The benefits of bilateral nerve-sparing procedures in men undergoing radical prostatectomy may be concentrated in those patients who have high sexual function at baseline.
Abiraterone acetate (ZYTIGA) should be considered a standard of care for newly diagnosed, metastatic, non-castrate prostate cancer, as should docetaxel (Taxotere), according to a new clinical practice guideline from ASCO.
Studies provide clear evidence to support MRI fusion biopsy’s use as the gold standard for men at risk for prostate cancer diagnosis following an initial negative biopsy.
Limitations of MRI fusion biopsy include its cost, interobserver variability, and low diagnostic accuracy for clinically significant cancer in the anterior prostate.
Evidence shows HIFU can provide cancer control outcomes comparable to those associated with radical prostatectomy or radiation therapy in properly selected patients.
Recommending either whole-gland or focal HIFU cannot be justified when their pros and cons are judged relative to the appropriate comparator.
There were significant improvements among those studied on the higher radiation dose in terms of biochemical failure and distant metastases, however.
Practicing urologists should consider the potential value of performing a multiparametric MRI for a biopsy in men with suspected prostate cancer based on results from the PRECISION trial, says Veeru Kasivisvanathan, MRCS.
A minority of patients are involved in shared decision-making about prostate cancer screening with PSA, but new strategies to incorporate shared decision-making into practice are being investigated.
"One thing I would like to see some guidance on is what to do about patients who use marijuana recreationally," says one urologist.