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 …

Whole-pelvic radiation therapy for high-risk patients

The decision about whether or not to treat the entire pelvic lymph node area along with the prostate (called whole pelvic radiation therapy or WPRT) or to treat just the prostate with a margin around it (called prostate-only radiation therapy or PORT) has long been a matter of judgment. … READ MORE …

Rethinking risk stratification for radiation therapy

In 2016, we looked at the Candiolo risk stratification system for radiation therapy. To our knowledge, it has not been prospectively validated or widely adopted. … READ MORE …

How does your doctor do prostate biopsies?

So (in our opinion) the time has come — for a whole bunch of reasons — for actual and potential prostate cancer patients to start asking their urologists about whether they are able to carry out transperineal as opposed to transrectal biopsies. … READ MORE …

Another new urine test for risk of prostate cancer

As we have mentioned previously, data on the use of a variety of methods of urine testing in assessment of risk for clinically significant prostate cancer (and therefore the need for a follow-up biopsy) continues to evolve. … READ MORE …

Risk for and detection of clinically significant prostate cancer in previously unbiopsied patients

The “best” way to identify clinically significant, localized prostate cancer continues to evolve. But there is still no consensus about what that “best” way might be to do this, let alone any consensus about the detection of “clinically insignificant”, localized prostate cancer. … READ MORE …

ADT and risk for COVID-19 infection?

Early in 2020, in the initial stages of the COVID-19 pandemic, there was a suggestion (based on data from a small Italian study) that men who were using androgen deprivation therapy (ADT) to manage their prostate cancer might be at lower than average risk for becoming infected with this virus. … READ MORE …

Urine testing for risk of prostate cancer: a current and future perspective

It is becoming very clear that over the next 5 to 10 years we will develop a whole new spectrum of urine-based tests for the assessment of risk for prostate cancer and whether a specific patient will actually need a biopsy and/or other tests to confirm diagnosis. … READ MORE…

Mediterranean diet, active surveillance, and low-risk prostate cancer: the details

As we advised readers yesterday, a newly published study by Gregg et al. from the M. D. Anderson Cancer Center has given some clear indications that men diagnosed with lower-risk forms of prostate cancer who are initially managed on active surveillance (AS) can benefit — in terms of time to disease progression — from what is known as the Mediterranean-type diet. … READ MORE …

The epidemiology of prostate cancer (2003-2017)

A recent report in the CDC’s Morbidity and Mortality Weekly Report (MMWR) may offer one of the best analyses of an increasing risk for diagnosis with and death from advanced forms of prostate cancer over the period from 2003 to 2017 (the last year for which we have accurate data from the SEER database). … READ MORE …

The PSA test in “screening” for prostate cancer: yesterday, today, and tomorrow

So our good friend Howard Wolinsky has just written up his assessment on the evolution of the use of the PSA test in “screening” for prostate cancer in an article on the MedPage Today web site. … READ MORE …

Breakthrough Device Designation for miR Sentinel™ urine test

According to a media release issued on Tuesday this week by miR Scientific, the US Food and Drug Administration (FDA) has issued a Breakthrough Device Designation for the company’s new urine-based test for risk of prostate cancer (the miR Sentinel™ Prostate Test). … READ MORE …

The virtual prostate cancer patient

A new type of “educational” service has been brought to our attention that uses virtual reality (VR) systems allowing a number of opportunities for men to “talk” to a virtual prostate cancer patient about their own risks for prostate cancer and things like the risks and benefits of PSA testing. … READ MORE …

Adding ADT to external beam radiation only benefits unfavorable risk patients

In 2013, Zumsteg et al. proposed a refinement in the NCCN “intermediate risk” classification into two subcategories, “favorable intermediate-risk (FIR)” and “unfavorable intermediate-risk (UIR).” … READ MORE …

Risk calculators for men already on active surveillance

The Prostate Active Surveillance Study (PASS), initially funded by the Canary Foundation, is a multi-center research study for men  with low-risk disease who have chosen active surveillance (AS) to manage their prostate cancer. Active surveillance in PASS means closely monitoring men with prostate cancer and offering treatment if test results show the cancer is getting worse. … READ MORE …