David M. Albala, MD, emphasizes the need for improved prostate cancer diagnostics to allow for better risk-stratification and guidance of personalized treatment. He then reviews findings from an analytical validation study of live-primary cell phenotypic biomarker-based diagnostic assay with the potential to address this need
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Paul D. Maroni, MD, argues that salvage pelvic lymph node dissection is feasible, safe, and may be efficacious in the treatment of oligometastatic prostate cancer. He reviews data suggesting that this method can optimize locoregional control, limit the risk of distant progression, avoid the necessity for immediate androgen deprivation therapy (ADT), and improve cancer-specific survival.
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James Sylora, MD, discusses the increasing demand for telemedicine services and the advantages it provides to patients and clinical practices. He outlines steps, as well as practical and legal considerations, for establishing a telemedicine protocol in a practice.
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Mohit Khera, MD, MBA, MPH, reviews current practices for treatment of erectile dysfunction, including timing of therapy after radical prostatectomy, risk factors for penile rehabilitation, and the current American Urological Association (AUA) guidelines.
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Jason M. Hafron, MD, discusses the growing presence of millennials in the workplace, particularly in urologic practices. He emphasizes that millennial physicians’ have the ability to advance the urologic field by applying their talents and perspectives regarding technology, efficiency, and physician/patient relationships.
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Robert E. Reiter, MD, reviews data comparing tumor analysis as seen on MRI and fusion biopsy to whole-mount histology following radical prostatectomy. He discusses whether evidence supports the use of MRI for determining patient eligibility and planning for focal therapy.
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Raoul S. Concepcion, MD, FACS, reviews the role of androgen receptor (AR) resistance mechanisms in recently-approved drugs for metastatic castration-resistant prostate cancer (mCRPC) and disease progression. He then emphasizes the need for better predictive and prognostic biomarkers and the optimization of therapeutic choices in precision medicine.
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J. Kellogg Parsons, MD, MHS, FACS, reviews the Men’s Eating and Living (MEAL) study, a randomized, phase III clinical trial testing diet intervention in prostate cancer patients under active surveillance. He describes the trial methodology and design, as well as clinical progression and quality of life outcomes.
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Nelson N. Stone, MD, discusses the need for adequate and accurate prostate cancer identification techniques, especially when selecting patients for active surveillance. He then reviews an emerging transperineal prostate mapping biopsy system that could be an improved tool for fusion biopsy, replace current transrectal biopsy devices, and better detect and localize lesions.
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Raoul S. Concepcion, MD, FACS, discusses the management of patients with oligometastatic prostate cancer. Currently, there is no standard definition of what defines oligometastatic. Additionally, questions remain about the handling of the primary tumor in this setting, as well as whether therapy directed at the primary has a long term benefit in overall survival.
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Steven E. Finkelstein, MD, FACRO, discusses the increasing prevalence of brachytherapy as an option for prostate cancer patients in need of radiation therapy, specifically in the recurrent space. Additionally, he addresses the limitations of the technique and the lack of studies directly comparing brachytherapy to other options.
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Gerald L. Andriole, MD, FACS, asserts that the fluciclovine PET-CT scan has a significant impact on the management of patients with biochemically recurrent prostate cancer.
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