University of British Columbia

Long-Term Outcomes of HDR

Juanita M. Crook, MD, FRCPC, reviews the radiobiologic rationale for high-dose-rate brachytherapy (HDR BT), its technical advantages, the evolution of HDR fractionation, and recent toxicity reports for both HDR BT boost and HDR BT monotherapy according to prescribed dose and fractionation.

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Does Radiation Therapy Favor Radical Prostatectomy in Long-Term QOL?

Juanita M. Crook, MD, FRCPC, discusses the challenges of assessing modalities for the management of high-risk prostate cancer in terms of quality of life (QOL) outcomes. She then reviews QOL data from the ProtecT trial, the efficacy and toxicity of presented for ASCENDE-RT trial, and data from two large, mature prospective databases. She also shares her opinion on the “tri-modality” approach.

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Focal Brachytherapy

Juanita M. Crook, MD, FRCPC, argues that focal brachytherapy is one of the most effective and least invasive treatments for prostate cancer. She discusses patient selection for focal therapy, technical limitations, efficacy data, and best practices in post-focal-therapy monitoring.

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Should Variant Histology Change Management of Bladder Cancer?

Peter Black, MD, FRCSC, fills in for Ashish Kamat, MD, at the 2nd annual IBCU, discussing why and how clinicians should adapt bladder cancer treatment based on variant histologies. Dr. Black identifies sub-types of bladder cancer and the way gene expression and squamous differentiation play a role in risk-stratifying the disease. He explains the proper management of each sub-type, including MD Anderson treatment algorithms for NMIBC and MIBC.

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Perioperative Pathways: What We Know Works

Peter Black, MD, FRCSC, provides an overview of the current Enhanced Recovery After Surgery (ERAS) protocol in the setting of radical cystectomy, recommendations from the ERAS Society, and how the practice increases bladder cancer patients’ quality of life. He also touches upon the possibility of adding alvimopan to ERAS protocol in the near future.

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