk patients post-surgery?

As many of our regular readers will know, there is no clear answer to the question whether, among men at elevated risk of progressive disease after first-line surgery, it is better to have adjuvant radiation therapy (ART) within a few months of surgery or to wait until salvage radiation therapy (SRT) is clearly advisable. … READ MORE …

The absolute increase in risk of prostate cancer after a vasectomy

Late last week we commented briefly on a paper by Siddiqui et al. that had assessed the association between risk for a diagnosis of prostate cancer and the prior occurrence of a vasectomy in men who participated in the Health Professionals Follow-up Study (HPFS). … READ MORE …

5-ARIs and risk for high-grade prostate cancer: yet another data set

The question of whether the use of 5α-reductase inhibitors (5-ARIs) like finasteride (Proscar) and dutasteride (Avodart) is really associated with a significantly increased risk for diagnosis of high-risk and/or lethal prostate cancers remains unanswered. However, yet another set of data from the Health Professionals Follow-up Study (HPFS) has offered us some additional insights. … READ MORE …

Vasectomy and prostate cancer — the debate evolves

As regular readers will be well aware, the question of whether there is a real cause and effect association between having a vasectomy and the later risk for diagnosis of prostate cancer is controversial and unanswered in any absolute sense. However, there are new data that we can now put on the table … … READ MORE …

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 screening for prostate cancer. … READ MORE …

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