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Archive for the ‘Diagnosis’ Category

NEW PROSTATE CANCER INFOLINK: The classification system used for prostate tumours within the gland may not be as much use in predicting the risk of cancer progressing as originally thought. “Current pT2 prostate cancer sub-stages may not have prognostic significance for intermediate term outcomes,” say researchers. READ MORE>

There are three pathological sub-classifications of prostate cancer that is confined to the prostate: T2a disease (cancer confined to one half of either the left or right lobe or side of the prostate), T2b disease (cancer that is found throughout one lobe or side of the prostate) and T2c disease (cancer that is evident in both lobes or sides of the prostate).

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URO TODAY: The risk of prostate cancer can be estimated in individual men primarily using PSA, but also prostate volume, previous biopsy status, family history and ethnicity. READ MORE>

Men at increased risk warrant enhanced surveillance and in the future may also be candidates for active risk reduction strategies.

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URO TODAY: Medical professionals should pay more attention to the emotional burden felt by prostate cancer patients, because their stress and strains during the time before treatment have a rather more emotional than physical character. READ MORE>

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URO TODAY: Not all patients with a biopsy prostate cancer Gleason score of  6 (< /=3 + 3) – usually considered safe – have low-risk disease, according to new German research. READ MORE>

High-risk Gleason score < /=3 + 3 patients have a similar risk profile as more favourable GS 3 + 4 patients. This finding warrants consideration when deciding on treatment.

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THE AUSTRALIAN: As Australians bask in the glow of Tasmanian-born Elizabeth Blackburn’s Nobel prize, a small Melbourne biotech firm is close to commercialising a diagnostic test based on her award-winning work that may  eventually work on prostate cancer. READ MORE>

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URO TODAY: A magnetic resonance imaging (MRI) scan before a biopsy is highly effective at detecting prostate cancer prostate cancer, particularly with tumours above a certain size. READ MORE>

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PROSTABLOG NZ: How best to advise doctors on what they should tell their patients about prostate cancer testing is a key issue facing the Parliamentary inquiry in NZ – but they’re not alone in their deliberations.

A global debate is going on about whether men are being properly counselled, whether they should be tested, whether they should even be told about testing.

A recent report in the US Archives of Internal Medicine referred to some Australian research produced last year that asked men about their doctor-patient discussions on prostate cancer. It’s worth revisiting:

Patient knowledge, interest in being screened, and anxiety associated with considering the benefits and limitations with prostate cancer screening may all influence the manner in which patients interact with their doctor and what role is adopted during the decision-making process. READ MORE> and HERE>

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URO TODAY: Measuring DNA in prostate cancer tissue samples and samples from adjacent benign areas helps predict if treatment for low-grade disease will be needed. READ MORE>

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URO TODAY: More US men were diagnosed with prostate cancer at a younger age and earlier stage in 2004-2005 than in earlier years and the racial disparity in cancer stage at diagnosis has decreased statistically significantly over time. READ MORE>

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mohPROSTABLOG NZ: New guidelines for general practitioners on how to handle men presenting with possible symptoms of prostate cancer (and other cancers) were released today by the NZ Ministry of Health.  READ MORE> and HERE (summary)>

The advice is contained in a 174-page report from the Ministry-backed NZ Guidelines Group called Suspected Cancer in Primary Care – Guidelines for investigation, referral and reducing ethnic disparities, which sets out background data and guiding principles on a range of cancers.

The report avoids getting into population-based screening – a major issue in detecting prostate cancer – saying:

Cancer screening, health promotion and prevention, case-finding in asymptomatic people, recurrence of a previous cancer and metastatic cancer were beyond the guideline scope and therefore are not included.

However, it does relent a little in the section on ethnicity and cancer treatment disparity:

Addressing the issue of cancer screening is outside the broad scope of this guideline. However, because of the impact that screening uptake can potentially have on disease outcomes, it is briefly included as part of this disparity chapter.

In the section on prostate cancer, it outlines the following advice for GPs seeing patients:

  1. A man presenting with macroscopic haematuria (blood in urine) should be referred urgently to a specialist;
  2. A man found to have an enlarged, smooth prostate on digital rectal examination and a normal PSA should only be referred to a specialist if they have macroscopic haematuria;
  3. An older man presenting with lower urinary tract symptoms (frequency, hesitancy, nocturia) should be recommended to have a digital rectal examination and a PSA test.

Men with erectile dysfunction are excluded from the referral guidelines.

The report also contains the latest data on cancer trends and explores in some depth the detection, care and mortality disparities between Maori, Pacific people and European Kiwis.

On the page listing organisations that endorse the report (so presumably have seen it already), the Cancer Society of NZ (which opposes population-based prostate cancer screening) is included – but not the Prostate Cancer Foundation of NZ (which supports it).

The report comes just a week before the Government’s Parliamentary inquiry into prostate cancer detection and treatment, which will hear its first submissions on Wednesday.

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