NCCN guidance on initial management of low-risk, localized prostate cancer (redux)

In late October, we had commented on the then-latest revision of the National Comprehensive Cancer Network (NCCN)’s guidelines on the initial management of men with low-risk forms of localized prostate cancer. Specifically we had protested the removal of any suggestion that this form of prostate cancer should — preferably — be managed using active surveillance. The NCCN has now released a new revision to the guidelines that has modified the prior suggestion. … READ MORE …

Projected attendance at AS research conference

About 100 patients, clinicians, and others are already registered as attendees at the conference on

Click on the link above for more information and to register. There is still plenty of time to join us.

The conference will take place from 12:00 pm to 4:00 pm Eastern time on Monday, December 13 AND on 12:00 pm to 4:00 pm on Thursday, December 16.

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NCCN guidance on the initial management of low-risk, localized prostate cancer

As many readers will already be aware, the National Comprehensive Cancer Network (NCCN) has recently removed the word “preferred” from its statement regarding the use of active surveillance (AS) as an appropriate form of management of men with low-risk forms of localized prostate cancer. A broad swath of specialists in the initial management of low-risk disease, as well as many in the patient advocacy community, have been highly critical of this change to the NCCN guidelines. … READ MORE …

Exceptions to “early salvage” radiation treatment for recurrence after prostatectomy

Three major randomized clinical trials and a meta-analysis have proved that for most men waiting for early signs of recurrence after prostatectomy (e.g., three consecutive PSA rises or a PSA of 0.1 ng/ml) to give radiation gave the same outcome as immediate (“adjuvant”) radiation (see this link). But there are exceptions. … READ MORE …

Fear of prostate cancer recurrence post-surgery

A new paper by Meissner et al. has reported important, long-term data on fear of recurrence and biochemical progression of prostate cancer among a large cohort of German patients undergoing radical prostatectomy. … READ MORE …

Timing of initiation of ADT for men with biochemical progression after first-line surgery

For many years your sitemaster has been advising patients that overly early use of androgen deprivation therapy (ADT) in many men with progressive prostate cancer is not necessarily the best decision (for a number of possible reasons). … READ MORE …

AS research survey: your help still needed

As of Friday (July 22), we had received more than 250 responses to our brief survey on research into active surveillance. Most of these are from patients and some from their familial supporters (spouses, partners, etc.). However,we are still interested in getting more input — especially from clinicians, including specialists, generalists, and allied health personnel like urology nurses! … READ MORE …

Helpful upcoming webinars this week

Three more upcoming webinars this week will deal with (a) the work-up of men with prostate cancer prostate cancer who progress after first-line therapy (such as surgery, radiation, etc.); (b) whether Gleason 6 disease should really be defined as “prostate cancer”; and (c) an update on the most current information related to the evaluation and management of men with prostate cancer appropriate for active surveillance. … READ MORE …

Three helpful upcoming webinars

Three upcoming webinars deal with (a) the diagnosis and work-up of clinically significant forms of localized prostate cancer; (b) handling anxiety and related issues for men on active surveillance (AS); and (c) whether AS is appropriate for African Americans and others of African ethnicity. See below for details. … READ MORE …

Research on AS in management of prostate cancer: your input is important!

A diverse group of patients, patient advocates, patient spouses/supporters, physicians, and other researchers has come together, with funding support from the Patient Centered Outcomes Research Institute (PCORI), to plan a virtual conference for the fall of 2021. At that conference, we intend to discuss and identify new and evolving opportunities for research into the most appropriate, high-need, high-impact topics affecting the use of active surveillance (AS) for the management of favorable-risk forms of prostate cancer (i.e., low-risk and “favorable” intermediate-risk disease). … READ MORE …

Extending OS on initial ADT for men with mHSPC

Back in 1989, the SWOG 8494 trial first showed that adding an antiandrogen (flutamide) to bilateral medical orchiectomy with an LHRH agonist (leuprolide acetate) extended median overall survival (OS) by 7 months in newly diagnosed men with metastatic, hormone-sensitive prostate cancer (mHSPC). … READ MORE …

Lower salvage radiation dose — are outcomes the same?

A large randomized clinical trial, SAKK 09/10, found that a salvage radiation dose of 64 Gy over 32 treatments had equivalent biochemical outcomes compared to 70 Gy over 35 treatments. … READ MORE …

Brief, intense radiation and hormone therapy for very high-risk prostate cancer

As we’ve seen, brachy boost therapy seems to have the best oncological results for men with very high-risk prostate cancer. … READ MORE …

Early data from the PEACE-1 trial

The so-called PEACE-1 trial is an ongoing Phase III trial among men diagnosed with de novo metastatic castration-sensitive prostate cancer (mCSPC). … READ MORE …

FDA approves Pylarify for diagnosis of advanced/recurrent forms of prostate cancer

In ,a recent media release, Lantheus Holdings announced that the US Food and Drug Administration (FDA) had approved the imaging agent known as piflufolastat F 18 Injection (also known as Pylarify® or more commonly just “PyL”) as a PSMA-based PET imaging agent for identification of prostate cancer. … READ MORE …