University of British Columbia Archives

Rationale for Focal Therapy for Prostate Cancer

Posted by Abhinav Sidana, MD, MPH | Mar 2021

Abhinav Sidana, MD, Urologic Surgeon at the University of Cincinnati Medical Center, makes a case for the adoption of focal therapy for patients with prostate cancer as an alternative to radical treatment or active surveillance. To show how incorporating focal therapy into the treatment paradigm could help personalize care, Dr. Sidana highlights three points: the shortcomings of a treatment strategy that involves only dichotomous options; the increasing need for treatment tailored to the biology of prostate cancer; and how the advent of visible prostate cancer due to next-generation imaging has altered treatment approaches. Following this, Dr. Sidana takes questions from E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology, about related topics, including the role of micro-ultrasound in the disease space and the patient followup process.

Cardiovascular & Metabolic Risk Profiles of Hormonal Agents for Managing Advanced Prostate Cancer

Posted by Celestia S. Higano, MD | Mar 2021

Celestia S. Higano, MD, FACP, Adjunct Professor in the Department of Urologic Sciences at the University of British Columbia and Medical Director of the Prostate Cancer Supportive Care Program at the Vancouver Prostate Centre, reviews her 2020 paper outlining the cardiovascular risks associated with ADT and new treatments for prostate cancer, highlighting its increasing relevance in the wake of recent approvals for drugs like relugolix. She explains that there is controversy in the literature regarding whether ADT increases cardiovascular risks, but suggests that patients who are already at risk of cardiovascular disease may see more adverse cardiovascular effects on ADT. Phase 3 trials combining ADT with drugs like enzalutamide, apalutamide, and abiraterone, as well as other second-generation antiandrogens, demonstrate greater cardiovascular risk to patients on a combination as opposed to on ADT alone. Dr. Higano emphasizes that urologists must discuss risk factors for cardiovascular disease with their patients before prescribing these treatments, and she recommends following the Vanderbilt Cardiooncology Group’s ABCDE checklist with them.

Fred’s Verdict: Exercise as a Replacement for “Fight or Flight” and Its Impact on Brain Health

Posted by Wesley Smith, PhD | Mar 2020

Fred H. Bartlit, Jr., JD, founder of Bartlit Beck LLP and co-founder of StrongPath, talks with Wesley Smith, PhD, Chair of the Undergraduate Exercise Physiology Program at the University of Miami and the Chief of Product Development for StrongPath, about the effects of exercise on brain health as well as the physiological benefits of how exercise mimics the body’s “fight or flight” response. Fred discusses research indicating that exercise is an essential component of brain health, as well as influencing and improving numerous biological processes. Dr. Smith breaks down how the evolutionary “fight or flight” response to stress actually has a positive impact on health and how exercise mimics that stress in a world with fewer threats. He also details the physiological processes resulting from exercise that can impact brain health.

Clinical Implications of Similarities and Differences Between Upper-Tract and Bladder Urothelial Carcinoma

Posted by Peter Black, MD, FACS, FRCSC | Feb 2020

Peter Black, MD, FACS, FRCSC, a Urologic Oncologist at Vancouver General Hospital, a Senior Research Scientist at the Vancouver Prostate Centre, and a Professor in the Department of Urologic Sciences at the University of British Columbia, examines key differences between upper-tract and bladder urothelial carcinomas, and their impact on diagnosis and treatment of each respective disease. He discusses subtle molecular differences between each disease, how these variations’ relationship to genetic alterations could lead to marker-based therapy, as well as treatments that are effective in treating both diseases.

Diagnostic Challenges with Upper-Tract Urothelial Carcinoma

Posted by Peter Black, MD, FACS, FRCSC | Feb 2020

Peter Black, MD, FACS, FRCSC, discusses questions, challenges, and methods in diagnosing upper-tract urothelial cancer. He analyzes established criteria for when to conduct a biopsy, discusses various methods and tools used for obtaining sufficient tissue for diagnosis, and how risk stratification impacts the selection of options for management of the disease.