International Prostate Cancer Update Archives

Accuracy of ExactVu™ Micro-Ultrasound for Diagnosis of Prostate Cancer

Posted by Priya N. Werahera, PhD | Aug 2020

Priya N. Werahera, PhD, Research Assistant Professor in the Departments of Pathology and Bioengineering at the University of Colorado Anschutz Medical Campus, shares results from a study that compared ExactVu™ Micro-Ultrasound’s accuracy with that of mapping biopsy’s. He specifies that although more studies are needed to confirm these positive findings, this study has shown that the PRIMUS scoring system (similar to PIRADS) is consistent, and that there is potential clinical utility thanks to ExactVu’s™ ability to deliver real-time diagnoses and be used with or without MRI.

Improving Specificity of PSA Screening with Serum and Urine Markers – Who Doesn’t Need a Prostate Biopsy?

Posted by Daniel W. Lin, MD | Aug 2020

Daniel W. Lin, MD, Chief of Urologic Oncology at the University of Washington, discusses improving the specificity of PSA screening using serum and urine markers to determine which patients do not need a prostate biopsy. He lists the ideal biomarker characteristics, including sensitivity and specificity, correlation with disease outcome, reproducibility, low cost, quick and easy assay, and high negative predictive value. He then discusses some of the major studies done on pre-diagnosis biomarkers for prostate cancer, highlighting how PHI score, 4Kscore, and PCA3, among other markers, all significantly reduce the biopsy rate compared with older diagnostics like percent free PSA. Dr. Lin concludes by noting how urologists can further reduce unnecessary biopsies through smart screening strategies, including biennial rather than annual PSA screenings and considering not biopsying men with low early PSA scores.

Clinical Implications of Genetics in Prostate Cancer

Posted by A. Karim Kader, MD, PhD | Aug 2020

A. Karim Kader, MD, PhD, Professor in the Department of Urology and Director of Urologic Oncology at the University of California, San Diego, discusses the use of genetic and genomic prostate cancer markers as a risk assessment tool in men from screening to post-treatment workup. He describes several case studies in-depth, notes what markers were used for each individual case, and details the patient-specific outcomes associated with each case.

Physician Burnout: Facts, Fiction, and Fixes

Posted by Peter M. Knapp, MD, FACS | Jul 2020

Peter M. Knapp, MD, FACS, a urologist with Urology of Indiana, LLC in Carmel, Indiana, discusses how doctors burnout at nearly 2x the rate of the general population and urologists are ranked second amongst all doctors. The AUA found that 40% of urologists reported burnout in their annual census and that this directly correlated to the number of hours worked and number of patients seen – the higher the number the higher the chance of burnout. Urologists who do not have a specialization also seem to have a higher likelihood of burnout. Dr. Knapp suggests three fixes to address this issue: finding free-time, finding a sub-specialization, and utilizing team-based care.

Immunotherapy Trials

Posted by Daniel P. Petrylak, MD | Jul 2020

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center, discusses the various trials currently evaluating immunotherapies for castration-resistant prostate cancer (CRPC) and metastatic castration-resistant prostate cancer (mCRPC). To this point, Dr. Petrylak explains, there have not been many obvious survival benefits from immunotherapy in prostate cancer, except in patients with specific tumor mutations; therefore, sipuleucel-T and pembrolizumab are currently the only FDA-approved immunotherapeutic agents for CRPC. Fortunately, numerous trials are underway that study more effective ways to use immunotherapies for prostate cancer, including trials to improve sipuleucel-T, trials researching vaccine-based immunotherapy regimens, and numerous combination therapy trials. Dr. Petrylak also discusses alternative approaches to immune treatment, including CAR-T cell and BiTE studies in CRPC.