Hideyuki Akaza

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 77-80, 2005

Abstract Two decades have passed since the concept of Maximal Androgen Blockade (MAB) was first applied to the clinical treatment of prostate cancer. The theory is that by cutting off the supply of androgen from the adrenal gland, androgen blockade of the prostate could be made more complete. However, to date the clinical benefit of MAB has failed to live up to the theoretically expected effect. Having said that, fundamental research and clinical trials in recent years do indicate that the benefit of MAB is not merely an illusion. More >

Fred Saad

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 71-76, 2005

Abstract Modern medicine offers multiple treatment options to prolong the survival of patients with prostate cancer. However, in the absence of adequate supportive care, the systemic effects of prostate cancer and therapies such as androgen deprivation therapy (ADT) can undermine skeletal integrity, resulting in skeletal complications. Skeletal morbidity contributes to the erosion in quality of life in patients with prostate cancer. These patients are at risk for fractures from cancer treatment-induced bone loss and, later on, pathologic fractures from bone metastases, which may occur during the progression of prostate cancer. Several supportive care options are available More >

Abdullah M. Al Ghamdi, Michael A. S. Jewett

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 62-65, 2005

Abstract For patients with clinical stage I nonseminomatous germ cell tumor (NSGCT), the therapeutic options after orchiectomy are retroperitoneal lymphadenectomy, surveillance, and chemotherapy. Ideally the option selected will be based on an individualized assessment of the estimated risk of progression based on prognostic factors, so called risk-adapted treatment, to reduce overall burden of therapy while maintaining survival. It is possible to identify patients at low risk of progression who can be followed by active surveillance initially. Prognostic factors for high risk, while well defined, do not identify all patients at risk and those that are destined More >

Sophie G. Fletcher, Dan Theodorescu

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 58-61, 2005

Abstract Introduction: To date, randomized trials comparing radiotherapy to surgery for adenocarcinoma of the prostate are few. Lacking, are randomized comparisons between treatment modalities for the patient with high-risk locally advanced disease. Hence, there is a need to determine which approach offers superior results in these patients who comprise a significant proportion of those dying of prostate cancer. In this short review we highlight key studies that may provide interim answers while awaiting definitive results from randomized studies.
Material and methods: A MEDLINE literature review was performed of studies evaluating current treatment modalities for high-risk (TNM stage >T2b,… More >

Laurence H. Klotz

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 53-57, 2005

Abstract Purpose: To summarize the case for active surveillance for good risk prostate cancer with selective delayed intervention for rapid biochemical or grade progression, and review the results of a large phase II experience using this approach.
Materials and methods: A prospective phase II study of active surveillance with selective delayed intervention was initiated in 1995. Patients were managed initially with surveillance; those who had a PSA DT of 2 years or less, or grade progression on rebiopsy were offered radical intervention. The remainder were closely monitored.
Results: The cohort consists of 299 patients with good risk prostate cancer,… More >

Bob Djavan, Shirin Milani, Mesut Remzi

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 44-48, 2005

Abstract Biochemical parameters and pathological features as well as biopsy related morbidity of prostate cancer detected on second, third and fourth repeat prostate biopsy in men with a serum total PSA level between 4 ng/mL and 10 ng/mL were evaluated and compared to those cancers detected on initial prostate biopsy.
In a prospective European Prostate Cancer Detection study, 1051 men with a total PSA level between 4 ng/ mL and 10 ng/mL underwent transrectal ultrasound (TRUS)–guided sextant biopsy and two additional transition zone biopsies. All subjects whose biopsy samples were negative for prostate cancer (CaP) underwent a… More >

Jonathan Izawa¹, Daniel Kedar¹, Franklin Wong², Curtis A. Pettaway¹

Canadian Journal of Urology, Vol.12, Suppl.1, pp. 24-29, 2005

Abstract Introduction: Defining the presence or absence of microscopic metastases in the inguinal lymph nodes in patients with invasive penile squamous carcinoma and no palpable adenopathy remains crucial but difficult short of performing inguinal lymphadenectomy.
Methods: We reviewed the results of less invasive procedures such as traditional sentinel node biopsy and contemporary dynamic sentinel node biopsy aided by intraoperative lymphatic mapping (IOLM) to determine their role in the management of patients without palpable inguinal adenopathy.
Results: Inguinal node biopsy directed to the sentinel node area or region although initially promising was associated with a recurrence rate of 16% (24/150)… More >

Fred Saad¹, Paul Perrotte¹, François Bénard¹, Michael McCormack¹, Pierre I. Karakiewicz^1,2

Canadian Journal of Urology, Vol.12, Suppl.3, pp. 9-15, 2005

Abstract With current treatments, men usually survive many years after being diagnosed with prostate cancer. However, the systemic effects of prostate cancer and therapies such as androgen deprivation therapy (ADT) can undermine skeletal integrity, resulting in skeletal complications that may erode quality of life (QOL). Prostate cancer patients are at risk for fractures from cancer treatment-induced bone loss. In addition, they are also at risk for pathologic fractures, severe bone pain, and other sequelae from bone metastases, which almost invariably occur during the progression of prostate cancer. This review investigates the incidence and pathophysiology of bone More >

Pierre I. Karakiewicz, Paul Perrotte, Mike McCormack, François Peloquin, Jean-Paul Perreault, Philippe Arjane, Hughes Widmer, Fred Saad

Canadian Journal of Urology, Vol.12, Suppl.3, pp. 5-8, 2005

Abstract Introduction: Prostate biopsy strategies have greatly evolved over the past 2 decades.
Methods: We performed a literature review which addressed the initial and repeat biopsy schemes, pathologic risk factors for a positive repeat biopsy, and the ideal timing as well as the number of repeat biopsy sessions.
Results: Extended biopsy schemes (11-13 cores) should be used at initial and repeat biopsy. In the era of extended biopsy schemes, high-grade prostatic intraepithelial neoplasia no longer represents an independent predictor of prostate cancer on repeat biopsy. Conversely, the risk is appreciably increased with atypical small acinar proliferation, and its presence More >

Kevin C. Zorn, Sebastien Daigle, Francois Belzile, Le Mai Tu

Canadian Journal of Urology, Vol.12, No.1, pp. 2560-2563, 2005

Abstract Introduction: Since its description by Ulmsten, the TVT procedure has been proven to be safe and well tolerated. Bleeding and hematoma formation, although rare, can occur. Both conservative and surgical managements of this complication have been described.
Materials: We report the first case in which a pelvic branch of the obturator artery was embolized using angiography.
Results: Our patient was spared surgical exploration and retained the TVT tape.
Conclusion: Angiography with vessel embolization, when available, should be considered in the treatment of TVT-procedure retropubic hemorrhages. More >