Prostate Cancer

A multicenter study in the United Kingdom found 5-year prostate cancer control rates following treatment with focal therapy are similar to those of patients who have undergone radical prostatectomy, even when accounting for variation in tumor location, size, and risk.

A simple intervention aiming to curb the contribution of postoperative pain medication prescribing to the opioid crisis was shown to reduce post-discharge opioid prescribing and use and increase opioid disposal without seeming to jeopardize pain control for patients who had undergone radical prostatectomy.

Several decades of data show that Black men are less likely to be screened and treated for prostate cancer than their white counterparts. In this interview, Kelvin A. Moses, MD, PhD, of Vanderbilt University Medical Center, Nashville, TN discusses the reasons for these disparities and how practicing urologists can address them.

For this installment of “Speak Out,” urologists were asked to discuss recent studies indicating African-American men with prostate cancer may be put on active surveillance without suffering complications and that they respond to radiation and some chemotherapy better than Caucasian men.

"A more standardized protocol that is office based, reliable, and reproducible as well as cost- and time-efficient is required to entice more urologists to abandon the TRUS-BX approach," writes J. Brantley Thrasher, MD.

Reduced infection rate may drive increased use of the transperineal approach.

Eating more vegetables will not alter the natural history of prostate cancer or otherwise prevent progression of localized disease, according to a recent study.

“To my knowledge, this is the first sanctioned guideline from a national organization that addresses the role of molecular biomarker testing for localized prostate cancer,” says guideline panel co-chair Scott E. Eggener, MD.

"Irrespective of treatment, fewer than half of men reported the ability to maintain erections sufficient for intercourse at 5 years," writes Badar M. Mian, MD.

A radiolabeled small molecule that binds to prostate-specific membrane antigen is continuing to show promise for treating progressive metastatic castrate-resistant prostate cancer, according to researchers at the University of California, Los Angeles.

Chronic opioid use is rare following radical prostatectomy in Europe. Slightly more than half of men undergoing RP in Sweden between 2007 and 2017 were found to have filled an opioid prescription, but the proportion who became chronic opioid users was less than 1%.

"Even in this selected cohort of men with very low-risk features, stable MRI score was not protective against disease progression during surveillance," writes Badar M. Mian, MD.

Myovant Sciences recently announced positive phase III trial results for its once-daily oral small molecule gonadotropin-releasing hormone antagonist relugolix, for the treatment of advanced prostate cancer.

“I think [MRI-guided transurethral ultrasound ablation] is a potentially great option for patients who opt for either whole- or partial-gland treatment,” says researcher Steven S. Raman, MD.

The FDA has approved a supplemental New Drug Application or enzalutamide (XTANDI) for the treatment of patients with metastatic castration-sensitive prostate cancer.

Urologists, oncologists, and prostate cancer patients are entering a new era in prostate cancer therapy-one that is going to be genetically defined.

Urology Times asked Maha H. Hussain, MD: How will the advent of PARP inhibitors change the management of advanced prostate cancer?

Leonard G. Gomella, MD, Tanya Dorff, MD, Scott Eggener, MD, and Jorge Garcia, MD, all reflect on prostate cancer treatment in 2019.

"The relevant professional associations in the field of medicine and/or urology must do their part to inform and educate their members about the appropriate use of finasteride and PSA to eliminate avoidable morbidity and mortality from prostate cancer," writes Badar M. Mian, MD.

“There is now sufficient data to support the use of prostate MRI in all men before their initial prostate biopsy when the MRI is of sufficient quality,” says policy statement co-author Marc A. Bjurlin, DO, MSc.

Newly diagnosed low- and high-risk prostate cancer patients seen during the same appointment by a urologist and radiation oncologist were more likely than patients in a nationwide cohort to choose evidence-based care, according to a recent study.

Urology Times asked Scott Eggener, MD: How should urologists decide between focal therapy and active surveillance in men with low-risk prostate cancer?

The PARP inhibitor olaparib significantly extended radiographic progression-free survival compared with physician’s choice of hormonal therapy in men with metastatic castration-resistant prostate cancer who had defects in genes involved in DNA repair mechanisms.

Men who take statins for at least 11 months might be at lower risk for low- and high-Gleason grade prostate cancer than men who do not take the cholesterol-lowering drugs, according to a recent study.

Researchers have described a new class of pseudogene-associated fusion transcript in prostate cancer that has potential application as a therapeutic target and biomarker for early prostate cancer detection.

"Of note, the number needed to treat analysis revealed that 18 patients treated with ADT resulted in one patient being diagnosed with Alzheimer’s and 10 patients treated with ADT resulted in one patient with a dementia diagnosis," writes Badar M. Mian, MD.

Three novel androgen receptor inhibitors provide an embarrassment of riches when it comes to treatment options for nmCRPC patients, but there are still questions to be answered-including the extent of these drugs’ clinical benefit.

Findings from 18-fluciclovine (Axumin) positron emission tomography/computed tomography imaging had a major impact on management decisions for men with biochemical recurrence of prostate cancer.

Published findings from PROCEED, a large registry collecting data from men treated with sipuleucel-T (Provenge) for asymptomatic/minimally symptomatic metastatic castration-resistant prostate cancer, provide valuable insight on real-world outcomes associated with this immunotherapy agent in the modern era of prostate cancer management.

The FDA has approved apalutamide (Erleada) for the treatment of patients with metastatic castration-sensitive prostate cancer, a new indication for the next-generation androgen receptor inhibitor.