Thomas E. Keane, MD

Thomas E. Keane, MD

Medical University of South Carolina

Charleston, South Carolina

Thomas E. Keane, MD, is Professor and Chairman of the Department of Urology at the Medical University of South Carolina in Charleston. Dr. Keane specializes in managing prostate, bladder, and renal cancers. An avid researcher, Dr. Keane has served as principal investigator or co-investigator on more than 20 major clinical and preclinical studies. Much of his work focuses on innovative concepts in translational research, including utilizing human tumor xenografts to investigate the efficacy of new therapies as they relate to GU malignancies with particular reference to cytotoxic agents, sphingolipids, and boron-containing compounds. He holds a United States patent for sphingolipid derivatives and their use. Dr. Keane’s research has led to publication of more than 100 articles peer-reviewed in such journals as The Journal of Urology, Urologic Oncology, and the Journal of Vascular Surgery. He provides editorial services to publications ranging from Urology to the International Journal of Cancer and is co-editor of the text Glenn’s Urologic Surgery, 6th, 7th, and 8th Editions. He is an accomplished speaker, having delivered many presentations to professional societies and symposia throughout the United States and abroad.


Talks by Thomas E. Keane, MD

Experience with Radical Perineal Prostatectomy at a Single Institution in the Era of Robotic-Assisted Laparoscopic Prostatectomy

Thomas E. Keane, MD, presents data on the use and outcomes of Radical Perineal Prostatectomy (RPP) as a treatment for prostate cancer. He begins by reviewing the many options available to patients, allowing their treatment to be customized by their disease, priorities, and functional status. He then focuses on the viability of RPP as a treatment option for a wider population, especially for those who do not qualify for robotic-assisted surgery.

In this presentation, Dr. Keane illustrates:

The equipment necessary to perform RPP
The steps of the surgery, with photographs at each stage
The objectives of the surgery
The results from patients who received RPP over the past ten years

Dr. Keane concludes by comparing the outcomes of patients treated with Robotic-Assisted Laparoscopic Prostatectomy (RALP) to those of RPP patients. After ten years, patients treated with RPP showed no difference in progression to metastatic disease, no difference in rates of urinary symptoms, and higher rates of continence when compared to those treated with RALP.

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Case Discussion: Early Detection of Prostate Cancer

Thomas E. Keane, MD, leads a discussion with Dr. Kader and Dr. Crawford concerning the case study of a 63-year-old patient presenting with increasing PSA levels. The panel navigates through the various considerations and next steps in patient management, with an emphasis on personalized care in prostate cancer management.

After reiterating the importance of gathering comprehensive medical history and meticulously examining the patient’s PSA history, the panel discusses the range of options available, including ordering further tests such as blood or urine tests, an MRI, or even performing a biopsy. The panel explores the complexities behind treatment decision-making, emphasizing the need to carefully weigh the risks and benefits of each approach.

Drawing upon their vast experience, the panel discusses the significance of risk calculators in evaluating the patient’s condition. While these tools provide valuable insights, the panel underscores their limitations, emphasizing the need for continued research and refinement. Additionally, they explore the emerging role of MRI in detecting high-grade prostate cancer, emphasizing the importance of standardized and high-quality interpretation to ensure accurate diagnoses.

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The PRONOUNCE Trial: The Cardiovascular Safety of Degarelix vs. Leuprolide

Thomas E. Keane, MD, Professor and Chairman of the Department of Urology at the Medical University of South Carolina in Charleston, summarizes the design and results of the PRONOUNCE trial on the cardiovascular safety of degarelix versus leuprolide in patients with advanced prostate cancer. The PRONOUNCE trial looked at whether there was a difference in adverse cardiovascular effects between patients treated with a gonadotropin-releasing hormone (GnRH) antagonist (degarelix) and a GnRH agonist (leuprolide). Dr. Keane says that he believes that the different mechanisms of action of the two kinds of drugs logically seem to favor the GnRH antagonist as less likely to cause cardiovascular complications, although he notes that this remains a contentious topic. He observes that while the PRONOUNCE did find some advantage to degarelix over leuprolide, it was significantly less in this trial compared to others that have compared agonists and antagonists, including the HERO trial. Dr. Keane suggests this may be due to the fact that all patients in the PRONOUNCE trial were under the supervision of a cardiologist for the duration of the trial. He concludes that, although PRONOUNCE was a prospective trial that was cut short and only included 545 out of 900 planned patients, its results are suggestive and will hopefully help lead to further research.  

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Panel on Androgen Deprivation Therapy: A Closer Review of the Cardiovascular Risk

Thomas E. Keane, MD, Professor and Chairman of the Department of Urology at the Medical University of South Carolina, Charleston, leads a panel discussion including Lawrence I. Karsh, MD, Peter J. Rossi, MD, and Neal D. Shore, MD, FACS, to discuss the process of treating prostate cancer in a patient who is at risk for cardiovascular disease and how extra care is needed in such cases. They also stress the importance of being in contact with a patient’s PCP even if one chooses to do their own assessment of patient risk, as well as when ADT should not be considered an option, such as in the case of a patient with significant CAD and elevated liver enzymes. The group, over the course of the panel, discuss the many ADT options available, including their strengths and weaknesses.

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Androgen Deprivation Therapy: A Closer Review of the Role of Anti-Androgens

Thomas E. Keane, MD, Professor and Chairman of the Department of Urology at the Medical University of South Carolina in Charleston, discusses the role of anti-androgens in androgen deprivation therapy (ADT). Dr. Keane looks at some studies out of Canada showing the ideal T levels during ADT, but goes on to point out that both the FDA and EU regulatory authorities do not follow these guidelines. He emphasizes throughout his talk why this is problematic and why doctors should be following the Canadian guidelines. He also goes over some of the adverse effects of ADT and emphasizes the increased risk for cardiovascular and liver disease. Dr. Keane goes on to discuss different clinical data that show how to address these risks.

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