in prostate cancer Donata Villari Azienda Ospedaliera Universitaria Careggi Firenze

Size: px
Start display at page:

Download "in prostate cancer Donata Villari Azienda Ospedaliera Universitaria Careggi Firenze"

Transcription

1 surgery as primary treatment in prostate cancer Donata Villari Sod Urologia II Azienda Ospedaliera Universitaria Careggi Firenze

2 Prostatectomia radicale (PR) Terapia "gold standard del tumore prostatico localizzato mediante rimozione in blocco di prostata e vescicole seminali Life expectancy >10 anni Età 75 anni (?) Stadio ct1b-t2, T2 N0, M0 T3a, GS>8, PSA<20ng/mL Prostatectomia retropubica open Prostatectomia videolaparoscopica Prostatectomia robotica

3 Stadiazione clinica accurata - il paziente ideale Età e performance status Familiarità ER PSA alla diagnosi Gleason score bioptico, numero e sede dei frustoli positivi T clinico IIEF-5

4 Fig. 4 Number of men aged 70 years and 80 years in more developed countries. Men over the age of 70 years are the fasted growing segment of the population. Data from 2010 to 2050 are projections <ce:cross-ref refid="bib8"> [8]</ce:cross-ref>. Jean-Pierre Droz, Lodovico Balducci, Michel Bolla, Mark Emberton, John M. Fitzpatrick, Steven Joniau, Michae... Background for the proposal of SIOG guidelines for the management of prostate cancer in senior adults Critical Reviews in Oncology/Hematology, Volume 73, Issue 1, 2010, 68-91

5 Fig. 6 Life expectancy in senior adults: a large variability reflecting health status variability. For a given age, a proportion of men in the top 25th percentile have a good health status and may have a longer life expectancy than men who are 5, 10 or eve... Jean-Pierre Droz, Lodovico Balducci, Michel Bolla, Mark Emberton, John M. Fitzpatrick, Steven Joniau, Michae... Background for the proposal of SIOG guidelines for the management of prostate cancer in senior adults Critical Reviews in Oncology/Hematology, Volume 73, Issue 1, 2010, 68-91

6 Fig. 7 General scheme for the treatment decision-making in senior adults with prostate cancer. Jean-Pierre Droz, Lodovico Balducci, Michel Bolla, Mark Emberton, John M. Fitzpatrick, Steven Joniau, Michae... Background for the proposal of SIOG guidelines for the management of prostate cancer in senior adults Critical Reviews in Oncology/Hematology, Volume 73, Issue 1, 2010, 68-91

7 Fig. 7 General scheme for the treatment decision-making in senior adults with prostate cancer. Jean-Pierre Droz, Lodovico Balducci, Michel Bolla, Mark Emberton, John M. Fitzpatrick, Steven Joniau, Michae... Background for the proposal of SIOG guidelines for the management of prostate cancer in senior adults Critical Reviews in Oncology/Hematology, Volume 73, Issue 1, 2010, 68-91

8

9 2014

10

11 Low risk < 25% PSA failure ng/ml T2a and Gleason 6 and PSA < 10 Intermediate risk 25-50% PSA failure T2b or Gleason 7 or PSA ng/ml High risk > 50 % PSA failure T2c or Gleason 8-10 or PSA> 20 ng/ml

12 Contemporary Trends in Low Risk Prostate Cancer: Risk Assessment and Treatment J Urol Matthew R. Cooperberg,* Jeannette M. Broering,* Philip W. Kantoff and Peter R. Carroll, 7 Biochemical survival among radical prostatectomy patients with low risk prostate cancer. Kaplan Meiercurvesfor biochemical recurrence free survivalamongamong patients with low risk prostate cancer undergoing radical prostatectomy, stratified by Cancer of the Prostate Risk Assessment (CAPRA) score.

13 L importanza delle categorie di rischio J Clin Oncol 2011 Click to edit the outline text format Second Outline Level Third Outline Level Fourth Outline Level Fifth Outline Level

14 La stadiazione clinica VOLUME GLEASON + PSA = STADIO PRESUNTO Partin AW Combination of Prostate-specific antigen,clinical stage, and Gleason score to predict pathological stage of localized prostate cancer :a multiisituzional update JAMA 1997

15

16 VOLUME DELLA NEOPLASIA

17 PENETRAZIONE CAPSULARE T2 (intra) T3(extra) T3(extra) T2 (intra)

18 Very promising technique Useful in selected cases. Could suggest to perform first or repeated biopsy

19

20 2014

21 Fascio vasculo-nervoso T1 T2

22

23 Achieving the balance between preserving the neurovascular bundles and eliminating the entire tumour continues to be a difficult task. The more the crucial structures are spared, the higher the chance that parts of the tumour will be left behind.

24 Trifecta outcomes in radical prostatectomy series according to the literature

25 Quality of life Fig. 1 Patient flow chart. CaPSURE = Cancer of the Prostate Strategic Urologic Research Endeavor; QoL = quality of life. Sanoj Punnen, Janet E. Cowan, June M. Chan, Peter R. Carroll, Matthew R. Cooperberg Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry European Urology, 2014 Median follow up:74 mo (50 102)

26 Adjusted mean summary scores for the Medical Outcomes Studies 36-item Short Form (a) physical function and (b) mental health, and for the University of California, Los Angeles, Prostate Cancer Index (c) sexual function, (d) sexual bother, (e) urinary function, (f) urinary bother, (g) bowel function, and (h) bowel bother are displayed over time by primary treatment type among 3294 men in the study cohort. BT =brachytherapy; EBRT =external beam radiotherapy; NSRP = nervesparing radicalprostatectomy;nonnsrp=non t t N NSRP nerve sparing radical prostatectomy PADT = primary androgen deprivation therapy; PRE = before treatment; WW/AS = watchful waiting/active surveillance. Sanoj Punnen, Janet E. Cowan, June M. Chan, Peter R. Carroll, Matthew R. Cooperberg Eur Urol 2014 Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry

27 Mean health-related quality of life summary scores at baseline for 3294 men in the study cohort by primary treatment modality BT = brachytherapy; EBRT = external beam radiotherapy; NSRP = nerve-sparing e radical prostatectomy; PADT = primary androgen deprivation therapy WW/AS = watchful waiting/active surveillance Health NSRP Non NSRP NSRP BT EBRT PADT WW/AS domain SF 36 Physical 93 (14) 88 (19) 82 (22) 78 (23) 74 (24) 71 (29) function Mental health UCLA PCI Sexual function 79 (16) 78 (16) 79 (15) 81 (15) 80 (16) 77 (19) 65 (26) 54 (28) 43 (30) 35 (28) 32 (26) 32 (28) Sexual bother 71 (34) 61 (37) 54 (39) 53 (40) 55 (41) 44 (41) Urinary 93 (12) 93 (13) 92 (13) 91 (14) 90 (16) 87 (22) function Urinary bother 89 (19) 85 (24) 83 (24) 81 (27) 79 (28) 77 (33) Bowel 90 (12) 88 (14) 88 (14) 87 (13) 84 (17) 86 (17) function Bowel 93 (16) 90 (20) 88 (21) 86 (23) 83 (25) 87 (22) bother Data are shown as mean (standard deviation).

28

29

30

31

32

33 2014

34

35 CHIRURGIA ROBOT-ASSISTED IN ITALIA L Italia è il secondo paese in Europa e il quarto nel mondo per numero di robot «Da Vinci» attualmente in uso: 1.U.S.A. (2000) 2.Giappone (138) 3.Francia (69) 4.Italia (64) Oltre 9000 procedure robotiche eseguite in Italia nel 2013

36 POLO DI CHIRURGIA ROBOTICA DELLA REGIONE TOSCANA procedure a Settembre2014 Dept. Of Urology, AOUC Careggi, Florence

37 POLO DI CHIRURGIA ROBOTICA DELLA REGIONE TOSCANA Stratificazione per tipo di intervento Dept. Of Urology, AOUC Careggi, Florence

38 POLO DI CHIRURGIA ROBOTICA DELLA REGIONE TOSCANA Vantaggi dell impiego del sistema robotico monodisciplinare in struttura con alto volume operatorio Rapida acquisizione di casistica adeguata Riduzionedella della curva diapprendimento Formazione rapida di una equipe Miglioramento outcomes oncologici e funzionali e riduzione dei costi

39 POLO DI CHIRURGIA ROBOTICA DELLA REGIONE TOSCANA RAPN Open VS. Simple Laparoscopic VS. Robot assisted procedures Dept. Of Urology, AOUC Careggi, Florence Jan Sept 2014 Open VLP Robot

40 Dati intraoperatori Clinica Urologica, AOUC Careggi Procedure Radical (non NS) (5,6%) NS Monolateral (18.3%) NS Bilateral (76.3%) Linfoadenectomy (8,9%) Operative time (min) mean (range) 208 (70 540) Consolle time (min) mean (range) 178 (40 510) Estimated Blood Loss (cc) mean (range) 240 (50 800)

41 Dati peri e postoperatori Clinica i Urologica, AOUC Careggi Open (1) Robot (2) P Catheter removal (day) 14 (10 21) 7 (6 12) Drainage removal (day) (3 34) 34) 3 (2 14) Length of hospitalization (days) 6.5 (4 36) 4 (2 16) 0.04 Positive surgical Open (1) Robot (2) P margins Overall 9.5% 16.1% < Apex Lateral Posterior pt2a b pt2c pt3a pt3b 4% 3.3% 2.1% 0 5.9% 11.2% 23.4% 5.1% 6.4% 4.6% 2.1% 13.2% 34.6% 35.7%

42 * Ratio drainage creatinine/serum creatinine 2 Complicanze Clinica i Urologica, AOUC Careggi Perioperative complications P OPEN (1) ROBOT (2) (INTRA + POST) Conversion to open 0 Bleeding requiring transfusion 3,4% 0,8% 0.08 Bleeding requiring reintervention 0,6% 0 Infections 5,2% 4,0% 0.55 Drain leakage for urine fistula * 4,6% 2,7% Reintervention for urine fistula 0 0 Drain leakage for lymphorrea 7,6% Not applicable Thrombosis/Embolisms 2,1% 1,3% 0,74 Bowel lesions (suture) 1,2% 0,4% 0.65 Overall surgical complications 24% 9,1% 0,0001 Clavien grade 3 4 surgical complications 4,9% 0,4% 0,0007 Cardiac/respiratory 3,4% 3,5% 0,89

43 Continenza Clinica i Urologica, AOUC Careggi URINARY CONTINENCE Open (1) Robot (2) P (zero pad) 1 month 46.8% 64.4 % month 79.5 % 82.7 % month 87.2 % 88.0 % month 92.3 % 94.1 % 0.559

44 Potenza Clinica i Urologica, AOUC Careggi NS Bilateral 6 months potency rate: Open (1) RALP (2) P 38.3% 77.7% 74.3% 79.5% 0.24 NS Monolateral 29% 17.3% 6 months potency rate: 43.0% 62.5% Non NS 32.7% 8.4% 6 months potency rate:

45 UTILIZZO DEL SISTEMA ROBOTICO «MONODISCIPLINARE» ANOMALIA??

46

Questions to Ask My Doctor About Prostate Cancer

Questions to Ask My Doctor About Prostate Cancer Questions to Ask My Doctor Being told you have prostate cancer can be scary and stressful. You probably have a lot of questions and concerns. Learning about the disease, how it s treated, and how this

More information

Quality of Life After Radical Prostatectomy

Quality of Life After Radical Prostatectomy Quality of Life After Radical Prostatectomy Bernard H. Bochner, MD FACS Attending Surgeon, Urology Service Vice Chairman, Department of Surgery Memorial Sloan-Kettering Cancer Center Quality of Life After

More information

Questions to ask my doctor: About prostate cancer

Questions to ask my doctor: About prostate cancer Questions to ask my doctor: About prostate cancer Being diagnosed with prostate cancer can be scary and stressful. You probably have a lot of questions and concerns. Learning about the disease, how it

More information

Historical Basis for Concern

Historical Basis for Concern Androgens After : Are We Ready? Mohit Khera, MD, MBA Assistant Professor of Urology Division of Male Reproductive Medicine and Surgery Scott Department of Urology Baylor College of Medicine Historical

More information

The Business of Prostate Cancer Care: A Clinician-Researcher s Perspective

The Business of Prostate Cancer Care: A Clinician-Researcher s Perspective The Business of Prostate Cancer Care: A Clinician-Researcher s Perspective David F. Penson, MD, MPH Departments of Urology and Preventive Medicine Keck School of Medicine University of Southern California

More information

Robotic Radical Prostatectomy: What s s the Advantage? Matthew T. Gettman, M.D. Associate Professor Department of Urology

Robotic Radical Prostatectomy: What s s the Advantage? Matthew T. Gettman, M.D. Associate Professor Department of Urology Robotic Radical Prostatectomy: What s s the Advantage? Matthew T. Gettman, M.D. Associate Professor Department of Urology Prostate Cancer Epidemiology: 2009 Estimated new cases: 230,000 Estimated deaths:

More information

SIOG Guidelines Update 2014 Prostate Cancer. Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon

SIOG Guidelines Update 2014 Prostate Cancer. Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon SIOG Guidelines Update 2014 Prostate Cancer Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon Droz JP, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, Dickinson L, Efstathiou

More information

Thomas A. Kollmorgen, M.D. Oregon Urology Institute

Thomas A. Kollmorgen, M.D. Oregon Urology Institute Thomas A. Kollmorgen, M.D. Oregon Urology Institute None 240,000 new diagnosis per year, and an estimated 28,100 deaths (2012) 2 nd leading cause of death from cancer in U.S.A. Approximately 1 in 6 men

More information

These rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma.

These rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma. Prostate Cancer OVERVIEW Prostate cancer is the second most common cancer diagnosed among American men, accounting for nearly 200,000 new cancer cases in the United States each year. Greater than 65% of

More information

Facing Prostate Cancer Surgery? Learn about minimally invasive da Vinci Surgery

Facing Prostate Cancer Surgery? Learn about minimally invasive da Vinci Surgery Facing Prostate Cancer Surgery? Learn about minimally invasive da Vinci Surgery The Condition: Prostate Cancer Your prostate is a walnut-sized gland that is part of the male reproductive system. The prostate

More information

PROSTATE CANCER. Get the facts, know your options. Samay Jain, MD, Assistant Professor,The University of Toledo Chief, Division of Urologic Oncology

PROSTATE CANCER. Get the facts, know your options. Samay Jain, MD, Assistant Professor,The University of Toledo Chief, Division of Urologic Oncology PROSTATE CANCER Get the facts, know your options Samay Jain, MD, Assistant Professor,The University of Toledo Chief, Division of Urologic Oncology i What is the Prostate? Unfortunately, you have prostate

More information

Prostate Cancer Treatment Comparison

Prostate Cancer Treatment Comparison Prostate Cancer Treatment Comparison Treatment Comparative Data Outcome Comparison: Surgery vs. Radiotherapy Outcome Radical Prostatectomy* Radiation** Survival duration compared to conservative disease

More information

Summary of Harms from Screening and Treatment for Prostate Cancer

Summary of Harms from Screening and Treatment for Prostate Cancer DRAFT: Advice from Dr John Childs MoH advisor Summary of Harms from Screening and Treatment for Prostate Cancer There are minimal risks directly attributable to PSA testing or transrectal ultrasound (TRUS)

More information

Prostate Cancer Treatment Comparison

Prostate Cancer Treatment Comparison Prostate Cancer Treatment Comparison Treatment Comparative Data Outcome Comparison: Surgery vs. Radiotherapy Outcome Radical Prostatectomy* Radiation** Survival duration compared to conservative disease

More information

Prostate Cancer. Treatments as unique as you are

Prostate Cancer. Treatments as unique as you are Prostate Cancer Treatments as unique as you are UCLA Prostate Cancer Program Prostate cancer is the second most common cancer among men. The UCLA Prostate Cancer Program brings together the elements essential

More information

Cancer research in the Midland Region the prostate and bowel cancer projects

Cancer research in the Midland Region the prostate and bowel cancer projects Cancer research in the Midland Region the prostate and bowel cancer projects Ross Lawrenson Waikato Clinical School University of Auckland MoH/HRC Cancer Research agenda Lung cancer Palliative care Prostate

More information

Gleason Score. Oncotype DX GPS. identified for. about surveillance. time to get sophisticated

Gleason Score. Oncotype DX GPS. identified for. about surveillance. time to get sophisticated patient: MARK SMITH PSA 6.2 Gleason Score 6 Oncotype DX GPS 8 identified for active surveillance time to get sophisticated about surveillance Accurate prediction of prostate cancer risk is needed at the

More information

Therapies for Prostate Cancer and Treatment Selection

Therapies for Prostate Cancer and Treatment Selection Prostatic Diseases Therapies for Prostate Cancer and Treatment Selection JMAJ 47(12): 555 560, 2004 Yoichi ARAI Professor and Chairman, Department of Urology, Tohoku University Graduate School of Medicine

More information

Precise, Minimally Invasive Prostate Cancer Removal

Precise, Minimally Invasive Prostate Cancer Removal Precise, Minimally Invasive Prostate Cancer Removal Learn why da Vinci Surgery may be your best treatment option 1 Beyond Minimally Invasive For Prostate Cancer 1 Facing Prostate Cancer Prostate cancer

More information

East Lancashire Surgical Robot

East Lancashire Surgical Robot East Lancashire Surgical Robot For ALL patients in Lancashire Prostate cancer claims the life of one man every hour and by 2030 will be the most common cancer; it is already the most common male cancer.

More information

da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy)

da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy) da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy) Prostate Cancer Overview Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

Management of Localized Prostate Cancer. Treatment Options

Management of Localized Prostate Cancer. Treatment Options Management of Localized Prostate Cancer Surgery James A. Eastham, MD Chief, Urology Service Memorial lsloan Kettering Cancer Center Treatment Options 1. Active surveillance/watchful waiting 2. Focal therapy

More information

Real Time MRI guided Focal Laser Ablation Therapy for Prostate Cancer

Real Time MRI guided Focal Laser Ablation Therapy for Prostate Cancer Real Time MRI guided Focal Laser Ablation Therapy for Prostate Cancer A/Prof Celi Varol and Dr Orit Raz Uro-Oncologist Nepean and Macquarie Hospital Trial at Macquarie University Hospital Ethics board

More information

SRO Tutorial: Prostate Cancer Treatment Options

SRO Tutorial: Prostate Cancer Treatment Options SRO Tutorial: Prostate Cancer Treatment Options May 7th, 2010 Daniel M. Aebersold Klinik und Poliklinik für Radio-Onkologie Universität Bern, Inselspital Is cure necessary in those in whom it may be possible,

More information

7. Prostate cancer in PSA relapse

7. Prostate cancer in PSA relapse 7. Prostate cancer in PSA relapse A patient with prostate cancer in PSA relapse is one who, having received a primary treatment with intent to cure, has a raised PSA (prostate-specific antigen) level defined

More information

Prostate Cancer What Are the Outcomes of Radical Prostatectomy for High-risk Prostate Cancer?

Prostate Cancer What Are the Outcomes of Radical Prostatectomy for High-risk Prostate Cancer? Prostate Cancer What Are the Outcomes of Radical Prostatectomy for High-risk Prostate Cancer? Stacy Loeb, Edward M. Schaeffer, Bruce J. Trock, Jonathan I. Epstein, Elizabeth B. Humphreys, and Patrick C.

More information

4/8/13. Pre-test Audience Response. Prostate Cancer 2012. Screening and Treatment of Prostate Cancer: The 2013 Perspective

4/8/13. Pre-test Audience Response. Prostate Cancer 2012. Screening and Treatment of Prostate Cancer: The 2013 Perspective Pre-test Audience Response Screening and Treatment of Prostate Cancer: The 2013 Perspective 1. I do not offer routine PSA screening, and the USPSTF D recommendation will not change my practice. 2. In light

More information

CYBERKNIFE RADIOSURGERY FOR EARLY PROSTATE CANCER Rationale and Results. Alan Katz MD JD Flushing, NY USA

CYBERKNIFE RADIOSURGERY FOR EARLY PROSTATE CANCER Rationale and Results. Alan Katz MD JD Flushing, NY USA CYBERKNIFE RADIOSURGERY FOR EARLY PROSTATE CANCER Rationale and Results Alan Katz MD JD Flushing, NY USA Prostate Ablative Therapy Over the last 10 years our therapy has improved bned rates for LDR/HDR

More information

Secondary Cancer and Relapse Rates Following Radical Prostatectomy for Prostate-Confined Cancer

Secondary Cancer and Relapse Rates Following Radical Prostatectomy for Prostate-Confined Cancer Copyright E 2007 Journal of Insurance Medicine J Insur Med 2007;39:242 250 MORTALITY Secondary Cancer and Relapse Rates Following Radical Prostatectomy for Prostate-Confined Cancer David Wesley, MD; Hugh

More information

PATIENT GUIDE. Localized Prostate Cancer

PATIENT GUIDE. Localized Prostate Cancer PATIENT GUIDE Localized Prostate Cancer The prostate* is part of the male reproductive system. It is about the same size as a walnut and weighs about an ounce. As pictured in Figure 1, the prostate is

More information

Treatment of Incidental Prostate Cancer Diagnosed during BPH Surgery with Radical Prostatectomy: Appropriate or over Treatment?

Treatment of Incidental Prostate Cancer Diagnosed during BPH Surgery with Radical Prostatectomy: Appropriate or over Treatment? Journal of Cancer Therapy, 2012, 3, 256-262 http://dx.doi.org/10.4236/jct.2012.34036 Published Online August 2012 (http://www.scirp.org/journal/jct) Treatment of Incidental Prostate Cancer Diagnosed during

More information

The 4Kscore blood test for risk of aggressive prostate cancer

The 4Kscore blood test for risk of aggressive prostate cancer The 4Kscore blood test for risk of aggressive prostate cancer Prostate cancer tests When to use the 4Kscore Test? Screening Prior to 1 st biopsy Prior to negative previous biopsy Prognosis in Gleason 6

More information

Quality of Life After Open or Robotic Prostatectomy, Cryoablation or Brachytherapy for Localized Prostate Cancer

Quality of Life After Open or Robotic Prostatectomy, Cryoablation or Brachytherapy for Localized Prostate Cancer Quality of Life After Open or Robotic Prostatectomy, Cryoablation or Brachytherapy for Localized Prostate Cancer John B. Malcolm, Michael D. Fabrizio,* Bethany B. Barone, Robert W. Given, Raymond S. Lance,

More information

Your Health Matters. Localized Prostate Cancer and Its Treatment

Your Health Matters. Localized Prostate Cancer and Its Treatment Your Health Matters Localized Prostate Cancer and Its Treatment Greetings! Understanding prostate cancer and choosing among the various treatment options can be a difficult and anxiety-arousing process.

More information

CMScript. Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014

CMScript. Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014 Background CMScript Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014 Prostate cancer is second only to lung cancer as the leading cause of cancer-related deaths in men. It is

More information

Does my patient need more therapy after prostate cancer surgery?

Does my patient need more therapy after prostate cancer surgery? Does my patient need more therapy after prostate cancer surgery? Contact the GenomeDx Patient Care Team at: 1.888.792.1601 (toll-free) or e-mail: client.service@genomedx.com Prostate Cancer Classifier

More information

Roswell Park scientists and clinicians:

Roswell Park scientists and clinicians: The Prostate Cancer Center at Roswell Park Connects You to Nationally Recognized Experts for State-of-the-Art Treatment Options and Compassionate, Evidence-based Care Founded in 1898, Roswell Park Cancer

More information

Prostate cancer is the second most

Prostate cancer is the second most Treatment Options for Localized Prostate Cancer RAVINDER MOHAN, MD, PhD, and PAUL F. SCHELLHAMMER, MD Eastern Virginia Medical School, Norfolk, Virginia In the United States, more than 90 percent of prostate

More information

Incidents and complications in our first 200 davinci radical prostatectomies

Incidents and complications in our first 200 davinci radical prostatectomies Incidents and complications in our first 200 davinci radical prostatectomies II International Symposium Robotic Surgery and New technologies in Urology. Bilbao 5-65 March,, 2009 PATIENTS AND METHODS Period:

More information

855-DRSAMADI or 212-241-8779

855-DRSAMADI or 212-241-8779 SMART SURGERY NEWS MARCH 2013 Dr. David Samadi 855-DRSAMADI or 212-241-8779 YOUR PROSTATE CANCER NEWS PREVENTION DIAGNOSIS TREATMENT LIFE AFTER PROSTATE CANCER PREVENTION Prostate Cancer Need-to-Knows

More information

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical Summary. 111 Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical recurrence (BCR) is the first sign of recurrent

More information

PROSTATE CANCER. Diagnosis and Treatment

PROSTATE CANCER. Diagnosis and Treatment Diagnosis and Treatment Table of Contents Introduction... 1 Patient and Coach Information... 1 About Your Prostate... 1 What You Should Know About Prostate Cancer... 2 Screening and Diagnosis... 2 Digital

More information

A New Biomarker in Prostate Cancer Care: Oncotype Dx. David M Albala, MD Chief of Urology Crouse Hospital Syracuse, NY

A New Biomarker in Prostate Cancer Care: Oncotype Dx. David M Albala, MD Chief of Urology Crouse Hospital Syracuse, NY A New Biomarker in Prostate Cancer Care: Oncotype Dx David M Albala, MD Chief of Urology Crouse Hospital Syracuse, NY Learning Objectives Review the current challenges in the prediction and prognosis of

More information

ACCEPTED MANUSCRIPT. Understanding the performance of active surveillance selection criteria in diverse urology practices

ACCEPTED MANUSCRIPT. Understanding the performance of active surveillance selection criteria in diverse urology practices Understanding the performance of active surveillance selection criteria in diverse urology practices Scott R. Hawken BS*,1, Paul R. Womble MD*,1, Lindsey A. Herrel MD 1, Zaojun Ye MS 1, Susan M. Linsell

More information

Treating Prostate Cancer

Treating Prostate Cancer Treating Prostate Cancer A Guide for Men With Localized Prostate Cancer Most men have time to learn about all the options for treating their prostate cancer. You have time to talk with your family and

More information

Prostate cancer. Christopher Eden. The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing.

Prostate cancer. Christopher Eden. The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing. Prostate cancer Christopher Eden The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing. Screening Screening men for PCa (prostate cancer) using PSA (Prostate Specific Antigen blood

More information

Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto

Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto Clinical Trials and Radiation Treatment Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto What I will cover.. A little about radiation treatment The clinical trials

More information

FAQ About Prostate Cancer Treatment and SpaceOAR System

FAQ About Prostate Cancer Treatment and SpaceOAR System FAQ About Prostate Cancer Treatment and SpaceOAR System P. 4 Prostate Cancer Background SpaceOAR Frequently Asked Questions (FAQ) 1. What is prostate cancer? The vast majority of prostate cancers develop

More information

da Vinci Prostatectomy (Robotically Assisted Radical Prostatectomy)

da Vinci Prostatectomy (Robotically Assisted Radical Prostatectomy) Peninsula Urology Center, Inc. Dieter Bruno, M.D, F.A.C.S Chris Threat, M.D. 3351 El Camino. Real, Suite 101 Atherton, CA 94027 (650) 306-1016 dbrunomd@pucenter.com http://www.pucenter.com/ da Vinci Prostatectomy

More information

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative.

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative. Adjuvante und Salvage Radiotherapie Ludwig Plasswilm Klinik für Radio-Onkologie, KSSG CANCER CONTROL WITH RADICAL PROSTATECTOMY ALONE IN 1,000 CONSECUTIVE PATIENTS 1983 1998 Clinical stage T1 and T2 Mean

More information

Defining Sexual Outcomes after Treatment for Localized Prostate Carcinoma

Defining Sexual Outcomes after Treatment for Localized Prostate Carcinoma 1773 Defining Sexual Outcomes after Treatment for Localized Prostate Carcinoma Leslie R. Schover, Ph.D. 1 Rachel T. Fouladi, Ph.D. 1 Carla L. Warneke, M.S. 1 Leah Neese, M.A. 1 Eric A. Klein, M.D. 2 Craig

More information

A Woman s Guide to Prostate Cancer Treatment

A Woman s Guide to Prostate Cancer Treatment A Woman s Guide to Prostate Cancer Treatment Supporting the man in your life Providing prostate cancer support and resources for women and families WOMEN AGAINST PROSTATE CANCER A Woman s Guide to Prostate

More information

Proton Therapy for Prostate Cancer: Your Questions, Our Answers.

Proton Therapy for Prostate Cancer: Your Questions, Our Answers. Proton Therapy for Prostate Cancer: Your Questions, Our Answers. When you re looking for the right treatment for your prostate cancer, nothing s more important than accurate information. Read on, and learn

More information

DIAGNOSIS OF PROSTATE CANCER

DIAGNOSIS OF PROSTATE CANCER DIAGNOSIS OF PROSTATE CANCER Determining the presence of prostate cancer generally involves a series of tests and exams. Before starting the testing process, the physician will ask questions about the

More information

Radiation Therapy for Prostate Cancer: Treatment options and future directions

Radiation Therapy for Prostate Cancer: Treatment options and future directions Radiation Therapy for Prostate Cancer: Treatment options and future directions David Weksberg, M.D., Ph.D. PinnacleHealth Cancer Institute September 12, 2015 Radiation Therapy for Prostate Cancer: Treatment

More information

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40. A.D.A.M. Medical Encyclopedia. Prostate cancer Cancer - prostate; Biopsy - prostate; Prostate biopsy; Gleason score Last reviewed: October 2, 2013. Prostate cancer is cancer that starts in the prostate

More information

Prostate Cancer Action Plan: Choosing the treatment that s right for you

Prostate Cancer Action Plan: Choosing the treatment that s right for you Prostate Cancer Action Plan: Choosing the treatment that s right for you Segment 1: Introduction Trust me, there's a better way to choose a treatment for your prostate cancer. Watching this program is

More information

the risk of developing skeletal metastases or local recurrence.

the risk of developing skeletal metastases or local recurrence. Original Article SERUM PSA AND CLINICAL RECURRENCE AFTER RRP FOR LOCALIZED PROSTATE CANCER HAUKAAS et al. Is preoperative serum prostate-specific antigen level significantly related to clinical recurrence

More information

Basics on Treatment for prostate cancer

Basics on Treatment for prostate cancer Basics on Treatment for prostate cancer SECTION 1: TREATMENTS This pamphlet provides information about different treatments for prostate cancer including what to expect and any risks and side-effects.

More information

For further information on screening and early detection of prostate cancer, see the Section entitled Screening for Prostate Cancer.

For further information on screening and early detection of prostate cancer, see the Section entitled Screening for Prostate Cancer. Prostate Cancer For many older men, prostate cancer may be present but never cause symptoms or problems and many men will die with their prostate cancer rather than of their prostate cancer. Yet it remains

More information

Beyond the PSA: Genomic Testing in Localized Prostate Cancer

Beyond the PSA: Genomic Testing in Localized Prostate Cancer Beyond the PSA: Genomic Testing in Localized Prostate Cancer Kelvin A. Moses, MD, PhD Vanderbilt University Medical Center Wednesday, December 2, 2015 5:00 p.m. ET/2:00 p.m. PT About ZERO ZERO s mission

More information

Prostate cancer volume at biopsy vs. findings at Prostatectomy

Prostate cancer volume at biopsy vs. findings at Prostatectomy Prostate cancer volume at biopsy vs. findings at Prostatectomy May 2005 By Shelly Smits, RHIT, CCS, CTR Ian Thompson, MD Data Source: Cancer registry data of prostate cancer treated with prostatectomy

More information

Oncological and functional outcomes of laparoscopic radical prostatectomy following fellowship training.

Oncological and functional outcomes of laparoscopic radical prostatectomy following fellowship training. Oncological and functional outcomes of laparoscopic radical prostatectomy following fellowship training. Journal: BJU International Manuscript ID: Draft Manuscript Type: Original Article Date Submitted

More information

Advances in Diagnostic and Molecular Testing in Prostate Cancer

Advances in Diagnostic and Molecular Testing in Prostate Cancer Advances in Diagnostic and Molecular Testing in Prostate Cancer Ashley E. Ross MD PhD Assistant Professor Urology, Oncology, Pathology Johns Hopkins School of Medicine September 24, 2015 1 Disclosures

More information

Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward

Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward 33 rd Annual Internal Medicine Update December 5, 2015 Ryan C. Hedgepeth, MD, MS Chief of

More information

Prostate Cancer Patients Report on Benefits of Proton Therapy

Prostate Cancer Patients Report on Benefits of Proton Therapy Prostate Cancer Patients Report on Benefits of Proton Therapy Dobson DaVanzo & Associates, LLC Vienna, VA 703.260.1760 www.dobsondavanzo.com Prostate Cancer Patients Report on Benefits of Proton Therapy

More information

Newly Diagnosed Prostate Cancer: Understanding Your Risk

Newly Diagnosed Prostate Cancer: Understanding Your Risk Newly Diagnosed Prostate Cancer: Understanding Your Risk When the urologist calls with the life-changing news that your prostate biopsy is positive for prostate cancer, an office appointment is made to

More information

Use Of Testosterone In Men With Prostate Cancer. Traditional view: T is dangerous for PCa

Use Of Testosterone In Men With Prostate Cancer. Traditional view: T is dangerous for PCa Use Of Testosterone In Men With Prostate Cancer Abraham Morgentaler, MD, FACS Director, Men s s Health Boston Associate Clinical Professor of Urology Harvard Medical School Boston, USA Traditional view:

More information

Robotic Radical Prostatectomy

Robotic Radical Prostatectomy Robotic Radical Prostatectomy This booklet gives you information about a procedure which uses keyhole surgery to remove the prostate using robot assistance. It is called Robot Assisted Laparoscopic Prostatectomy

More information

New Technologies in Surgery

New Technologies in Surgery New Technologies in Surgery Jim C. Hu MD, MPH Center for Advanced Surgical and Interventional Technology (CASIT) Director of Robotic and Minimally Invasive Surgery Associate Professor Department of Urology

More information

An Introduction to PROSTATE CANCER

An Introduction to PROSTATE CANCER An Introduction to PROSTATE CANCER Being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the

More information

Early Prostate Cancer: Questions and Answers. Key Points

Early Prostate Cancer: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Early Prostate Cancer:

More information

P R O S T A T E C A N C E R

P R O S T A T E C A N C E R The Management of Localized P R O S T A T E C A N C E R Patient Guide Based on recommendations from the Prostate Cancer Clinical Guideline Panel of the American Urological Association The AUA Foundation

More information

Understanding the. Controversies of. testosterone replacement. therapy in hypogonadal men with prostate cancer. controversies surrounding

Understanding the. Controversies of. testosterone replacement. therapy in hypogonadal men with prostate cancer. controversies surrounding Controversies of testosterone replacement therapy in hypogonadal men with prostate cancer Samuel Deem, DO CULTURA CREATIVE (RF) / ALAMY Understanding the controversies surrounding testosterone replacement

More information

Focal therapy for prostate cancer: seriously or seriously? Disclosures

Focal therapy for prostate cancer: seriously or seriously? Disclosures Focal therapy for prostate cancer: seriously or seriously? Mitchell Kamrava, MD Assistant Clinical Professor Department of Radiation Oncology University of California Los Angeles Disclosures Speaking honorarium

More information

Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer

Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer Jonathan A. Eandi,* Brian A. Link, Rebecca A. Nelson, David Y. Josephson, Clayton Lau, Mark H. Kawachi and Timothy

More information

ROBOTIC ASSISTED RADICAL PROSTATECTOMY

ROBOTIC ASSISTED RADICAL PROSTATECTOMY Associates: Dr Kim Pese Dr Kym Horsell Dr Michael Chong Dr Jason Lee The Tennyson Centre Suite 19, First Floor 520 South Road Kurralta Park SA 5037 Appointments: 08 8292 2399 Fax: 08 8292 2388 admin@urologicalsolutions.com.au

More information

The PSA Controversy: Defining It, Discussing It, and Coping With It

The PSA Controversy: Defining It, Discussing It, and Coping With It The PSA Controversy: Defining It, Discussing It, and Coping With It 11 TH ANNUAL SYMPOSIUM ON MEN S HEALTH June 12, 2013 The PSA Controversy Defining It, Discussing It and Coping With It As of May 2012,

More information

Prostate Cancer 2014

Prostate Cancer 2014 Prostate Cancer 2014 Eric A. Klein, M.D. Chairman Glickman Urological and Kidney Institute Professor of Surgery Cleveland Clinic Lerner College of Medicine Incidence rates, US Men Mortality Rates, US Men

More information

High Intensity Focused Ultrasound for Prostate Cancer

High Intensity Focused Ultrasound for Prostate Cancer High Intensity Focused Ultrasound for Prostate Cancer Patient Information Exploring a Minimally Invasive Prostate Cancer Therapy The Choice for HIFU Worldwide A Patient s Guide to Prostate Cancer and Sonablate

More information

Short-term outcome of patients with robot-assisted versus open radical prostatectomy: for localised carcinoma of prostate

Short-term outcome of patients with robot-assisted versus open radical prostatectomy: for localised carcinoma of prostate O R I G I N A L A R T I C L E Short-term outcome of patients with robot-assisted versus open radical prostatectomy: for localised carcinoma of prostate KL Lo CF Ng Cleo NY Lam Simon SM Hou KF To Sidney

More information

Neoadjuvant and Adjuvant Hormone Therapy: How and When?

Neoadjuvant and Adjuvant Hormone Therapy: How and When? european urology supplements 7 (2008) 747 751 available at www.sciencedirect.com journal homepage: www.europeanurology.com Neoadjuvant and Adjuvant Hormone Therapy: How and When? Hein Van Poppel * Department

More information

ACTION PLAN. Choosing the treatment that s right for you. Endorsed by Kaiser Permanente Inter-regional Chiefs of Urology

ACTION PLAN. Choosing the treatment that s right for you. Endorsed by Kaiser Permanente Inter-regional Chiefs of Urology Prostate Cancer ACTION PLAN Choosing the treatment that s right for you Video Series Guidebook View videos at kpactionplans.org Endorsed by Kaiser Permanente Inter-regional Chiefs of Urology 2015 Kaiser

More information

NATURAL HISTORY OF CLINICALLY STAGED LOW- AND INTERMEDIATE-RISK PROSTATE CANCER TREATED WITH MONOTHERAPEUTIC PERMANENT INTERSTITIAL BRACHYTHERAPY

NATURAL HISTORY OF CLINICALLY STAGED LOW- AND INTERMEDIATE-RISK PROSTATE CANCER TREATED WITH MONOTHERAPEUTIC PERMANENT INTERSTITIAL BRACHYTHERAPY doi:1.116/j.ijrobp.9..1 Int. J. Radiation Oncology Biol. Phys., Vol. 76, No., pp. 349 354, 1 Copyright Ó 1 Elsevier Inc. Printed in the USA. All rights reserved 36-316/1/$ see front matter CLINICAL INVESTIGATION

More information

Welcome to the February Edition of the Robotic Oncology Newsletter! February 2012

Welcome to the February Edition of the Robotic Oncology Newsletter! February 2012 NEWSLETTER FROM DR. DAVID SAMADI TEL: 1-855-DRSAMADI or 1-212-241-8779 FAX: 1-212-308-6107 www.roboticoncology.com www.smart-surgery.com Welcome to the February Edition of the Robotic Oncology Newsletter!

More information

A New Anatomic Approach for Robot-Assisted Laparoscopic Prostatectomy: A Feasibility Study for Completely Intrafascial Surgery

A New Anatomic Approach for Robot-Assisted Laparoscopic Prostatectomy: A Feasibility Study for Completely Intrafascial Surgery EUROPEAN UROLOGY 58 (2010) 457 461 available at www.sciencedirect.com journal homepage: www.europeanurology.com Case Series of the Month A New Anatomic Approach for Robot-Assisted Laparoscopic Prostatectomy:

More information

Local Coverage Determination (LCD): MolDX: Genomic Health Oncotype DX Prostate Cancer Assay (L36153)

Local Coverage Determination (LCD): MolDX: Genomic Health Oncotype DX Prostate Cancer Assay (L36153) Local Coverage Determination (LCD): MolDX: Genomic Health Oncotype DX Prostate Cancer Assay (L36153) Contractor Information Contractor Name Palmetto GBA LCD Information Document Information LCD ID L36153

More information

The PLCO Trial Not a comparison of Screening vs no Screening

The PLCO Trial Not a comparison of Screening vs no Screening PSA Screening: Science, Politics and Uncertainty David F. Penson, MD, MPH Hamilton and Howd Chair of Urologic Oncology Professor and Chair, Department of Urologic Surgery Director, Center for Surgical

More information

EUROPEAN UROLOGY 65 (2014) 610 619

EUROPEAN UROLOGY 65 (2014) 610 619 EUROPEAN UROLOGY 65 (2014) 610 619 available at www.sciencedirect.com journal homepage: www.europeanurology.com Prostate Cancer Comparisons of the Perioperative, Functional, and Oncologic Outcomes After

More information

Saturation Biopsy vs. 3D Spatial Biopsy vs. Free Hand Ultrasound biopsy for Targeted Prostate Cancer Therapies

Saturation Biopsy vs. 3D Spatial Biopsy vs. Free Hand Ultrasound biopsy for Targeted Prostate Cancer Therapies Saturation Biopsy vs. 3D Spatial Biopsy vs. Free Hand Ultrasound biopsy for Targeted Prostate Cancer Therapies John F. Ward, MD Assistant Professor University of Texas M. D. Anderson Cancer Center Ablation

More information

Individual Prediction

Individual Prediction Individual Prediction Michael W. Kattan, Ph.D. Professor of Medicine, Epidemiology and Biostatistics, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Chairman, Department

More information

Cyberknife Information Guide. Prostate Cancer Treatment

Cyberknife Information Guide. Prostate Cancer Treatment Cyberknife Information Guide Prostate Cancer Treatment CYBERKNIFE INFORMATION GUIDE PROSTATE CANCER TREATMENT As a patient recently diagnosed with localized prostate cancer, it is important that you familiarize

More information

Development of prostate cancer research database with the clinical data warehouse technology for direct linkage with electronic medical record system

Development of prostate cancer research database with the clinical data warehouse technology for direct linkage with electronic medical record system Original Article Prostate Int 2013;1(2):59-64 P R O S T A T E INTERNATIONAL Development of prostate cancer research database with the clinical data warehouse technology for direct linkage with electronic

More information

Prostate Cancer Treatment

Prostate Cancer Treatment Scan for mobile link. Prostate Cancer Treatment Prostate cancer is a tumor of the prostate gland, which is located in front of the rectum and below the bladder. Your doctor may perform a physical exam,

More information

Prognostic factors in locally advanced prostate cancer as determined by biochemistry, imaging studies and pathology

Prognostic factors in locally advanced prostate cancer as determined by biochemistry, imaging studies and pathology Prognostic factors in locally advanced prostate cancer as determined by biochemistry, imaging studies and pathology Authors Key words C.Y. Hsu, S. Joniau, R. Oyen, T. Roskams, H. Van Poppel Prognostic

More information

Use of Androgen Deprivation Therapy (ADT) in Localized Prostate Cancer

Use of Androgen Deprivation Therapy (ADT) in Localized Prostate Cancer Use of Androgen Deprivation Therapy (ADT) in Localized Prostate Cancer Adam R. Kuykendal, MD; Laura H. Hendrix, MS; Ramzi G. Salloum, PhD; Paul A. Godley, MD, PhD; Ronald C. Chen, MD, MPH No conflicts

More information

Precise, Minimally Invasive Prostate Cancer Removal

Precise, Minimally Invasive Prostate Cancer Removal Precise, Minimally Invasive Prostate Cancer Removal Why da Vinci Surgery may be your best treatment option 1 Beyond Minimally Invasive For Prostate Cancer 1 Facing Prostate Cancer Prostate cancer is the

More information