International Prostate Cancer Update Archives

Assessing and Managing Metabolic Risk in Patients with Prostate Cancer

Posted by Robert H. Eckel, MD, FAHA, FACC, FNLA | Aug 2024

Robert H. Eckel, MD, FAHA, FACC, FNLA, presents a high-level overview of the assessment of metabolic risk in patients with prostate cancer. He begins with a summary of the known metabolic risks associated with Androgen Deprivation Therapy (ADT) in prostate cancer management.

Dr. Eckel then presents data on the changes in patient body composition which result from 12 weeks of ADT. He notes that while weight does not significantly change in patients being treated with ADT, he reviews the impact of changes in insulin resistance, waist circumference, and other factors which contribute to metabolic syndrome.

He concludes by examining racial disparities in those who develop metabolic syndrome after being treated with ADT for prostate cancer. He presents a short questionnaire that urologists can use to assess ongoing risk during ADT.

APC Pathways – The Large Urology Group Practice Model

Posted by Jeffrey M. Spier, MD | Aug 2024

Jeffrey M. Spier, MD, and Travis Mendel, MD, discuss the use of Advanced Prostate Cancer (APC) Pathways within large urology group practices. Dr. Spier begins by reviewing the impact of oral options and other advances in treatment collaboration between APC patients and their physicians which led to the formation of large urology group practices.

Dr. Spier then discusses the factors which contribute to the success of large urology groups in treating patients with APC, with an emphasis on improved quality of care. He highlights the importance of combining real-world clinical intelligence with a multidisciplinary approach for continuous improvement in the quality of care received by patients.

Dr. Mendel takes over from Dr. Spier by explaining the differences between clinical guidelines and clinical pathways. He presents examples of treatment pathways for various stages of APC, with a focus on the impact of PSMA-PET.

Dr. Mendel concludes by discussing the potential use of these pathways in creating better AI treatment aids for physicians. Dr. Spier ends the presentation with an emphasis on the positive impact of a multidisciplinary team.

Therapeutic Modalities for BPH

Posted by Brian T. Helfand, MD, PhD | Aug 2024

Brian T. Helfand, MD, PhD, explores therapeutic modalities to prevent non-compliance in patients with Benign Prostatic Hyperplasia (BPH). He begins by establishing the pattern of medication-based non-compliance in BPH patients due to the impact on sexual function, and the evolution of BPH management.

Dr. Helfand then discusses recent technologies for BPH management which preserves sexual function. He presents current options for surgical intervention for BPH ranging from minimally-invasive surgical therapies to prostatectomies. For each option, he explores the treatment’s durability and impact on quality of life.

Dr. Helfand concludes by presenting resources to help urologists and patients choose the most appropriate treatment modality for their individual cases. He emphasizes the importance of involving the patient in the decision-making process in order to ensure compliance.

Pathological Aspects of BPH, Prostatitis, and Other Painful Co-Occurrences

Posted by Francisco G. La Rosa, MD | Aug 2024

Francisco G. LaRosa, MD, FCAP, explores the pathology of benign prostatic hyperplasia (BPH), prostatitis, and associated urological conditions. He begins by reviewing the pathophysiology of BPH, presenting examples of usual and specific patterns of BPH and their progression.

Transitioning to prostatitis, Dr. LaRosa examines acute and chronic prostatitis. He highlights the mechanisms behind its close association with BPH, despite its frequent misdiagnosis and mismanagement in BPH patients.

Dr. LaRosa concludes by providing examples of other non-cancerous co-occurrences which can be discovered after prostate biopsy. He focuses on fibromas, thromboembolisms, and calcification.

High Resolution Micro-Ultrasound: Going Beyond MRI

Posted by Laurence Klotz, MD, FRCSC | Jul 2024

Laurence Klotz, MD, FRCSC, illustrates the value of high resolution micro-ultrasound over that of multiparametric MRI (mpMRI) in prostate cancer staging and diagnosis. He begins by reviewing the history, strengths, and limitations of mpMRI, and he presents his own history with high resolution micro-ultrasound.

Dr. Klotz then explains the differences between high resolution micro-ultrasound and conventional ultrasound. He compares the sensitivity, precision, and accuracy of high resolution micro-ultrasound against those of mpMRI and conventional ultrasound.

Dr. Klotz concludes by examining the efficacy of combining mpMRI and high resolution micro-ultrasound for prostate cancer diagnosis and staging. He presents data from ongoing trials supporting the use of high resolution micro-ultrasound as a complement to mpMRI.