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Turnover is a growing concern at medical groups nationwide, while targeted initiatives to retain physicians are on the rise, according to findings from 2005 physician retention survey recently released by the Cejka Search and American Medical Group Association.

The National Comprehensive Cancer Network has announced that its guidelines on kidney cancer have been updated as a result of new therapeutic options available for advanced kidney cancer.

San Francisco--An increase in the rate of PSA rise is bad news forpatients, but just how bad remains unclear. A series of trialsunveiled at the 2006 Prostate Cancer Symposium point to PSAvelocity, or PSAV, as a prognostic tool that is useful, but thathas some limitations.

Washington--Congress has received a detailed recommendation from the Medicare Payment Advisory Commission (MedPAC) that would result in an average payment increase of an estimated 2.8% for next year, rather than continued cuts as projected by Medicare.

I have found that one of the most effective ways to enhance the efficiency of my practice has been to hire a scribe. A scribe is a person who shadows a physician and takes notes either in the chart, or, better yet, on the computer, freeing the doctor to have more eyeball-to-eyeball contact with the patient.

Yonkers, NY--The Prostate Px test from Aureon Laboratories applies a proprietary integrated algorithm to patient histologic, molecular, and clinical data to predict the likelihood of prostate cancer recurrence after radical prostatectomy. Using stored patient tissue, the program generates a risk report within 1 week of testing. The report provides a score for both the probability of PSA recurrence and clinical failure.

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Indevus Pharmaceuticals, Inc. has completed enrollment of approximately 600 patients in the first of two phase III trials for its once-daily formulation of trospium chloride (Sanctura XR) for the treatment of overactive bladder.Enrollment of the second trial is expected to close in May 2006.

Beaver Creek, CO--Driven by demand from U.S. consumers, business is booming for companies that produce dietary and herbal supplements, as well as health foods. Many patients, including those with prostate cancer, take a dizzying array of supplements and alternative therapies. Those who have not yet jumped on the supplement bandwagon frequently ask physicians which supplements they should take or which foods they should eat to ward off or treat prostate cancer.

Washington--Even after surgical ablation, posterior urethral valves (PUVs) in boys can cause bladder and kidney problems in later years. But now, for the first time, a team of pediatric urologists has shown that PUVs also can affect sex accessory glands and, ultimately, fertility. Justine M. Schober, MD, a pediatric urologist at Hamot Medical Center, Erie, PA, reported the group's findings here at the 2005 American Academy of Pediatrics Section on Urology annual meeting.

Beaver Creek, CO--An in-depth pathologic review of specimens collected from participants in the Prostate Cancer Prevention Trial (PCPT) revealed that the reported increase in high-grade prostate cancer was most likely due to increased early detection of high-grade tumors in men receiving finasteride (Proscar), and that finasteride did not appear to potentiate the growth of high-grade prostate cancer. These findings were reported at the 16th annual International Prostate Cancer Update here by Scott Lucia, MD, associate professor of pathology, University of Colorado and the University of Colorado Health Sciences Center, Denver.

Beaver Creek, CO--For patients with hormone-refractory prostate cancer, the new standard of care is docetaxel (Taxotere)-based chemotherapy. The landmark TAX 327 study demonstrated an improvement in median survival and pain relief in patients with advanced, hormone-refractory disease who received this treatment regimen (N Engl J Med 2004; 351:1502-20). The challenge now is to look for new drug combinations that can provide additional benefits.

Beaver Creek, CO--Urologists should not abandon combined androgen blockade as first-line therapy for metastatic prostate cancer, an expert in the disease told colleagues at the International Prostate Cancer Update here.

San Francisco--Despite improvements in detection and treatment over the past 2 decades, African-American men remain at higher risk for recurrence of prostate cancer than Caucasian men. While factors such as initial PSA levels and disease severity are similar between the two racial groups, African-American men are 11% more likely than Caucasian men to have a biochemical failure after radical prostatectomy, according to a new study.

San Francisco--A pair of international phase III trials have shown that taxane-based chemotherapy can lead to increased survival in men with hormone-refractory prostate cancer. While the study results effectively made docetaxel (Taxotere) the current standard of care for androgen-independent disease, many questions about when to administer it remain, said Cora Sternberg, MD, chair of the department of medical oncology at the San Camillo and Forlanini Hospitals in Rome, Italy.

San Francisco--The long-standing debate over radical prostatectomy versus radiation therapy for unfavorable-risk prostate cancer has not gone away. But if the recent Prostate Cancer Symposium reflects broader professional opinions, the surgery camp and the radiation camp are moving toward combination treatments. There are no definitive prospective randomized trials, but evidence of a consensus that prostatectomy plus radiation therapy may offer the best patient outcomes is emerging.

San Francisco--The traditional bone scan remains an important tool for evaluating prostate cancer patients with a rising PSA. Next to PSA testing itself, metastable technetium-99 bone scans currently are the second most common test in men with rising PSA following definitive therapy, said Richard Wahl, MD, director of nuclear medicine at Johns Hopkins University School of Medicine, Baltimore. But as useful as bone scans can be, they have limited utility.

Traverse City, MI--Oct. 1, 2006, marks the fifth anniversary of the date on which Michael Harris, MD, opted out of Medicaid and Medicare and rid himself of all commercial insurers. He put his urology practice on a strict cash-for-services basis in 2001 and he has not looked back.