October 2016—The Gleason classification for prostate cancer is by no means going away. But within the Gleason grade, the presence or absence of a DNA-repair gene mutation may signal who is likely to proceed to invasive cancer, says Colin C. Pritchard, MD, PhD, lead author of a study published Aug. 4 in the New England Journal of Medicine.
Read More »Studies split on pre-prostate TRUS biopsy screening
October 2016—Take a bar graph, any bar graph, and compare it to the natural landscape of the United States. If most of it resembles the Great Plains but the right-hand side starts looking more like Rocky Mountain territory . . . well, something interesting is going on.
Read More »Prostate pointers—PIN, ASAP, mimics, and markers
April 2016—Presenting on prostate cancer diagnosis at CAP ’15 last fall, David G. Bostwick, MD, MBA, recalled how he and Kenneth A. Iczkowski, MD, came up with the term “atypical small acinar proliferation suspicious for but not diagnostic of malignancy,” or ASAP, when they were at Mayo Clinic in 1997. They had scoured the Mayo files trying to spot the right term because they didn’t know what to call it, said Dr. Bostwick, who is medical director of Granger Diagnostics in Richmond, Va. “Should we call it suspicious but not diagnostic? Should we call it worrisome? Problematic?” Dr. Bostwick joked that his favorite expression seen in the files as a prostate biopsy finding in the 1980s was “semi-malignant,” saying, “I still don’t know what that means.”
Read More »The challenge of intraductal carcinoma of prostate
April 2016—In his CAP ’15 presentation last fall, David Bostwick, MD, MBA, referred to intraductal carcinoma of the prostate as “sort of the rage right now in the urologic pathology field.” “The problem is that it has multiple different definitions, and interobserver agreement with it is moderate at best,” said Dr. Bostwick, medical director of Granger Diagnostics in Richmond, Va. Even when pathologists can agree on an IDC diagnosis, he said, they aren’t on the same page about treatment.
Read More »No answers yet for prostate biopsy infection
January 2016—When Kimberle Chapin, MD, learned in 2014 that Lifespan’s urologists in Rhode Island wanted to begin screening transrectal prostate needle biopsy specimens for fluoroquinolone-resistant Escherichia coli, her first reaction was: “What?”
Read More »Prostate biopsy’s role in active surveillance
December 2015—As a treatment option, a strategy of active surveillance is becoming more widely accepted for early stage prostate cancer where risk of progression is low. But the new emphasis on active surveillance brings increased anxiety among prostate cancer patients about the information they’re getting from their physicians and how to deal with it. When M. Elizabeth H. Hammond, MD, participated four years ago in an open dialogue with prostate cancer patients at a conference on active surveillance, “I was really rocked by the things I heard,” she said. “The patients were angry and frustrated by our telling them active surveillance is a good treatment option.
Read More »Keeping an active eye on prostate cancer
April 2015—In December 2011, M. Elizabeth H. Hammond, MD, was a member of an expert panel for an NIH State-of-the-Science conference on the role of active surveillance in managing men with localized prostate cancer. At these public meetings patients can address the panelists.
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