AUA report and update no. 1: Sunday, April 26, 2009

We apologize for the delay in this first report, but since bad weather in Chicago stopped a lot of people from flying there yesterday, your correspondent is back in Philadelphia airport this morning to “try again.” In the meantime, we can tell you what happened at the Society for Urologic Oncology subspecialty meeting yesterday.

There were presentations by Klein and by Catalona regarding the ongoing debate over how best to use PSA data to identify men most in need of prostate biopsy. We do not expect this debate to be resolved any time soon! Interestingly, however, Klein began his presentation by very clearly stating that his objective is to detect clinically significant and potentially lethal prostate cancer, not necessarily all prostate cancer. He went on to state his belief that, given the available tests for prostate cancer today, we need to rely on risk calculators rather than PSA data alone to define those patients in need of biopsy. By contrast, Catalona continued to argue that PSA velocity and PSA doubling time data are highly effective tools for determining the need for biopsy.

Wei suggested that biopsy methods need to be improved as we move toward an increased emphasis on active surveillance and focal therapy. He showed that when there is a negative biopsy result, there is still a 25-50 percent chance of finding some cancer. He noted that computer mapping allows for better probe placement and provides the ability to know where previous biopsies were performed at the time of repeat biopsies. He argued that extended biopsy schemas (i.e., 12-18 core biopsies) should always be performed.

There were also updates on such items as the need for pelvic lymph node dissection and the definition of appropriate patients, on drugs in development (e.g., abiraterone, OGX-011, etc.), on the future potentgial of focal therapy, and improvements in the process of clinical trials development in prostate cancer, but no new data on any of specific agents appear to have been presented in this session.

One Response

  1. Doctor Wei’s conclusions help explain why urologists are so ready to offer RPs to those diagnosed with early stage PCa.

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