Incidence, outcomes, ethnicity, and distant, de novo, metastatic prostate cancer

Diagnosis of men with distant, metastatic prostate cancer at first presentation (distant, “de novo”, metastatic prostate cancer) is a lot less common today than it was 30 or 40 years ago, but it does still happen on a regular basis. … READ MORE …

Life expectancy, mortality, surgery, risk, and management of localized prostate cancer

A critical factor in understanding why non-treatment (i.e., monitoring with either active surveillance or watchful waiting) may be a better idea than immediate treatment for men with localized prostate cancer has to do with risk of death from causes other than the cancer. … READ MORE …

PSMA protein targeting agent and metastatic disease

According to a company press release, Molecular Insight Pharmaceuticals, Inc. presented clinical data earlier today on a development-stage, radiolabeled, small-molecule, molecular imaging pharmaceutical with potential in the diagnosis, staging, and perhaps even the treatment of advanced forms of prostate cancer. … READ MORE …

What newly diagnosed patients expect from prostate cancer treatment

A newly published study appearing in the Journal of the American Board of Family Medicine appears to demonstrate that patients newly diagnosed with localized prostate cancer grossly underestimate their life expectancy without treatment and grossly overestimate the survival benefit of treatment. … READ MORE …

Radiation therapy following surgery for pT3-4N0 disease

It has long been unclear what the optimal radiation treatment was for men with pathologic T3-4N0 prostate cancer following radical prostatectomy (RP). Trabulsi et al. have recently conducted a multi-institutional analysis of the relative values of early adjuvant radiation therapy (ART) vs. delayed (salvage) radiation therapy (SRT) in such patients. … READ MORE …

Enrollment in Cancer Trials

We say that we need clinical trials, but only a small percentage of patients actually enroll in these trials. We’ve known this for a while, but it has just been confirmed.

A study published in the Journal of Clinical Oncology shows that the overall enrollement in cancer trials hovers in the very low single digits. Men were less likely than women to enroll. Enrollment was lower for African-American and older patients. Lack of enrollment badly hampers the relevance (generalizability) of any trial. This is because it brings an extreme volunteer bias, whose impact on observations is hard to gauge.

To understand prostate cancer tomorrow, we need enrollment today.

A molecular urine assay for prostate cancer?

Anyone who has learned a reasonable amount about the diagnosis and management of prostate cancer has learned that the prostate specific antigen or PSA test is not a particularly good test for identifying or monitoring the status of men with active prostate cancer. It is simply better than anything else we have. Researchers have been looking for better options for years. … MORE