Treatment options for high-risk prostate cancer perform similarly. In a single-institution study, radical prostatectomy was associated with worse biochemical failure, less clinical failure, and superior prostate cancer-specific mortality compared with radiation therapy and brachytherapy, reported Jay P. Ciezki, MD, at the 2016 Genitourinary Cancers Symposium in San Francisco.
Four current clinical practice guidelines on prostate cancer provide urologists with valuable, evidence-based decision points about diagnosis and treatment while raising questions that will likely be addressed by future research.
Years ago, decisions about screening men for PSA looked relatively straightforward. You offered screening to patients aged 40 or older, performed a biopsy on the ones with a total PSA >4.0 ng/mL, and offered treatment to those with positive biopsies. Today, conflicting guidelines and new techniques in cancer detection and treatment have left clinicians with a more complicated puzzle. The good news, experts say, is that physicians who put these pieces together stand a better chance of protecting their patients’ health than ever before.
New clinical practice guidelines for the management of prostate cancer from the National Comprehensive Cancer Network expand the number of patients who may be considered for active surveillance to those with favorable intermediate-risk prostate cancer.
In May 2013, the AUA and the American Society for Radiation Oncology released a joint guideline for radiotherapy after prostatectomy (J Urol 2013; 190:441-9). As a framework for practitioners caring for men who undergo surgery for treatment of prostate cancer, the evidence-based guideline contains nine statements that address use of adjuvant and salvage radiotherapy, conduct of a restaging evaluation, patient counseling, and a definition for biochemical recurrence
In its current iteration, the AUA's CRPC guideline contains 20 statements relating to treatments for six index patients defined by the presence or absence of metastatic disease, presence and degree of symptoms, ECOG performance status, and prior treatment with docetaxel (Taxotere) along with two statements on the use of preventive treatments for bone health.
To guide you through the 2016 AUA annual meeting and help maximize your time, Urology Times’ editorial board has reviewed the program to identify the key trends and noteworthy research at this year’s meeting.