Prostate Cancer

November 11, 2020 2 min read Source/Disclosures Disclosures: Tewari reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures. ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . Subscribe ADDED TO EMAIL ALERTS We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio A novel “hood technique” for robotic prostatectomy allowed men with prostate cancer to achieve early return of urinary continence without compromising positive surgical margins, according to study results published in European Urology . “The limitations of the existing approach and treatment for prostate cancer is urinary continence and sexual function. Despite treatment, prostate cancer may still come back,” Ash Te...

Should men who undergo radical prostatectomy receive adjuvant radiation treatment? It's not a simple question with a straightforward answer. According to Robert Dreicer, MD, deputy director of the University of Virginia Cancer Center in Charlottesville, previous studies evaluating the effect of adjuvant radiotherapy have presented a "mixed picture" about its benefits. These trials showed that adjuvant radiotherapy after radical prostatectomy achieved a reduced risk of disease recurrence, but only one – the SWOG 8794 trial – showed a survival benefit. "So there has been controversy about the true utility [of adjuvant radiotherapy] and an increased adoption of salvage radiotherapy, meaning treating patients when there is evidence of biochemical or PSA recurrence," Dreicer told MedPage Today . "So you are now theoretically treating people at true risk, with evidence that you could still cure some of those patients. Therefore, over time, what evolved was a p...

A feasibility study showed that 68Ga-PSMA Cerenkov luminescence imaging (CLI), a novel operative imaging technique, demonstrated precision in assessing surgical margins during radical prostatectomy, according to findings published in the Journal of Nuclear Medicine . 1,2 68Ga-PSMA CLI showed the capacity to image the entire surface of an excised prostate specimen in order to identify prostate cancer tissue at the resection margin. “Intraoperative radioguidance with CLI may help surgeons in the detection of extracapsular extension, positive surgical margins, and lymph node metastases with the aim of increasing surgical precision,” study author Christopher Darr, PhD, of the University Medical Center Essen in Essen in Germany, stated in a press release. “The intraoperative use of CLI would allow the examination of the entire prostate surface and provide the surgeon with real-time feedback on the resection margins.” The study took place at a single site and included 10 patients with hi...

Sexual difficulties are one of the most common, distressing, and persistent treatment-related challenges for men diagnosed with prostate cancer, often under-recognized and poorly managed. Many men who have received prostate cancer treatment have unmet sexual care needs that remain over time, with these needs further exacerbated by men’s reluctance to seek help for their sexual concerns. We explored this reluctance by surveying men diagnosed with prostate cancer who received an active treatment (radical prostatectomy or other non-hormonal treatment) at two time points and asked them about their sexual help-seeking intentions and behaviors, and unmet sexual care needs. The goal of this research was to identify contributors to prostate cancer survivors' unmet sexual care needs and to their decisions to seek help for these needs. Of particular interest were those contributors that might be potentially modifiable to encourage more prostate cancer survivors to engage with primary and spe...

In   “Journal Article of the Month,"   Badar M. Mian, MD,   offers perspective on noteworthy research in the peer-reviewed literature. Dr. Mian is professor of surgery in the division of urology at Albany Medical College, New York. Despite previous randomized controlled studies demonstrating a benefit from post-prostatectomy adjuvant radiation therapy (RT), urologists have been slow to adopt this approach. This may be related to inconsistencies in the reported outcomes as well as the timing of salvage RT, which was thought to have been initiated much later than the contemporary clinical practice. Consequently, 3 randomized controlled trials (RADICALS-RT, GETUG-AFU 17, and RAVES) were initiated nearly a decade ago to evaluate the oncologic outcomes after adjuvant RT or early-salvage RT in post-prostatectomy patients with high-risk and/or locally advanced pathology. Recently, a combined analysis of these 3 trials was reported, which did not demonstrate any advantage to ad...

Cerenkov luminescence imaging (CLI), a novel intraoperative imaging method, can precisely assess surgical margins during radical prostatectomy, according to findings from a first-in-human trial published in the Journal of Nuclear Medicine . Radical prostatectomy, the removal of the prostate gland and surrounding tissues, is a primary treatment option for localized prostate cancer. Incomplete removal of the cancer tissue during this procedure is associated with poorer clinical outcomes, including tumor recurrence and prostate cancer-related mortality. Prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET) is utilized to detect prostate cancer in both primary staging and during biochemical recurrence. Cerenkov luminescence is a phenomenon that occurs when PET imaging agents emit optical photons. In this feasibility study, the researchers sought to evaluate diagnostic accuracy of CLI in detecting prostate cancer, particularly cancer tissue that remains at...

Our study demonstrated that pelvic visceral fat (PVF) and working space (WS) in the pelvic cavity are factors that significantly affect operative time in robot-assisted radical prostatectomy (RARP). Diverse space volumes were measured using the Synapse Vincent® (FUJIFILM, Tokyo) 3D image analysis software. This technology allows calculation of the volume of any space using magnetic resonance imaging (MRI) or computed tomography (CT) scan images. Working space is the area in the pelvis in which surgeons work during RARP. PVF and WS only can be measured using specific software. Therefore, we explored the measurement of pelvic width (PW) and body mass index (BMI) as practical alternatives. BMI and PW were correlated with PVF and WS, respectively. We concluded that increased PVF (BMI) and a narrower WS (PW) increase operative difficulty, leading to postoperative complications such as urine leakage from anastomoses. In this study, the cohort included only Asians (Japanese). The USA or Eur...

A novel surgical technique called the “hood technique” for robotic-assisted radical prostatectomy was shown to achieve early return of urinary continence without a negative impact on complications and cancer outcomes among men with localized prostate cancer, according to study findings published in European Urology. 1   The findings indicate that the hood technique allows for early return of continence after surgery without compromising positive surgical margin rates by sparing musculofascial structures anterior to the urethral sphincter complex. “A common [adverse] effect that patients worry about following a radical prostatectomy is urinary incontinence,” said Ashutosh Tewari, MD, senior author of the trial. 2  “This study shows that [by] using a novel surgical technique, the robotic-assisted radical prostatectomy ‘hood technique,’ we can reduce postoperative urinary incontinence and facilitate early return of continence in patients with localized prostate cancer.” T...

When adjusting for only age and year of diagnosis, the mortality rate was 51% higher for Black versus White patients receiving the procedure; however, when the model adjusted for all clinical and nonclinical factors, this survival disparity dropped to 20%. Disparities in mortality rates between Black and White patients receiving radical prostatectomy were significantly lower, but not erased, after statistical modeling adjusted for clinical factors and healthcare access issues. Following the same adjustments, the survival disparity between Asian Americans and Pacific Islanders (AAPIs) and White patients significantly increased. 1 According to the analysis, which was published in Cancer, when adjusting for only age and year of diagnosis, the mortality rate was 51% higher for Black patients receiving the procedure; however, when the model adjusted for all clinical and nonclinical factors, this survival disparity dropped to 20%. Conversely, the AAPI-White disparity in survival was 22%...

A study published in Cancer suggested that after adjustments for a number of clinical factors and factors related to access to care, the overall survival disparity among men undergoing radical prostatectomy was significantly decreased, but not eliminated, for Blacks and significantly increased for Asian Americans and Pacific Islanders (AAPIs) compared to whites. With an adjustment for all nonclinical and clinical factors, the survival disparity observed between Blacks and whites was decreased to 20%. Contrastingly, the survival disparity increased to 35% between AAPIs and whites. However, adjustments for these prognostic factors had little effect on the survival disparity between Hispanics and whites. “As shown in this study, if Blacks had similar education levels, median household income, and insurance status, the survival disparity between Blacks and whites would decrease from 51% to 30%,” the authors noted. “Unfortunately, income inequality in the United States has continued to ...

medwireNews : Data from the phase 3 RADICALS-RT, RAVES, and GETUG-AFU 17 trials and the ARTISTIC meta-analysis suggest that observation with early salvage radiotherapy should be the standard of care for men undergoing radical prostatectomy for localized or locally advanced prostate cancer. The authors of the studies explain that although prior clinical trials have shown a benefit of adjuvant radiotherapy versus observation in this population, the findings are difficult to interpret as a large proportion of the observed participants did not receive salvage radiotherapy, and thus the optimal timing of postoperative radiotherapy remains to be determined. Advertisement All three of the current trials therefore compared adjuvant radiotherapy, initiated within 3–6 months after surgery, with salvage radiotherapy triggered at a prostate-specific antigen (PSA) level of 0.1 ng/mL or three consecutive rises without reaching this cutoff in RADICALS-RT, at 0.2 ng/mL in RAVES, ...

PET-based optical imaging detects cancer cells after radical prostatectomy Top We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings. Ok

October 09, 2020 5 min read Source/Disclosures Disclosures: Parker reports personal fees and research funding from Bayer. Vale reports no relevant financial disclosures. Please see the studies for all other authors’ relevant financial disclosures. D’Amico and Tilki report no relevant financial disclosures. ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . Subscribe ADDED TO EMAIL ALERTS We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Adjuvant radiotherapy after prostatectomy did not improve outcomes compared with observation and salvage radiotherapy for men with prostate cancer, according to results of three studies published in The Lancet and The Lancet Oncology. A systematic review and meta-analysis of the randomized phase ...

Reviewed by Emily Henderson, B.Sc. Oct 7 2020 A new intraoperative imaging technique, Cerenkov luminescence imaging (CLI), can accurately assess surgical margins during radical prostatectomy, according to a first-in-human research published in the October issue of the Journal of Nuclear Medicine . The feasibility study showed that 68Ga-PSMA CLI can image the entire excised prostate specimen's surface to detect prostate cancer tissue at the resection margin. Radical prostatectomy is one of the primary treatment options for men with localized prostate cancer. The goal of a radical prostatectomy is to completely resect the prostate without positive surgical margins. Incomplete removal of the cancer tissue during radical prostatectomy is often associated with poorer patient outcomes, including increased likelihood of recurrence and prostate cancer-related mortality. Prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET) has emerged as an accurate tool t...

Steve Ranson LVN Radiation oncologist Dr. Gary Campbell develops a plan for every patient to treat prostate cancer. Steve Ranson / LVN Radiology technician Sarah Pimentel brings up my treatment plan. Steve Ranson / LVN Show CaptionsHide Captions An elevated PSA (prostate-specific antigen) score and biopsy all pointed toward cancer. Dr. Brian Montgomery, an urologist with Carson Urology, ordered a bone scan to ensure the cancer hadn’t metastasized. On bone scans, Montgomery said he uses criteria based on National Comprehensive Cancer Network (NCCN) guidelines to determine if the cancer had spread beyond the prostate to another organ or the bones. “The higher the PSA, the more likely prostate cancer is present,” he said. In two years my PSA scored quadrupled to almost 17. Normal is less than four. I had to wait two more weeks to learn of the results. If the cancer spread, I may be looking at a radical prostatectomy and some type of treatment like chemot...

Peng Xue, 1 Ziyu Wu, 2 Kunpen Wang, 1 Guojun Gao, 3 Min Zhuang, 4 Miao Yan 4 1 Department of Urology, First People Hospital of Lianyungang, Lianyungang, Jiangsu Province, People’s Republic of China; 2 Department of Urology, NO 2 Hospital of Huaian, Huaian, Jiangsu Province, People’s Republic of China; 3 Department of Urology, The Affiliated Hospital of Weifang Medical College, Weifang, Shandong Province, People’s Republic of China; 4 Department of Oncology, First People Hospital of Lianyungang, Lianyungang, Jiangsu Province, People’s Republic of China Correspondence: Miao Yan Department of Oncology, First People Hospital of Lianyungang, Zhenghua Road 6, Lianyungang, Jiangsu Province 222002, People’s Republic of China Tel +86051885605016 Email yanmiao_ym@126.com Background: The current standard of care for metastatic prostate cancer (mPCa) is androgen deprivation therapy (ADT) with or without anti-androgen and chemotherapy. The aim of this study was to evaluate the efficacy...

This article was originally published here Cancer. 2020 Sep 8. doi: 10.1002/cncr.33152. Online ahead of print. ABSTRACT BACKGROUND: Although racial disparities in prostate cancer survival are well documented, the relative importance of contributing factors remains unclear. Few studies have examined the disparity between Whites and Hispanics or between Whites and Asian Americans and Pacific Islanders (AAPIs). METHODS: Using data from the National Cancer Database for 526,690 patients with prostate cancer who underwent radical prostatectomy between 2004 and 2014, this study systematically evaluated the impact of clinical characteristics and factors related to access to care on survival by race. Included in the analysis were 432,640 White patients (82.1%), 63,602 Black patients (12.1%), 8990 AAPI patients (1.7%), and 21,458 Hispanic patients (4.1%). Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals to measure racial surviva...

Increasing the Time Between Prostate Cancer Screenings May Improve Outcomes An analysis observed a significant surge in prostatectomies in high-risk prostate cancer patients over a 12-year period, nearly matching that of radiotherapy, which sharply declined during the same time period. The study, published in JAMA Network Open , evaluated data from the National Cancer Database (NCDB) spanning 2004 through 2016. The NCDB houses data on more than 70% of new cancer diagnoses in the U.S.; the present analysis included men diagnosed with high-risk prostate cancer, defined as: clinical stage T3 to T4, a prostate-specific antigen level >20 ng/mL, or a Gleason score between 8 and 10. Final analysis included 214,972 men; 79.2% were white, and 16.1% were black. More than half of the patients had government-based insurance (59.3%); about 82% of patients had a Charlson-Deyo comorbidity index of 0. The rate of high-risk prostate cancer nearly doubled over the study period, from 11.8% to...