2021

Does the Radiation Dose Required to Eradicate Local Disease Differ by Gleason Grade Group?

Does the Radiation Dose Required to Eradicate Local Disease Differ by Gleason Grade Group?

Posted by | Jun 2021

Nelson N. Stone, MD, Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and at the Derald H. Ruttenberg Cancer Center at Mount Sinai, discusses the radiation dose requirements for local disease eradication and the implications for focal therapy. He presents studies of external vema radiation and brachytherapy, which both showed that as the radiation dose increased the likelihood of a positive biopsy decreased two years post treatment. Dr. Stone concludes that it does not matter what type of disease the patient has, it matters how much radiation is used to get rid of the disease. Longer term follow up is needed to see the impact of radiation doses. Post-irradiation biopsies imply that a BED of over 240 Gy can eradicate all prostate cancer. If a tumor is small then there is a potential for a high dose of radiation just to the affected regions. Larger tumors or cases with extensive multifocality will require a full dose treatment with a full or partial implant.

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Updates in Upper Tract Urothelial Cancer

Updates in Upper Tract Urothelial Cancer

Posted by | Jun 2021

Seth P. Lerner, MD, Professor of Urology and holder of the Beth and Dave Swalm Chair in Urologic Oncology in the Scott Department of Urology at Baylor University, provides an update on recent trials and treatment options for Upper Tract Urothelial Cancer (UTUC). He begins with the OLYMPUS study, outlines the rationale for neoadjuvant therapy, reviews ECOG’s EA8141 trial, and concludes with a discussion of adjuvant therapy.

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Leveraging the EMR to Improve Quality in Risk Stratification for Prostate Cancer

Leveraging the EMR to Improve Quality in Risk Stratification for Prostate Cancer

Posted by | Jun 2021

In part 1 of a 3-part series, Franklin Gaylis, MD, FACS, Chief Scientific Officer of Genesis Healthcare Partners and Voluntary Professor of Urology at the University of California, San Diego, looks at how improved quality reporting can improve risk stratification for prostate cancer. He explains that quality reporting is expensive and time-consuming, but also necessary, and looks at how it can be improved. As an example, he considers a study by Genesis Healthcare intended to improve documentation and staging templates for digital rectal examinations (DREs) for prostate cancer staging and risk stratification. They found that by leveraging the electronic medical record (EMR) with explicit templates, they were able to increase physician confidence in DRE findings. Dr. Gaylis concludes that by encouraging urology practices to record more accurate and precise DRE information, better templates for reporting can improve patient care.

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