Topic: Prevention and Screening

Prostate Cancer Screening: Who? Why? How?

Gerald Andriole, MD, discusses the limitations and successes in the design of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) and European Randomized Study of Screening for Prostate Cancer (ERSPC) trials. He also emphasizes the importance of patient selection in PSA screening and utilizing other diagnostic methods.

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Transperineal Prostate Biopsy: State of the Art

Roberto Miano, MD, compares transperineal versus transrectal access for prostate biopsies. He argues that transperineal is safer in terms of infectious complications and more accurate for detecting cancer versus a transrectal approach. Therefore, it is essential that clinicians receive proper training for the procedure.

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Advanced Disease — A Real Need for Understanding and Shared Care

Daniel P. Petrylak, MD, stresses the importance of taking a multidisciplinary approach when treating prostate cancer. Not only does this mean involving urologists, oncologists, and primary care physicians for better access to therapies and coordination of care, but also involving nutritionist, mental health professionals, and pain management experts for maintaining patients’ quality of life.

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3D Biopsy – The Complete Interrogation of the Gland

Nelson N. Stone, MD, argues that performing prostate biopsies is beneficial for detecting malignancies and lesions and cannot be replaced by MRI, despite controversies. He describes the transperineal mapping biopsy (TPMB) procedure, the inadequacies of current technology, targeted focal therapy, and future directions in these techniques.

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The Role of FSH in Prostate Cancer

Marc B. Garnick, MD, addresses the question, “Does Follicle Stimulating Hormone (FSH) effect prostate cancer progression and adverse effects to androgen deprivation therapy (ADT), and should we be modulating it?” He presents evidence for both the pro and con sides of this argument.

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Updates on the ERSPC and the PLCO Trials

Dr. Gerald L. Andriole, MD, reviews the designs, materials, and outcomes of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) and The European Randomized Study of Screening for Prostate Cancer (ERSPC). He distinguishes between legitimate concerns and inappropriate criticisms of the trials. Also, he explains what this means for the practice of PSA testing.

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