Genitourinary Cancers

The purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer.

A 63-year-old man with no family history of prostate cancer has prostate biopsy that revealed 9 out of 12 cores involved with prostatic adenocarcinoma, mostly Gleason score 5+4=9.

Molecular imaging in prostate cancer can play the additional critical role of an early biomarker for response to therapy, similar to how 18F-FDG is used in other malignancies.

We briefly review these two imaging technologies and provide potential utilization strategies based on available data.

An extremely large database study across more than one million people found no increased risk of bladder cancer with the diabetes drug pioglitazone.

A large phase I study showed that the PD-L1 antibody known as MPDL3280A has promising activity in patients with urothelial bladder cancer.

Despite recommendations calling for their use, prescriptions for bisphosphonates among older men with prostate cancer undergoing ADT are still low.

If physicians are following the current NCCN and AUA renal cell carcinoma surveillance guidelines, they could be missing as many as one-third of recurrences.

The use of a prostate cancer antigen 3 urine test could help men avoid undergoing unnecessary repeat biopsies, and predict which will be positive for cancer.

Clinical trial results to date show that men with visceral CRPC metastases do not benefit from ipilimumab, while their counterparts with bone- or node-only metastases do. This suggests that visceral metastases should be a stratification factor for future immunotherapy clinical trials.

While evidence points to benefit from highly active hormonal agents in prostate cancer with visceral involvement, the usefulness of immunotherapy is much less clear.

Although the mechanism(s) underlying the relatively poor prognosis of prostate cancer patients with visceral disease have yet to be fully elucidated, these new findings suggest that the microenvironment of bone lesions may be immunologically distinct from those at other sites.

One should not advise a patient with low- or very-low-risk prostate cancer to undergo a focal ablation. The kindest and gentlest approach is to first do no harm.

Investigators and physicians caring for the spectrum of prostate cancer should have a targeted treatment option available for patients who would benefit by it.

In this edition of our ongoing series, the authors present two cases involving renal cell carcinoma patients treated with SBRT for pancreatic metastases.

Participants from two separate studies with higher levels of vitamin B6 were found to have a lower risk for renal cell carcinoma.

An increased intake of lycopene may be associated with a decreased risk for renal cell carcinoma, according to data from a study of postmenopausal women.

Partial nephrectomy may be just as effective as radical nephrectomy for the surgical removal of clinical T2 renal masses, results of a new study indicate.

A study found that prostate cancer patients with a history of heart problems are at increased risk of cardiac death following androgen-deprivation therapy.

Marked differences in renal cell carcinoma subtype were observed by race and sex in patients who underwent nephrectomy at a large tertiary care academic center.

Bladder neoplasms are associated with a high frequency of painless hematuria; however, when compared with the bleeding tendencies of other solid tumors, it is arguable that this comparatively high bleeding frequency is in part the result of an ascertainment bias.

Overall, approximately 2% of patients with bladder cancer will experience a venous thromboembolism event, a rate five times higher than that in the overall population; also, such an event results in a threefold increased risk of death in patients with cancer.

Cancer promotes the development of venous thromboembolism (VTE) by inducing a hypercoaguable state, through mechanisms that are complex and multifactorial.

Despite the higher risk of VTE in patients with bladder cancer, ironically, their risk of bleeding and anemia, and greater need for transfusion of blood products, poses an equally significant risk of morbidity and mortality, especially among those who undergo cystectomy.

Ultimately, while further follow-up will be enlightening, we believe that there is sufficient evidence now from the primary analysis of CHAARTED to justify the combination of docetaxel and androgen deprivation therapy in all men with metastatic hormone-sensitive prostate cancer.

Meta-analyses of patients with low-volume metastatic hormone-sensitive prostate cancer will likely be required to attain sufficient power to address the role of docetaxel in this setting.

Treatment-emergent small-cell/neuroendocrine prostate cancer is likely to become of increasing clinical relevance in the era of widespread use of potent androgen receptor–targeted therapies.

Aggressive variants of prostate cancer often take the form of neuroendocrine or small-cell carcinomas, which frequently lack androgen receptor expression and respond poorly to hormonal therapies.

Higher levels of triglycerides and cholesterol in the blood may signal an increased risk of recurrence for men with prostate cancer.

An external validation study has confirmed that biomarkers of the mTOR pathway have prognostic value in patients with clear cell renal cell carcinoma.