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Progress and Promise in Prostate Cancer

Journal

Getting the Word Out

Consider this the first of a series of messages on the mission and strategy of the Prostate Cancer Foundation (PCF).

The mission of PCF is to reduce the death and suffering from prostate cancer. I often wonder about what would be a good analogy for the mission. As one travels through the world of medical research organizations, patient groups, and even the general media we hear words like “war on cancer” “moonshot” “Manhattan project” to describe a problem to be conquered or a battle to be won.

Post-Operative Radiotherapy in Prostate Cancer – The State of the Data

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 4
Published January 2021

Contemporary treatment options for patients with clinically localized prostate cancer include radical prostatectomy, radiotherapy, and active surveillance. Surgery can be curative for approximately two-thirds of patients choosing radical prostatectomy.1 However, men with adverse pathologic findings at the time of radical prostatectomy, such as the presence of positive surgical margins, extraprostatic extension, or seminal vesicle invasion,2,3 experience up to a 60% risk of recurrence at 10 years and may require subsequent radiation therapy.2

The Evolving Landscape of First-Line Therapy for Metastatic Clear Cell Renal Cell Carcinoma

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 4
Published January 2021

When examined at a national level in the United States, cancers of the kidney and renal pelvis (despite different histology) are considered in aggregate and represent the sixth most common newly diagnosed tumors in men and eighth most common in women in the United States in 2020,1 representing an estimated 73,750 new diagnoses and 14,830 deaths. The vast majority of these cancers will be renal parenchymal tumors with renal cell carcinoma (RCC) comprising the preponderance of these lesions.

Everyday Urology: Volume 5, Issue 4

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From the Desk of the Editor: Volume 5, Issue 4

Dear Colleagues, As the 2020 pandemic has altered our behavioral, economic, educational policies, and numerous other career and life events worldwide, SARS-CoV-2 has also impacted global healthcare and patient outcomes. Fortunately, and not unexpectedly, frontline and advanced line healthcare workers, researchers, and scientists have never ceased the tradition of tireless sacrifice and dedication to advancing patient care. Assuredly we have reviewed and read exceptional cancer care advancements in 2020, including innovative efforts for delivering care via ambulatory processes or through virtual technologies while prioritizing our most vulnerable patient populations. Fortunately, numerous diagnostic and therapeutic advancements in 2020 have occurred in Genitourinary Oncology.

While safeguarding both patients and the healthcare team from unnecessary risk of SARS-CoV-2, telehealth technology and its widespread adoption among healthcare practitioners and patients have allowed for innovative patient care strategies. Virtual education has also persevered and improved during this year of in-person and travel adversity.

From the Desk of the Editor: Volume 5, Issue 3

Welcome to the third issue of Everyday Urology - Oncology Insights of 2020, published by Digital Science Press. This issue focuses on advances in the management of non-muscle-invasive bladder cancer and upper tract urothelial carcinoma; it also spotlights GU cancer care advancements from 2020 virtual global meetings.

This issue's cover story is written by Patrick J. Hensley, MD, Urological Oncology Fellow, and world-renowned urologist, Ashish M. Kamat from the University of Texas MD Anderson Cancer Center, Houston, Texas, entitled: “Overcoming Diagnostic and Therapeutic Challenges in Non-muscle Invasive Bladder Cancer (NMIBC)”. In 2020, approximately 81,000 cases of urothelial carcinoma of the bladder will be diagnosed in the United States, with nearly 18,000 associated deaths.¹ In their review article, Drs. Kamat and Hensley discuss current challenges in NMIBC, emerging diagnostic approaches, and advances in both intravesical and systemic therapy.

Sam S. Chang, MD, MBA, provides a concise and well-balanced update on low-grade upper tract urothelial carcinoma in the expert perspective article. Upper tract urothelial carcinomas (UTUCs) are a heterogeneous group of malignancies arising from the urothelium within the renal pelvis or upper ureter.

Update on Low-Grade Upper Tract Urothelial Carcinoma

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 3

Published Date: October 2020


Upper tract urothelial carcinomas (UTUCs) are a heterogeneous group of malignancies arising from the urothelium at the level of the renal pelvis or ureter. They comprise 5% to 10% of all urothelial carcinomas and are diagnosed in approximately two per 100,000 persons in the United States annually, the majority of whom are adults older than 70 years.1-3 A significant percentage of UTUCs are low-grade; these primarily papillary tumors are substantially less aggressive than high-grade UTUCs and demonstrate a low rate of cancer-specific mortality, but hematuria and urinary obstruction are common and require management.4-6

Non-muscle Invasive Bladder Cancer: Overcoming Diagnostic and Therapeutic Challenges

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 3
Published Date: October 2020

In 2020, approximately 81,000 cases of urothelial carcinoma of the bladder will be diagnosed in the United States, with nearly 18,000 associated deaths.1 Bladder cancer disproportionally affects men and is associated with well-defined environmental risk factors—tobacco use underlies approximately 50% of cases.2 Nonmuscle-invasive bladder cancer (NMIBC) is primarily managed by transurethral resection, risk-stratified use of intravesical chemotherapeutic or immunotherapeutic agents, and close surveillance.

Everyday Urology: Volume 5, Issue 3

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From the Desk of the Editor: Volume 5, Issue 2

Dear Colleagues,

Welcome to the second issue of Everyday Urology – Oncology Insights of 2020, published by Digital Science Press. Throughout the year, UroToday.com has provided information and expert perspectives on the evolving state of urology and GU oncology, as well as the impact COVID-19 has had on the healthcare environment, featuring video discussions amongst physicians at the frontlines of care and research. These videos, along with discussions of conference updates, journal clubs and the cancer patient journey series are featured on the UroToday.com website. This issue focuses on advances in the management of prostate cancer, as well as the ASCO 2020 virtual meeting held May 29-31, 2020.

In their article, “What is Changing in Advanced Prostate Cancer?” Christopher J.D. Wallis, MD, Ph.D., and Zachary Klaassen, MD, profile the ways in which advanced prostate cancer treatment has been revolutionized over the last 15 years, as no less than nine novel agents have been introduced with proven overall survival benefits. Reviewing the evidence that has defined these changes, Dr. Wallis and Dr. Klaassen detail the pivotal trials and FDA approvals that have demonstrated survival benefits across metastatic castration-resistant prostate cancer (mCRPC), metastatic castration sensitive prostate cancer (mCSPC) and nonmetastatic castration-resistant prostate cancer (nmCRPC), beginning with the introduction of docetaxel for men with castration-resistant prostate cancer in 2004, and continuing through recent phase 3 trials as well as reviewing novel treatment strategies.

What is Changing in Advanced Prostate Cancer?

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 2

Introduction 

Prostate cancer, while commonly diagnosed in early forms, remains the second leading cause of cancer mortality in the United States and Europe.1 For patients who die of prostate cancer, some will be initially diagnosed and treated for metastatic castration-sensitive disease (mCSPC) while others will progress through non-metastatic castration-resistant disease (nmCPRC) following initial local therapy followed by androgen deprivation therapy (ADT) for biochemical recurrence. In either case, nearly all men who die of prostate cancer will have metastatic castration-resistant disease (mCRPC) prior to death.

ARAMIS: Favorable Overall Survival and Safety Findings for Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 2
Patients with non-metastatic castration-resistant prostate cancer (nmCRPC, formerly known as M0 CRPC) have rising prostate-specific antigen (PSA) levels despite castrate levels of testosterone with approved androgen deprivation therapy (ADT) and no detectable metastases on conventional imaging with computed tomography (CT) and bone scans.1

From the Desk of the Editor: Volume 5, Issue 1

Dear Colleagues,

Welcome back to another issue of Everyday Urology - Oncology Insights, the first issue of 2020 brought to you by UroToday. In the featured articles of this issue, we highlight the work of Edward Schaeffer, MD, PhD, and Ashley Baker, MD, presentations as well as work from Noah Hahn, MD, in a presentation I stepped in and gave at the 2019 Large Urology Group Practice Association (LUGPA) Continued Medical Education (CME) Program. This meeting’s agenda collectively focused on Leveraging Disruptive Technology: Pragmatic and Productive Advances for your Practice, which included a variety of presentations in prostate, bladder, and renal cancers as well as bladder health, minimally invasive procedures and preparing your clinics for the evolving future.

At the 2019 LUGPA CME, Dr. Edward Schaeffer presented on the relevancy of traditional culture testing in urinary tract infections (UTIs). Given the varying degree of complication associated with UTIs, Dr. Schaeffer highlights the available options for testing and treatment. He concludes by dissecting the benefits and pitfalls of a few of his most recommended tests and points out that clinical outcomes will ultimately depend on the nuances of symptoms that result from a host’s response to bacteria. 

The Advanced Bladder Clinic: Are You Ready?

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 1
Published Date: March 2020

In 2015, cisplatin-ineligible patients with metastatic urothelial carcinoma could not be offered a first-line treatment option capable of prolonging their survival. Also, a paucity of second-line treatments resulted in these same patients usually surviving for only 3 to 6 months after progressing on platinum-treatment.

Percutaneous Renal Biopsy in the Ambulatory Surgery Center: A Primer

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 1
Published Date: March 2020

The earliest renal biopsies were obtained by open surgical techniques performed by urologists or transplant surgeons, or by pathologists at the time of autopsy. In 1951, physicians in Copenhagen published the first clinical report of percutaneous renal biopsy.1 They placed patients in a seated position and used intravenous pyelogram (IVP) as the imaging guide. Not surprisingly, both the yield and quality of biopsy tissue samples were low by contemporary standards, with only about half to two-thirds of specimens permitting histologic examination.

UTI – Is Traditional Culture Testing Obsolete?

Published in Everyday Urology - Oncology Insights: Volume 5, Issue 1
Published Date: March 2020

Urinary tract infections are the most common type of bacterial infection,1 accounting for at least 11 million physician office visits, 2 to 3 million emergency department visits, 400,000 hospitalizations, and approximately $2.3 billion in healthcare costs annually in the United States.2,3,4,5

Everyday Urology: Volume 5, Issue 2

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Everyday Urology: Volume 5, Issue 1

In this issue

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From the Desk of the Editor: Volume 4, Issue 4

Welcome to the final 2019 issue of Everyday Urology - Oncology Insights. On December 6, 2019, UroToday celebrated its sixteenth year online. In our continuous effort to provide both concise and clinically relevant updates in urologic oncology, UroToday has established itself as a trusted leader in expounding the importance of multidisciplinary care models, emphasizing perspectives on rapidly changing and relevant topics in urology and GU Oncology, highlighting selected and specific studies,

Choosing First-Line Treatment for Metastatic Castration-Resistant Prostate Cancer: APCCC Highlights

Published in Everyday Urology - Oncology Insights: Volume 4, Issue 4

Published Date: December 2019

The choice of initial treatment for newly diagnosed metastatic castration-resistant prostate cancer (mCRPC) is far more complex than it was even a decade ago. Today, many patients with mCRPC have already received intensive upfront therapies during the hormone-sensitive stage— a “leftward” shift in treatment (based on the clinical states model we so frequently employ) which can spur a “rightward” shift in disease biology due to the earlier emergence of treatment-resistant clones.

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