Th. H. Van der Kwast, R. Postma, R. F. Hoedemaeker, G. J. L. H. van Leenders, F. H. Schröder

Canadian Journal of Urology, Vol.12, Suppl.3, pp. 16-20, 2005

Abstract Introduction: Prostate-specific antigen (PSA) testing of asymptomatic men may lead to the detection of "minimal" prostate cancers that are less likely to be associated with morbidity or mortality.
Objective: To examine the significance of various diagnostic outcomes from needle biopsies of the prostate in an asymptomatic population of men.
Methods: Prostatic needle biopsy findings were matched with those from radical prostatectomy specimens using data from the Rotterdam section of the European Randomized study of Screening for Prostate Cancer (ERSPC). Men, aged between 55 and 75 years, with elevated PSA levels underwent lateralized sextant needle biopsies. In corresponding radical… 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 In the era of extended biopsy schemes, high-grade prostatic intraepithelial neoplasia no longer represents an independent predictor of prostate cancer on repeat biopsy.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 >

Neil Fleshner, Rami Al Azab

Canadian Journal of Urology, Vol.12, Suppl.3, pp. 2-4, 2005

Abstract Introduction: If an agent can slow the growth of existing prostate cancer cells, it remains plausible that it may be effective as an adjunct to surgery, radiation or chemotherapy.
Discussion: Level-1 evidence will be needed in order to definitively prove the efficacy of agents as chemoprevention strategies for prostate cancer. Currently, only finasteride fulfills this criterion. Two major trials are underway that will assess the role of soy, vitamin E and selenium in prostate cancer prevention.
Conclusion: Tantalizing prospects for effective of prostate cancer exist. Fortunately, well-conducted randomized trials will allow us to answer many of these questions More >

Mana Al-Assiri, Zorn Kevin, Saleh Binsaleh, Peter T. K. Chan

Canadian Journal of Urology, Vol.12, No.1, pp. 2557-2559, 2005

Abstract Testicular cancer, which generally presents as a scrotal mass of variable sizes, is amongst the most common malignancies in men in the 15- to 35- year age group. A high inguinal orchiectomy is the standard approach for removal of a scrotal mass suspicious of being malignant. A recent report described a combined use of an inguinal incision, for early clamping of the spermatic cord, and a scrotal incision for orchiectomy of a large size testicular seminoma.1 We hereby report a case of a large size testis cancer removed using a single oblique inguinoscrotal incision. This More >

Richard Choo^1,2, Sarat Chander^1,3, Cyril Danjoux¹, Gerard Morton¹, Andrew Pearce¹, Gerrit Deboer¹, Ewa Szumacher¹, Andrew Loblaw¹, Patrick Cheung¹, Tony Woo¹

Canadian Journal of Urology, Vol.12, No.1, pp. 2547-2552, 2005

Abstract Purpose: To examine the change of hemoglobin in relation to testosterone level in non-metastatic prostate cancer patients receiving 2-year androgen suppression.
Methods and materials: A cohort of 72 patients, as participants of a phase II study, were treated with adjuvant radiotherapy plus 2-year androgen suppression after surgery to reduce the risk of relapse. Patients had laboratory tests including hemoglobin (Hb) and testosterone, and a quality of life questionnaire at regular intervals during the androgen suppression and post-androgen suppression period. The pattern of the change in Hb was evaluated in relation to testosterone level. The clinical significance of… More >

Alvaro Ramirez¹, Paul Perrotte¹, Luc Valiquette¹, Francois Benard¹, Mike McCormack¹, Fred Saad¹, Caroline Fournier¹, Shahrokh Shariat², Pierre I. Karakiewicz¹

Canadian Journal of Urology, Vol.12, No.1, pp. 2537-2542, 2005

Abstract Objectives: We explored the specific impact of urinary diversion type on HRQOL in men after cystectomy for bladder cancer. Our intent was to provide a basis for the development of a diversion-specific instrument.
Methods: We invited 13 ileal conduit and 12 orthotopic urinary diversion (neo-bladder) male patients to several open-ended interviews. We explored HRQOL domains that may have been affected by cystectomy and urinary diversion, and that could then be used to form a basis for a diversion-specific HRQOL measure.
Results: The average age of neo-bladder patients was 59 versus 65 years for ileal conduit patients. We identified More >

Himu Lukka¹, Tom Pickles², Gerard Morton³, Charles Catton⁴, Luis Souhami⁵, Padraig Warde⁴

Canadian Journal of Urology, Vol.12, No.1, pp. 2521-2531, 2005

Abstract In November 2000, the GU Radiation Oncologists of Canada had their first meeting, “Controversies in prostate cancer radiotherapy: consensus development”. The success of this meeting prompted a second meeting, held in December 2002 to discuss “The Way Forward” in prostate radiotherapy. Radiation oncologists from across Canada were brought together and integrated with key opinion leaders in prostate cancer treatment from throughout North America. The group debated current controversies including: intensity modulated radiotherapy (IMRT), external beam hypofractionation, high dose-rate brachytherapy, and hormone therapy in the management of prostate cancer. The meeting also sought to identify and… More >

Michael Eng¹, Liam Taylor², Marja Verhoef², Scott Ernst³, Bryan Donnelly⁴

Canadian Journal of Urology, Vol.12, No.2, pp. 2607-2613, 2005

Abstract Background: To date, few two-arm active treatment randomized control trials (RCTs) have compared prostate cancer therapies.
Objective: To examine the difference and similarities between the reasons for accepting and declining participation in a two-arm active treatment RCT comparing external beam radiation therapy (EBRT) versus cryotherapy.
Methods: Eleven men with prostate cancer, selected purposively, participated in a 30-minute post-treatment semi-structured interview. Interviews were transcribed verbatim, coded and analyzed for patterns with the assistance of the text management (TM) software (NVivo).
Results: RCT accepters participated principally with the hope of being randomized into the cryotherapy treatment arm. Consequently, randomization into the More >

Pierre I Karakiewicz, Jean-Baptiste Lattouf, Paul Perrotte, Luc Valiquette, François Bénard, Michael McCormack, Catherine Ménard, Thierry Lebeau, Serge Benayoun, Alvaro Ramirez, Simon Ouaknine, Fred Saad

Canadian Journal of Urology, Vol.12, No.2, pp. 2588-2592, 2005

Abstract Objective: The accuracy of 1997 Partin Tables' lymph node invasion (LNI) predictions exhibits important variability in different testing populations. We explored the LNI predictive accuracy in radical prostatectomy (RP) patients from Montreal, Canada. Moreover, we assessed the extent of change in predictive accuracy related to a modification of PSA coding from categorical to continuous.
Methods: We used pretreatment serum PSA, clinical stage, and biopsy Gleason sum from 537 men treated with RP to compare predicted and observed rates of LNI. Accuracy was quantified with receiver-operating characteristics curves.
Results: Accuracy was 0.760 in 369 evaluable patients, when categorically coded More >