Prostate Cancer

An intense higher-dose radiotherapy regimen may be a better treatment option for men with localized prostate cancer, according to the 10-year results of the international phase III RT01 trial.

Improved early detection of prostate cancer would ideally involve a noninvasive test that allows clinicians to distinguish aggressive cancers from relatively indolent ones. This distinction is especially important given that relatively few men who undergo screening are destined to die of prostate cancer.

For those undergoing screening for the presence of previously undiagnosed prostate cancer, the major challenge for new tests is to avoid the overdetection of indolent cancers that limits the clinical utility of the prostate-specific antigen (PSA) test.

The benefit-to-risk trade-offs associated with PSA screening are highly sensitive to patient preference, underscoring the importance of ensuring that men have the opportunity to decide for themselves whether they wish to have their individual risk for suffering and death from prostate cancer assessed through PSA screening.

Many urologists believe that all men, regardless of risk, should be offered a baseline prostate-specific antigen (PSA) test at age 40 years. I was once one of those urologists.

In this article, we review recent advances in the discovery of prostate cancer biomarkers, their integration into clinical practice, and implications for improving clinical management of the disease.

In a new prospective study on the role of dietary lycopene in reducing the risk of prostate cancer, researchers found that consuming foods high in lycopene is linked to a reduced risk of lethal prostate cancer.

In this interview we discuss prostate cancer highlights from the 2014 ASCO Genitourinary Cancers Symposium.

Adding a treatment course of local radiotherapy to hormonal treatment in men with locally advanced or high-risk prostate cancer more than halved the 10-year and 15-year prostate-cancer–specific mortality.

Androgen inhibition with enzalutamide significantly reduced the risk of disease progression and increased survival among men with previously untreated metastatic prostate cancer, according to the results of the phase III PREVAIL trial.

A personalized tool to predict the chances of a prostate cancer overdiagnosis has been developed and could enable better decision-making and tailored patient treatment.

As long as there is any risk of progression, G6 cancer cannot be equated to just a precursor lesion, and the emphasis should remain on screening patients with serum PSA measurement, contrary to the recommendation of the US Preventive Services Task Force.

While there is no doubt that many indolent prostate cancers have been treated, it is unclear where one should draw the line between indolent and aggressive tumors.

Of course we should offer active surveillance to African-American men with localized prostate cancer! We simply need to do it selectively and in a smarter way-and we need to be aware of some of the potential pitfalls.

Active surveillance seems to be generally safe, yet African-American men tend to have more aggressive prostate cancers. Thus, it is imperative that we learn the characteristics and outcomes of African-American men considering surveillance.

There is strong evidence from longitudinal cohort studies of men with both treated and untreated Gleason 6 prostate cancer to suggest that Gleason 6 disease, when not associated with higher-grade cancer, virtually never demonstrates the ability to metastasize and thus represents an indolent entity that does not require treatment.

Adding a spinal or epidural painkiller to general anesthesia during prostatectomy may benefit long-term patients outcomes, according to a large retrospective study.

Men with early-stage prostate cancer who ate a low-fat diet supplemented with fish oil had lower amounts of pro-inflammation molecules in their blood and lower prostate tumor cell proliferation compared with men who ate a high-fat Western diet.

Markers of inflammation should be analyzed and reported in prostate biopsies, according to the results of a new study. Researchers found that negative prostate biopsies that had markers of inflammation were less likely to be diagnosed with prostate cancer in a subsequent prostate biopsy.

Despite the promise of proton therapy, comparative evidence has yet to definitively demonstrate its clinical benefit over other forms of contemporary radiation for prostate cancer.

A new study shows that men who have a specific protein marker present in their prostate biopsy may benefit from close follow-up and additional biopsies as they may be at increased risk of developing cancer.

Men with a history of prostate cancer may be at increased risk for melanoma, according to data taken from two large cohort studies.

The results of a recently published study on the psychological impact of prostate cancer biopsies show that men who have post-biopsy symptoms have increased anxiety, even if they received a negative diagnosis.

In this podcast, we discuss whether all male colorectal cancer patients over the age of 60 should be screened for prostate cancer.

I have read multiple overviews of the current management of castration-resistant prostate cancer (CRPC). These articles have very adeptly summarized the key trials leading to a multitude of US Food and Drug Administration (FDA) approvals of new agents for men with CRPC.

With the emergence of several new agents for the treatment of advanced prostate cancer, new questions have arisen regarding the optimal sequence or combination of these agents. As we await the results of ongoing and planned clinical trials to answer some of these questions directly, the decision-making process will rely heavily on considerations of side effects and patient characteristics.

In this review we will outline an approach to sequencing new therapies for metastatic castration-resistant prostate cancer (CRPC), with particular attention paid to the biology of CRPC.

A recent study shows that men who were overweight or obese at the time of their prostate cancer diagnosis were more likely to die from their disease compared with their healthy weight counterparts.

The facts presented about screening should be tailored to the patient’s exact situation, and the patient’s values should be used to guide the final decision. For younger, healthy men, PSA screening should continue to be strongly considered.