Download or read book Active Surveillance for Localized Prostate Cancer written by Laurence Klotz and published by Humana Press. This book was released on 2017-09-29 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt: This fully updated and revised new edition provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in prostate cancer. The book reviews new data about molecular characteristics of the disease, profiles the new grading system for prostate cancer introduced in 2015, and provides new perspectives about imaging of prostate cancer, as well as the role of targeted biopsies. The text summarizes the role of biomarkers and MRI in patient selection and management and details the world wide results of active surveillance. Specific chapters address communication and ethical issues, QOL outcomes, economic aspects, and psycho-social aspects of surveillance. The role of focal therapy for low risk disease is summarized, and the data supporting preventive interventions during surveillance reviewed. This text will serve as a very useful resource for physicians and researchers dealing with, and interested in this common malignancy, as it provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts.

Download or read book Active Surveillance for Localized Prostate Cancer written by Laurence Klotz and published by Springer Science & Business Media. This book was released on 2012-06-21 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Active Surveillance for Localized Prostate Cancer: A New Paradigm for Clinical Management will serve as a useful resource for physicians dealing with, and interested in, this complex and evolving branch of prostate cancer management. The book will also be of interest to scientifically literate patients and their families. The volume provides an introduction to the concept of active surveillance in oncology in general and prostate cancer specifically. The primary focus is to provide a comprehensive guide to the management of patients on surveillance. The volume covers the many complexities and nuances to this approach including, patient selection, risk assessment, how to overcome 'cancer hysteria' when counseling patients, identifying appropriate triggers for intervention, use of PSA kinetics and MR imaging information, technique and frequency of biopsies, secondary prevention interventions, and the relative roles of surveillance and focal therapy.

Download or read book Evidence Review of Active Surveillance in Men With Localized Prostate Cancer written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Prostate Cancer Dilemma written by Nelson N. Stone and published by Springer. This book was released on 2015-10-19 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in early prostate cancer. The book reviews new data about genetic markers, transperineal mapping biopsy and mpMRI, how to apply each of these technologies in patients with elevated PSA, when a prior prostate biopsy performed by the standard TRUS method is negative and in cases where low risk disease is already diagnosed, how to differentiate those men who might harbor more aggressive disease from those who do not. Over 75% of newly diagnosed prostate cancer meets the criteria for low risk disease which has created a dilemma for both patients and clinicians. Active surveillance programs have been initiated and are reviewed. How the new technologies impact surveillance programs is addressed. Clinical stage designation is updated and a new intra-prostatic staging system is discussed. Prostate biopsy techniques utilizing transrectal ultrasound, transperineal mapping, elastography and mpMRI are compared. Finally, utilization of this new technology in the application of focal therapy is reviewed. The Prostate Cancer Dilemma will serve as a very useful resource for physicians and researchers dealing with, and interested in this challenging malignancy. Chapters are written by experts in their fields and include the most up to date scientific and clinical information as well as links to procedural video content.

Download or read book An Evidence Review of Active Surveillance in Men with Localized Prostate Cancer written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-06 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2011, more than 240,000 men are projected to be diagnosed with prostate cancer, and 33,000 are projected to die from the disease in the United States. In the United States, most cases of prostate cancer are detected via prostate-specific antigen (PSA) screening. The cancer is usually localized, and most tumors have low histological grades and low Gleason scores. Indeed, more than half of prostate cancers detected by PSA screening are expected to be early-stage, low-risk tumors. Such cancers are an infrequent cause of death, and those affected are more likely to die of unrelated causes. A number of immediate active treatment options are available for localized prostate cancer. Most commonly, radical prostatectomy (RP) or radiation therapy (RT), with or without androgen deprivation therapy (ADT), are offered with curative intent. However, the clinical benefit of immediate therapy with curative intent has not yet been demonstrated for localized prostate cancer in a PSA-screened population. It is likely that a large number of men are receiving active treatment with curative intent without much likelihood of obtaining any clinical benefit due to the slow progression of many prostate tumors. Both surgical and radiation treatments result in significant short- and long-term adverse events, including impotence, urinary dysfunction, and other complications. Thus, determination of the appropriate management strategy for early-stage, low-risk prostate cancer is an important public health concern. Active surveillance (AS) and watchful waiting (WW) are two observational followup strategies that forgo immediate therapy in patients with prostate cancer, with the goal of minimizing the morbidities and costs of immediate active treatment for men who may never develop cancer-related symptoms or who are interested in palliative treatments only. AS is curative in intent, and WW is palliative. AS is appropriate in men with disease believed to be indolent and therefore may not require therapy. Because prediction tools are imperfect, these men are monitored closely and treated with curative intent at signs of progression or patient choice. In this way, the considerable adverse effects of treatment are at best avoided, and at least deferred. This approach is to be distinguished from men for whom treatment is deemed inappropriate because of comorbidity; for these men, WW is generally considered, as it offers the option of palliative therapy upon symptomatic disease progression. AS often entails a multifactorial followup of patients—monitoring of PSA values, digital rectal examinations (DRE), prostate imaging, and periodic prostate biopsies—while WW is commonly a relatively passive strategy—with interventions triggered by symptoms. However, there is a continuum of aggressiveness of followup for both AS and WW, as practiced in the community. The objective of this report is to summarize the existing literature regarding the role of AS in the management of early-stage, low-risk prostate cancer. Both the report and the corresponding NIH State-of-the-Science conference are a part of the NIH Consensus Development Program, the purpose of which is to evaluate the scientific evidence on a particular topic and develop a consensus statement that advances research in that area. Key Questions provided to the EPC for systematic review include: 1. How have the patient population and the natural history of prostate cancer diagnosed in the United States changed in the last 30 years? 2. How are active surveillance and other observational management strategies defined? 3. What factors affect the offer of, acceptance, and adherence to active surveillance? 4. What are the comparative short- and long-term outcomes of active surveillance versus immediate treatment with curative intent for localized prostate cancer? 5. What are the research needs regarding active surveillance (or watchful waiting) in localized prostate cancer?

Download or read book An Evidence Review of Active Surveillance in Men with Localized Prostate Cancer written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Radical prostatectomy and radiation therapy for prostate cancer have side effects and unclear survival benefits for early stage and low-risk disease. Prostate cancer often has an indolent natural history, making observational management strategies potentially appealing. PURPOSE: To systematically review the role of active surveillance for triggers to begin curative treatment in men with low-risk prostate cancer. Key Questions address changes in prostate cancer characteristics over time, definitions of active surveillance and other observational strategies, factors affecting the offer of, acceptance of, and adherence to active surveillance, the comparative effectiveness of active surveillance with curative treatments, and research gaps. DATA SOURCES: MEDLINE(r), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and existing systematic reviews, evidence reports, and economic evaluations. STUDY SELECTION: Randomized controlled trials and nonrandomized comparative studies of treatments, multivariable association studies, and studies of temporal trends in prostate cancer natural history. Only published, peer-reviewed, English-language articles were selected based on predetermined eligibility criteria. DATA EXTRACTION: A standardized protocol was used to extract details on design, diagnoses, interventions, predictive factors, outcomes, and study validity. DATA SYNTHESIS: In total, 80 studies provided information on epidemiologic trends; 56 on definitions of active surveillance; 42 on factors affecting the offer of, acceptance of, or adherence to observational management strategies; and 26 on comparative effectiveness. Increased diagnosis of early-stage prostate cancer due to prostate-specific antigen (PSA) testing, led to an increase in prostate cancer incidence from the mid-1980s to the mid-1990s. The prostate cancer-specific mortality rate decreased for all age groups from the early-1990s to 1999. Currently, patients are diagnosed with earlier stage and lower risk prostate cancers compared to the pre-PSA era. Over time, a lower proportion of men received observational management versus active treatment, even among those with low-risk disease. There was no standardized definition of active surveillance. Sixteen cohorts used different monitoring protocols, all with different combinations of periodic digital rectal examination, PSA testing, rebiopsy, and/or imaging findings. Predictors that a patient received no initial active treatment generally included older age, presence of comorbidities, lower Gleason score, lower tumor stage, lower diagnostic PSA, and lower disease progression risk group. No trial provided results comparing men with localized disease on active surveillance with surgery or radiation therapy. LIMITATIONS: Because of the nonstandardized usages of the terms "active surveillance" and "watchful waiting" and their intended and often mixed (both curative and palliative) treatment objectives, it was difficult to determine which study patients received active monitoring for triggers indicative of curative treatment and which observation for clinical symptoms indicative of palliative treatment. CONCLUSIONS: More men are being diagnosed with early stage prostate cancer. Whether active monitoring with a curative intent is an appropriate option for these men remains unclear. A standard, universally agreed-upon definition of active surveillance that clearly distinguishes it from watchful waiting and other observational management strategies is needed to help clarify scientific discourse on this topic. Ongoing clinical trials may provide information on the comparative effectiveness of active surveillance compared to immediate active treatment, but will require long term followup.

Download or read book Role of Active Surveillance in the Management of Localized Prostate Cancer written by National Cancer Institute (U.S.) and published by . This book was released on 2011 with total page 121 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Technical Aspects of Focal Therapy in Localized Prostate Cancer written by Eric Barret and published by Springer. This book was released on 2015-01-29 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: Focal therapy is a promising option for selected patients who have localized low or intermediate-risk prostate cancer, providing a compelling alternative between active surveillance and radical therapies by targeting the index lesion and preserving as much tissue as possible. Numerous cohort studies have already investigated multiple focal techniques, such as cryotherapy, high-intensity focused ultrasound, brachytherapy, photodynamic therapy, laser therapy, irreversible electroporation and cyberknife methods, all of which have demonstrated positive oncological outcomes with 70 to 90 % negative follow-up biopsy. These various ablative techniques have produced only minor side-effects concerning urinary function, a low rate of erectile dysfunction, and have demonstrated a limited rectal toxicity. As a result, the primary end-point has now shifted and a new strategy needs to be established for patient follow-up and for defining treatment failure. Written by international experts in the field, this book is mainly focused on new techniques, all of which are amply illustrated. Technical Aspects of Focal Therapy in Localized Prostate Cancer will be of great practical value to all urologists and oncologists.

Download or read book NIH State of the Science Conference Statement on Role of Active Surveillance in the Management of Men with Localized Prostate Cancer written by and published by . This book was released on 2011 with total page 27 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Gleason Grading System written by Epstein and published by Lippincott Williams & Wilkins. This book was released on 2013 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Gleason system is the most important prognostic marker of prostate cancer that is critical to patient management and drives therapies across all disciplines dealing with prostate cancer. In addition to an extensive number of photographs, this book discusses in detail clinically related issues that are crucial for the urologist, radiotherapist, and oncologists to know, such as predicting upgrading and downgrading from needle biopsy to radical prostatectomy, risk of Gleason grading change over time, significance of tertiary grade patterns, and prognosis and implications related to various Gleason scores and different therapies. Images that were particularly difficult for contributing pathologists sent in for consultation are used in addition to classic examples, as these cases are the most informative in showing the difficulties with Gleason grading.

Download or read book Active Surveillance in Men with Low to Intermediate Risk Localized Prostate Cancer written by Arnas Rakauskas and published by . This book was released on 2021 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thèse. Biologie. Médecine. 2021.

Download or read book Management of Prostate Cancer written by Michel Bolla and published by Springer Science & Business Media. This book was released on 2012-04-24 with total page 335 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides an exhaustive review of the current state of the art in the management of prostate cancer, from screening to treatment. A particular feature is the emphasis placed on the value of a multidisciplinary approach. The opening chapters address basic aspects including epidemiology, biology, and chemoprevention. The role of individual and mass screening is carefully appraised, and diagnosis, clinical work-up, and the role of active surveillance are discussed in detail. Subsequent chapters are devoted to each of the therapies that may be employed, including open and robotic laparoscopic radical prostatectomy, the various forms of radiation therapy, high-intensity focused ultrasound, cryotherapy, hormonal therapy, and targeted therapies and vaccination. Up-to-date data from clinical trials are included. The editors are members of the EORTC who have coordinated phase III EORTC trials and have worldwide reputations.

Download or read book Reading MRI of the Prostate written by Ananya Panda and published by Springer Nature. This book was released on 2020-01-01 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a concise guide to prostate cancer imaging. Beginning with normal MR anatomy, the book details the various components of a typical mpMRI protocol and discusses MR interpretation and reporting under PI-RADS version 2 guidelines. MR appearances of atypical locations of prostate cancer, common tumor mimics, MR-guided biopsy strategies, and the role of active surveillance are also covered. Reading MRI of the Prostate aims to help urologists and radiologists understand the evaluation and interpretation of prostate MRIs.

Download or read book Chemotherapy and Immunotherapy in Urologic Oncology written by Edouard J. Trabulsi and published by Springer Nature. This book was released on 2020-09-29 with total page 303 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is designed to familiarize clinical practitioners in systemic therapy options and medical management of urologic malignancies including prostate cancer, bladder and upper tract urothelial carcinoma, and renal cell carcinoma. Organized by organ system, the text highlights new therapies such as novel forms of androgen deprivation, cytotoxic chemotherapy, immune check point and immunomodulatory agents, and targeted therapies. Written by experts in the field, the book also reviews current chemotherapy and immunotherapy regimens for genitourinary malignancies and discusses indications, outcomes, and toxicities, as well as clinical trial concepts. Each of the book’s chapters offers a bulleted box of clinical pearls on the particular role of the APP. Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider is a resource for urologists, uro-radiologists, medical clinicians and family practitioners alike, familiarizing its audiences with systemic therapy regimens for urologic malignancies, as well as their expected outcomes and side effects.

Download or read book Management of Prostate Cancer written by Michel Bolla and published by Springer. This book was released on 2017-01-19 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book, now in an extensively revised second edition, provides an exhaustive review of the state of the art in the management of prostate cancer, from screening to treatment, with emphasis on a multidisciplinary approach. The editors are very excited about the outstanding new or updated contributions from the different expert authors. The opening chapters address basic aspects including epidemiology, pathology, biology, genetics, and chemoprevention. The role of individual and mass screening is carefully appraised, and extensive attention is devoted to diagnosis and clinical work-up by means of recently implemented investigations such as multiparametric MRI and choline PET-CT. The use of active surveillance is examined in detail. Subsequent chapters discuss the different therapies that may be employed: open and minimally invasive, including robot-assisted, radical prostatectomy, the various forms of radiation treatment, high-intensity focused ultrasound, cryotherapy, hormonal manipulations, chemotherapy, targeted therapies, and immunotherapy. Up-to-date results from practice-changing phase III randomized clinical trials are included and special insights are provided into the interpretation of results and the patient’s perspective.

Download or read book Prostate Cancer written by Ashutosh K. Tewari and published by John Wiley & Sons. This book was released on 2013-12-23 with total page 395 pages. Available in PDF, EPUB and Kindle. Book excerpt: Do you manage patients with prostate cancer? Could you use an expert guide examining all possible management options? Prostate Cancer: diagnosis and clinical management providesurologists and oncologists of all levels with up-to-date, evidence-based guidance to the diagnosis, treatment and clinical management of a disease which accounts for a quarter of all cancers affecting men. Designed to be as practical and accessible as possible, leading experts discuss key issues in prostate cancer management and examine how to deliver best practice in the clinical care of their patients. Topics covered include: What must be considered when counseling newly-diagnosed cancer patients Radical surgery options for prostate cancer Novel therapies for localized prostate cancer How should metastatic prostate cancer be diagnostic and managed What are the best methods of administering end of life care for the patient Brought to you by a highly experienced editor team, and containing key points, management algorithms, practice tips and the latest AUA and EAU clinical guidelines, this is the ideal consultation tool for doctors both on the wards and in the office.