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"As evidenced by the flurry of activity at the state and federal levels of government, many physicians are fighting back against increasingly burdensome recertification requirements," writes the AACU's Ross E. Weber.

As a result of strong opposition from organized medicine, including the AUA and patients, the Centers for Medicare & Medicaid Services has put on hold its development of a draft plan to penalize physicians for ordering “non-recommended” PSA tests to screen for prostate cancer.

The next few years may bring more change for urologists in a more compressed time frame than ever before. Could a perfect storm be brewing, and what should you be doing about it?

In men with metastatic prostate cancer, those assigned to intermittent androgen deprivation therapy have more ischemic and thrombotic events than those assigned to continuous androgen deprivation, according to Columbia University researchers.

If medical specialties were competing for which would have the most dire shortage of practicing physicians by 2025, urologists would likely win.

Treatment options for high-risk prostate cancer perform similarly. In a single-institution study, radical prostatectomy was associated with worse biochemical failure, less clinical failure, and superior prostate cancer-specific mortality compared with radiation therapy and brachytherapy, reported Jay P. Ciezki, MD, at the 2016 Genitourinary Cancers Symposium in San Francisco.

Gynecologists derive higher complication rates than urologists during the first 30 days following sling procedures for urinary incontinence, according to a multicenter study presented at the European Association of Urology annual congress in Munich, Germany.

"I have no personal experience with marijuana. But I do practice medicine in Colorado and given the state’s ongoing experiment with legal recreational marijuana, I am accumulating a significant amount of professional experience with the drug," writes Henry Rosevear, MD.

Four current clinical practice guidelines on prostate cancer provide urologists with valuable, evidence-based decision points about diagnosis and treatment while raising questions that will likely be addressed by future research.

In May 2013, the AUA and the American Society for Radiation Oncology released a joint guideline for radiotherapy after prostatectomy (J Urol 2013; 190:441-9). As a framework for practitioners caring for men who undergo surgery for treatment of prostate cancer, the evidence-based guideline contains nine statements that address use of adjuvant and salvage radiotherapy, conduct of a restaging evaluation, patient counseling, and a definition for biochemical recurrence

New clinical practice guidelines for the management of prostate cancer from the National Comprehensive Cancer Network expand the number of patients who may be considered for active surveillance to those with favorable intermediate-risk prostate cancer.

Years ago, decisions about screening men for PSA looked relatively straightforward. You offered screening to patients aged 40 or older, performed a biopsy on the ones with a total PSA >4.0 ng/mL, and offered treatment to those with positive biopsies. Today, conflicting guidelines and new techniques in cancer detection and treatment have left clinicians with a more complicated puzzle. The good news, experts say, is that physicians who put these pieces together stand a better chance of protecting their patients’ health than ever before.

In its current iteration, the AUA's CRPC guideline contains 20 statements relating to treatments for six index patients defined by the presence or absence of metastatic disease, presence and degree of symptoms, ECOG performance status, and prior treatment with docetaxel (Taxotere) along with two statements on the use of preventive treatments for bone health.