Is anyone with intermediate-risk prostate cancer a “good” candidate for AS?

There is no longer any doubt that men initially diagnosed with low- and very low-risk forms of prostate cancer are, in most cases, either excellent or good candidates for first-line management on active surveillance (AS). … READ MORE …

Les Raff “gives people cancer” … sort of …

Here is a link to a clever article by a pathologist in the Chicago suburbs who spends a lot of his working days deciding whether he can or can’t see prostate cancer cells in the biopsy samples sent to his laboratory. It makes a good read. … READ MORE …

Low volume, Gleason 3 + 4 = 7 disease: is active surveillance a realistic option?

It would be easy to misinterpret (or at least “over-interpret”) a recent paper from the group at Johns Hopkins about the pathological outcomes of men initially diagnosed with very low-, low-, or “favorable” intermediate-risk localized disease and treated by immediate radical prostatectomy. … READ MORE …

A pathological “take” on the potential role of focal therapy

Various forms of focal therapy are now being used by some physicians to treat selected patients with well-identified, usually relatively small, “dominant” or “index” tumors that are confined to highly defined areas of the prostate. … READ MORE …

Are low serum levels of vitamin D a risk factor for aggressive forms of prostate cancer?

It has long between understood that there is an association between a man’s serum levels of vitamin D and his risk for prostate cancer in general and clinically significant prostate cancer in particular. … READ MORE …

Post-surgical pathology, active surveillance, and selection of appropriate candidates for expectant management

An interesting — if unsurprising — new set of data in the Journal of Korean Medical Science has again shown that most of the current “standard” sets of criteria for selection of patients aren’t even close to being perfect at identification of “the surgically ideal” patients for management on active surveillance. … READ MORE …

The biology and pathology of “young age” prostate cancer

A recent article in the Journal of Clinical Pathology reviews available data about the epidemiology, biology, and clinical pathology of “young age” prostate cancer, which the authors define as clinically significant cancer in men under 55 years of age. … READ MORE …

Toward a new prostate cancer grading system — step 1

In the most recent issue of AUA News, Dr. Jonathon Epstein of  Johns Hopkins — unarguably one of the world’s leading prostate cancer pathologists — has laid out the general principles behind a new, validated, prostate cancer grading system that is designed and intended to replace the traditional Gleason grading system over the next few years. … READ MORE …

Declining trend in the utilization of adjuvant radiation after surgery

A recent report in European Urology found that, in spite of three randomized clinical trials (RCTs) that proved the efficacy of immediate or adjuvant radiation following surgery with adverse pathology results compared to a wait-and-see approach, a lower percentage of such patients are actually getting adjuvant treatment. Why should this be? … READ MORE …

Short-term outcomes after radical prostatectomy and surgeon training/practice site

Now here’s some data that may cause a bit of a furore … so before the US-based urologists get upset, we’d like to point out that this is a Canadian study based on data from members of the Canadian urology community in a single, unidentified Canadian province! … READ MORE …

Consensus statement on pathologic factors and active surveillance

As previously mentioned earlier this week, a long statement that deals with the role of the pathologist in determining the suitability of patients for enrollment into active surveillance management protocols has been issued and endorsed by a number of organizations. … READ MORE …

Increasing consensus on eligibility criteria for active surveillance

A paper in the journal Virchows Archiv suggests increasing consensus on both inclusion criteria for management on active surveillance and progression criteria suggesting the need for active treatment. … READ MORE …

Active surveillance and African Americans with very low-risk disease

A new study in the Journal of Clinical Oncology has suggested that African American men with very low-risk disease (according to the National Comprehensive Cancer Network or NCCN definition) are at higher risk for disease progression than comparable Caucasian patients if they follow active surveillance protocols. … 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 …

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 …