Is Howard done with biopsies “forever”?

One of the questions that has been nagging at Howard Wolinsky for a while now is whether he really needs to have another biopsy … ever! … READ MORE …

3-year outcomes of men on AS in US community urology settings

To date we have seen very few data on the long-term follow-up of men in the US being initially managed on active surveillance (AS) after diagnosis with prostate cancer out in the “real world” of community urology practice. … READ MORE …

Did you get an MRI scan as part of your clinical work-up for prostate cancer risk?

A report in the journal Urology (the so-called “Gold Journal”) from a team of researchers at Yale School of Medicine has shown that having a prostate MRI as part of the work-up for a patient initially diagnosed with low-risk prostate cancer roughly doubled the chance that such a patient was initially managed on “observation”. … READ MORE …

Active surveillance in men with Gleason 3 + 4 = 7 prostate cancer at diagnosis

A critical question for men with favorable intermediate-risk prostate cancer (based primarily on a Gleason score of 3 + 4 = 7) can often be, “How safe would it be for me to go on active surveillance for a while after initial diagnosis?” … READ MORE …

Reports from the EAU “Update on Prostate Cancer” meeting in Vienna

The European Association of Urology (EAU) “Update on Prostate Cancer” meeting was held in Vienna, Austria, on Friday and Saturday, and Dr. Zachary Klaassen was again busy providing summary reports on presentations for UroToday. … READ MORE …

Significant variation in application of active surveillance

According to an article in the journal Cancer, men with low-risk prostate cancer diagnosed and managed at high-volume hospitals are 3.6 times more likely to be managed on active surveillance than those managed at low-volume institutions. … READ MORE …

Howard Wolinsky has a new problem …

… and it’s one that is not exactly uncommon for older men (with or without prostate cancer). … To get the scoop, just click here. … READ MORE …

Howard Wolinsky takes another step on his active surveillance travels

In his latest post on the MedPage Today web site, Howard Wolinsky (a freelance journalist based in the Chicago area), who has been on active surveillance since 2010, writes about the result of his most recent rebiopsy. His last one was in 2013. There was (again) “no evidence of malignancy” in the post-biopsy pathology report. … READ MORE …

It was true 3 years ago, but is it still the case?

One of the problems with a lot of research is that it is out of date by the time it is published. The following example may be a classic case in point. And it has serious implications. … READ MORE …

PRIAS reports data from a 5,000+ patient active surveillance study

Data from a recent paper in European Urology has further confirmed the value of active surveillance as a first-line management option for men diagnosed with low-risk prostate cancer. It has also confirm recent guidance for when men on active surveillance actually need to be advised that treatment is probably wise. … READ MORE …

Can a man be too young for active surveillance?

There is a “conventional wisdom” that active surveillance (AS) is only for older men, and that younger men are better off having immediate radical treatment, typically prostatectomy (RP).

Management of incident prostate cancer on active surveillance

Back in the dim and distant past (i.e., the 1980s and the very early 1990s, before PSA testing was widespread) one of the most common ways to find early stage prostate cancer was as an incidental consequence of the conduct of a transurethral resection of the prostate (a “TURP”) to treat symptoms of urinary tract obstruction. … READ MORE …

New trial of investigational immunotherapy in men on active surveillance

There appears to be a high degree of confidence that Barvarian Nordic’s Prostvac will show positive results in the ongoing Phase III clinical trial in men with metastatic, castration-resistant prostate cancer. An early stage trial has now been initiated among men with much less advanced disease disease. … READ MORE …

Expectant management is really “coming of age” in the USA

An excellent new review article in CA: A Cancer Journal of Clinicians, along with a research letter just published in the Journal of the American Medical Association (JAMA) have provided us with an important update on the value and the increasing acceptance of expectant management in the treatment of lower-risk forms of prostate cancer. … READ MORE …

Active surveillance under-used (back in 2010-2011)

A new research letter just published in JAMA Internal Medicine suggests that only about 12 percent or less of the men who are good candidates for active surveillance are actually being managed in that manner. But, … READ MORE …