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QUEST Newsletter

QUEST is a FREE newsletter published three times a year by the Urological Research Foundation. It informs readers of the latest advances in urologic research, especially prostate cancer treatment.

Please click here to subscribe to QUEST.

QUEST is a free newsletter, but we appreciate your support in helping the URF bring this publication to its readers.

QUEST Articles of High Interest
Additional Quest Articles
Article 1 of 315
Reevaluating Screening Trial Data: Important New Study Shows PSA Screening Saves Lives
A new analysis of data from two large prostate cancer screening trials showed that PSA testing does reduce death from prostate cancer. This noteworthy analysis came from the Cancer Intervention and Surveillance Modeling Network of the National Cancer...

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Article 2 of 315
Developing an Innovative Treatment: Prostate Cancer Immunotherapy Research Receives Grant
Dr. Catalona is part of a research team seeking to develop a breakthrough immunotherapy treatment for prostate cancer. The project is unique because the multidisciplinary team will use advances in the fields of nanotechnology and immuneoncology to de...

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Article 3 of 315
We'll take a cup o' kindness yet for auld lang syne!
At this time of year, when friends and families come together to preserve old relationships and look back over the events of the year, we renew our commitment to help those afflicted with an inherited susceptibility to cancer, or with cancer itself, ...

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Article 4 of 315
Evaluating Active Surveillance in Prostate Cancer
Younger men with prostate cancer had a decreased risk of cancer progression while under active surveillance, compared to men older than 60, according to a study published in the Journal of Clinical Oncology. William Catalona, M.D., professor of Ur...

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Article 5 of 315
New Results from PIVOT Study: Comparing Watchful Waiting and Prostatectomy
PIVOT, the Prostate Intervention Versus Observation Trial, started in 1994 and included 731 men randomly assigned to either watchful waiting or radical prostatectomy groups. Previous reports from the study found no significant differences in mortalit...

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Article 6 of 315
Dave Anderson: Living Life to the Fullest After Early Detection
By by Betsy Haberl
Due to PSA testing, Dave Anderson’s prostate cancer was diagnosed early. Ten years later, he is free of cancer and enjoying life in Chicago. Dave Anderson has seen the same primary care physician at least annually since first moving to Chicago 20 ...

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Article 7 of 315
New Research on ADT Risks and Prostate Cancer: Androgen-Deprivation Therapy Increases Risk of Heart Failure
A large prospective study found that men without preexisting cardiovascular disease had a significantly higher risk of heart failure after having androgen deprivation therapy (ADT) to treat localized prostate cancer. The study included 7,637 men w...

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Article 8 of 315
Pre-surgical Weight Loss in Men with Prostate Cancer
Numerous studies have found an association between obesity and aggressive prostate cancer, but it is unclear how pre-surgical weight loss affects men with the disease. A new randomized trial examined weight loss in men before they had surgery for ...

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Article 9 of 315
High-Tech Intensity-Modulated Radiation Therapy to Pelvic Lymph Nodes Improves Outcomes for Patients with Prostate Cancer
Intensity-modulated radiation therapy (IMRT) shapes radiation beams to tumors, thus reducing the amount of radiation that affects healthy tissue. Results from a long-term clinical trial in the UK found that IMRT improved outcomes for prostate cancer ...

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Article 10 of 315
Statin Use After Prostate Cancer Diagnosis Lowers Risk of Death
A Danish study found that men who took statins after being diagnosed with prostate cancer had a 17% lower risk of dying from the disease. The study included 31,790 patients diagnosed with prostate cancer. During a median follow-up of nearly 3 year...

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Article 11 of 315
Genetic Risk Score: A Tool for Calculating Prostate Cancer Risk
Family history is a known risk factor for prostate cancer. However, family history only assigns prostate cancer risk to family members based upon the degree of relationship. For example, a man who has a first-degree relative (brother, father, son) wi...

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Article 12 of 315
Low Testosterone Earlier in Life Could Increase Risk of Developing Prostate Cancer
Men who have significant drops in testosterone levels, especially when they are younger, may be more likely to develop prostate cancer. A study looked at 376 men ages 45 to 75 years with untreated low testosterone. During follow-up ranging from 2 ...

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Article 13 of 315
Incorporating Genetic Testing into Prostate Cancer Guidelines
Heritable genetic mutations are important in prostate cancer because they are related to the development of the disease, and certain mutations increase the risk for more aggressive cancer. Dr. Catalona and his research team have been directly invo...

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Article 14 of 315
Advances in Precision Medicine: New “Liquid Biopsy” Blood Test Targets Advanced Prostate Cancer Treatment
An ongoing early clinical trial in the UK is using a “liquid biopsy” to individualize treatment for advanced prostate cancer in patients who have BRCA genetic mutations. The researchers are studying a new 3-in-1 blood test as a way to identify pat...

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Article 15 of 315
Upfront Abiraterone: New Research Could Transform Treatment for Men with Advanced Prostate Cancer
Results from two studies presented at the American Society of Clinical Oncology (ASCO) 2017 Annual Meeting found that taking that abiraterone upfront with standard hormonal therapy helped men with advanced prostate cancer live longer. Testosterone...

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Article 16 of 315
Early Detection is Critical: My Response to the New USPSTF Recommendations
By William J. Catalona, M.D.
The medical community has become polarized in routine practice since debate erupted over PSA screening in 2008. Because the USPSTF’s mission is to advise primary care practice, internists and family practitioners have largely stopped PSA testing. ...

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Article 17 of 315
A Different Approach for Early Detection: Using PSA Cutoff of 1.5
For primary care physicians, discussing the results of PSA tests while practicing shared decision-making can be time consuming and present logistical challenges in clinical practice. A study suggested a different approach to early detection with the ...

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Article 18 of 315
Research In Practice: Prostate Health Index (phi) Reduces Unnecessary Biopsies in the Clinic
Clinical trials found that using the Prostate Health Index (phi) test could have spared 30% of unnecessary biopsies for patients who had benign or insignificant prostate cancer. A new study looked at the impact of phi testing in a real-world clinical...

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Article 19 of 315
UK and South Korean Agencies Address Concerns About Finasteride
Equivalents of the U.S. Food and Drug Administration (FDA) in both the UK and South Korea have publicly addressed concerns over reports of depression and suicidal thoughts in patients taking finasteride. The UK Medicines and Health Products Regula...

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Article 20 of 315
New Research Looks at Higher Rates of Prostate Cancer in African-American Men
Researchers at the Fred Hutchinson Cancer Research Center in Seattle found that African-American men had a 30-43% chance of developing prostate cancer, compared to 24-29% in the general population. Also, African-American men were 44-75% more likely t...

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Article 21 of 315
Elaine Ostrander, PhD: Researching to Change Lives
By Betsy Haberl
Elaine Ostrander, PhD, is a Distinguished Investigator at the National Institutes of Health (NIH) and director of a lab at the National Human Genome Research Institute. Her interests are in cancer genetics and comparative genomics. For many years, sh...

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Article 22 of 315
Stories of Prostate Cancer: Joe Hawkins Takes Charge of His Health
By Betsy Haberl
Joe Hawkins’ commitment to his own health helped him detect—and manage—his prostate cancer. For more than 10 years, Joe Hawkins had been a “historian” of his PSA. He was particularly careful to note changes in his PSA velocity. PSA velocity is the...

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Article 23 of 315
Study Finds Better Survival Odds with Surgery as Initial Therapy for Younger Men with High-Risk Prostate Cancer
Researchers compared survival rates in men younger than 60 who had radical prostatectomy or radiation therapy as their initial prostate cancer treatment. Men who initially had surgery had a 48% improvement in overall survival after more than 4 years ...

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Article 24 of 315
Italian-Style Coffee Could Cut Prostate Cancer Risk
A study in Italy found that men who drank more than three cups of coffee per day lowered their risk of prostate cancer by 53%. Researchers analyzed coffee consumptions habits of about 7,000 Italian men for 4 years on average and compared prostate ...

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Article 25 of 315
Body Size and Prostate Cancer: Height and Obesity Associated with Aggressive Disease
A prospective study found that men who were taller or more obese were more likely to have aggressive prostate cancer and die from the disease. For each 4 inches of height, there was a 21% increase in being diagnosed with high-grade prostate cancer...

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Article 26 of 315
Looking for a Correlation: Fewer Men Smoking, Fewer Men Dying from Prostate Cancer
Researchers reported that as fewer U.S. men smoke, fewer men are also dying from prostate cancer. The investigators saw parallel declines in smoking rates and prostate cancer mortality rates in men 35 years and older from a number of states. Fr...

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Article 27 of 315
The Pendulum Begins to Swing Back: USPSTF Backs Away from PSA Screening Ban
The mission of the U.S. Preventive Services Task Force (USPSTF) is to evaluate the benefits and harms of health services for primary care physicians. On April 11, 2017, the USPSTF issued a new draft recommendation that no longer deprives men of PSA s...

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Article 28 of 315
In the Wake of the Previous USPSTF Guidelines
Recent research found declines in the numbers of U.S. men who were getting screened, diagnosed and therefore treated for prostate cancer in the wake of the 2008 and 2011 USPSTF recommendations against PSA testing. Fewer men were being screened for pr...

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Article 29 of 315
Regular Aspirin Use Could Lower Risk of Lethal Prostate Cancer
A new analysis found that patients who took aspirin regularly had a lower risk of developing lethal prostate cancer. Researchers defined regular aspirin usage as more than 3 tablets per week for at least 1 year, and lethal prostate cancer was defi...

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Article 30 of 315
Trajectory of Body Mass Index (BMI) and Prostate Cancer Risk
Previous research suggests that obesity in adulthood is associated with an increased risk of clinically significant prostate cancer. A new study examined the trajectory of BMI beginning at age 20 to determine if being overweight at a younger age affe...

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Article 31 of 315
Father Medard Laz's Journey of Healing, Hope and Help
Thirteen years ago, Father Medard Laz survived prostate cancer. After his successful surgery, he returned to his life in Florida and set his sights on spreading help—and hope—in Haiti. Father Laz had always been aware of his family’s history of pr...

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Article 32 of 315
5-ALPHA-REDUCTASE INHIBITORS Research Looks Further into Side Effects
5-alpha-reductase inhibitors are drugs such as finasteride (Propecia and Proscar) or dutasteride (Jalyn), which are used to treat hair loss and prostate enlargement. The medications have been under recent scrutiny for claims of adverse psychiatric si...

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Article 33 of 315
Prostate Health Index (phi) Predicts Aggressive Prostate Cancer
A study published in BJU International examined the use of the Prostate Health Index (phi) test as a tool in assessing risk for aggressive prostate cancer, defined as a Gleason score of 7 or greater upon biopsy. The men in the study all had PSA le...

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Article 34 of 315
Midlife Baseline PSA Predicts Lethal Prostate Cancer
A case-control study found that a midlife PSA above the median strongly predicted future lethal prostate cancer. The authors suggested that risk-stratified screening on the basis of midlife PSA should be considered for men ages 45 to 59 years. The...

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Article 35 of 315
The PROMIS Trial: Using MRI to Avoid Unnecessary Biopsies
New results from the UK-led PROMIS trial found that multiparametric MRI scans—advanced technology in scans—could improve diagnostic accuracy and prevent unnecessary biopsies for men with suspected prostate cancer. Typically, men with elevated PSAs...

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Article 36 of 315
Guidelines Urge Treating Older Men According to Their Health Status, Not Age
New guidelines from the International Society of Geriatric Oncology said that prostate cancer patients older than 70 years should be treated based on their individual health status, not on their age. The task force also said that elderly patients who...

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Article 37 of 315
Using PSA to Detect Men at High Risk for Death After Treatment
Two-thirds of all prostate cancer deaths in the U.S. occur in men with localized disease who developed metastatic cancer. New research looked at PSA levels in these men after treatment to determine if there was a way to predict who was more likely to...

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Article 38 of 315
Treating Prostate Cancer Recurrence: Adding Antiandrogen Therapy to Radiation Improves Survival
A long-term clinical trial at Harvard University evaluated the efficacy of adding antiandrogen therapy (bicalutamide) to radiation therapy for men with biochemical prostate cancer recurrence. Arising PSA following a prostatectomy is called biochem...

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Article 39 of 315
The Family History Effect: An Increase in Probability of Prostate Cancer
A large analysis of brothers in the Prostate Cancer data Base Sweden (PCBaSe) showed that men with a family history of prostate cancer were more likely to get clinically significant prostate cancer. The study included 51,897 brothers of 32,807 men...

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Article 40 of 315
ADT and Prostate Cancer: Dementia Risk, Fatique and Exercise
Studies Continue to Examine Androgen-Deprivation Therapy (ADT) and Dementia Risk and Exercise Can Improve Fatigue for Patients on Androgen Deprivation Therapy...

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Article 41 of 315
New Statistics on Prostate Cancer in the U.S.
2017 American Cancer Society Statistics Each year, the American Cancer Society (ACS) releases new data on cancer rates in the U.S. and Reduction of Cancer Mortality Rates in the U.S....

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Article 42 of 315
Reflections at the Year's End
At this time of year, it is natural to reflect on my good fortune in having support from my contributors and friends, and I want to send my thanks and best wishes for a happy holiday season and good health in the New Year. I also want to bring you up...

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Article 43 of 315
The Protect Trial: Comparing Surgery, Radiation and Surveillance for Localized Prostate Cancer at 10 Years Follow-Up
The latest results from the ProtecT trial, a large UK-based randomized study, compared radical prostatectomy, external beam radiation therapy, and active monitoring for patients who had PSA testing and were diagnosed with localized prostate cancer. T...

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Article 44 of 315
Understanding the Prostate Health Index (phi): A More Specific Test to Screen for Prostate Cancer
The prostate-specific antigen (PSA) test is widely used for prostate cancer screening. However, PSA has limited specificity for prostate cancer. The Prostate Health Index (phi) is nearly 3 times more accurate in detecting prostate cancer than the fre...

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Article 45 of 315
2016 NCCN Guidelines for Prostate Cancer Early Detection
The National Comprehensive Cancer Network (NCCN) annually updates its guidelines for the early detection of prostate cancer. These guidelines are important because many health insurance companies determine coverage based on NCCN panel recommendations...

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Article 46 of 315
Genetic Changes and Cancer
Cancer is a genetic disease- that is, cancer is caused by certain changes to genes that control the way our cells function, especially how they grow and divide. These changes include mutations in the DNA that makes up our genes. Genetic changes th...

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Article 47 of 315
Surviving Prostate Cancer through Early Diagnosis: A Patient’s Story
I have always taken control of my health and have been very active and proactive in my approach to my own health and well-being. I have always had routine physicals and monitored and documented my blood work results. I had my first PSA test when I...

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Article 48 of 315
Saturated Fat Linked to Aggressive Prostate Cancer
Saturated fat is commonly found in foods such as fatty beef and cheese. According to a new study, eating a diet high in saturated fat may increase the chances of having aggressive prostate cancer. The study used data on 1,854 men diagnosed with pr...

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Article 49 of 315
Research Assesses the Effects of the USPSTF Recommendation
The advent of PSA testing in the 1990s led to an increase in the number of men diagnosed with prostate cancer. However, concerns about over-screening and overdiagnosis led professional guidelines, such as those of the U.S. Preventive Services Task Fo...

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Article 50 of 315
The Göteborg Trial: Long-Term Results of Active Surveillance Raise Questions
The Göteborg Prostate Cancer Screening Trial is a randomized, population-based European study. Recent results assessed the long-term safety of active surveillance (AS) for men with prostate cancer detected through a screening program. The study in...

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Article 51 of 315
Statins and Aggressive Prostate Cancer: Study Looks for Effects in Caucasian and African American Men
Statin use has been associated with reduced prostate cancer aggressiveness, but the impact of race on this link is not well understood. New research examined the association between statin use and prostate cancer aggressiveness in Caucasian and Afric...

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Article 52 of 315
ADT Type, Duration and the Risk of Diabetes
A recent study investigated the association between the types and duration of androgen deprivation therapy (ADT, or hormone therapy) and the risk of type 2 diabetes. Researchers used data from the Prostate Cancer database Sweden and compared diabetes...

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Article 53 of 315
Actor Ben Stiller: “The Prostate Cancer Test That Saved My Life”
In October, actor Ben Stiller revealed he was diagnosed with prostate cancer in 2014 and had his tumor removed by Dr. Edward Schaeffer at Johns Hopkins Hospital later that year. Two years later, he is still cancer-free. Stiller broke the news in an o...

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Article 54 of 315
Ralph Wozniak, an Engineer for Life
Ralph Wozniak’s career as a chemical engineer brought him and his family all over the world. When faced with prostate cancer, his scientific approach helped him and his doctors identify the best course of treatment. Now, he’s retired in Florida, enjo...

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Article 55 of 315
Long-Term Consequences of Finasteride versus Placebo
Research efforts continue to assess the effectiveness and safety of finasteride, a drug used to treat hair loss in men (Propecia or generics) or enlarged prostate (Proscar or generics). Enlarged prostate is also known as benign prostatic hyperplastic...

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Article 56 of 315
Chemotherapy for Metastatic Castration-Resistant Prostate Cancer: Assessing Survival and the Optimal Number of Docetaxel Cycles
The current first-line chemotherapy for patients with metastatic castrationresistant prostate cancer (mCRPC) is docetaxel combined with prednisone. A new study found that a greater number of docetaxel cycles improved survival for men with mCRPC. T ...

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Article 57 of 315
External Beam Radiation Therapy: Dose Escalation and Fractionation
Radiation therapy uses high-energy rays or particles to kill cancer cells. The two main types of radiation therapy used for prostate cancer are external beam radiation and brachytherapy (internal radiation). In the last year, a number of studies repo...

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Article 58 of 315
PSA Screening: Where We Are and How We Got There
In the 1960s and 70s, several researchers independently identified proteins later shown to have the same amino acid sequence as PSA. T. Ming Chu’s laboratory at the Roswell Park Memorial Institute developed PSA as a biomarker and patented it in 1984....

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Article 59 of 315
Smarter Screening: New Research Supports Mid-Life PSA Approach
Researchers at Harvard University and Brigham and Women's Hospital found that mid-life PSA levels predict who will be more likely to develop prostate cancer later in life. Screening for prostate cancer with PSA testing has been shown to reduce dea...

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Article 60 of 315
Dr. Catalona's Research Program Seeking Patients Who Have Been Managed with Active Surveillance
Last summer, the National Cancer Institute (NCI) awarded an $11.5 million 5-year grant to the Prostate SPORE (Specialized Project of Research Excellence) at Northwestern University. Dr. Catalona is Principal Investigator of this collaborative researc...

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Article 61 of 315
Exercise Could Improve Survival for Men with Prostate Cancer
A new study from the American Cancer Society found that maintaining a moderate to high level of exercise could improve survival for prostate cancer patients and survivors. Earlier research has linked vigorous physical exercise with a lower risk of...

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Article 62 of 315
Using Google Scholar and Pub Med for Patient Education
Online tools and technology continue to make it easier for patients and their families to access current research in the medical field. Google Scholar is a specialized search engine created by Google. It provides a simple way to search for scholar...

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Article 63 of 315
Larger Waistlines Could Increase Prostate Cancer Risk
A new study by researchers at Oxford University found that increases in body mass index (BMI) and waist size are associated with an increased risk of aggressive and fatal prostate cancer. The study focused on aggressive prostate cancer, defined as...

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Article 64 of 315
Optimal Timing for Androgen-Deprivation Therapy
A new randomized, controlled trial found that giving androgen-deprivation therapy (ADT) immediately is more effective than delaying treatment for patients with PSA relapse after treatment or if they have prostate cancer that is considered incurable. ...

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Article 65 of 315
Looking for Risk Factors for Metastasis in Men with CRPC
Investigators looked for predictors of time to metastasis in men who had non-metastatic prostate cancer at diagnosis, were treated with androgen deprivation therapy (ADT), and then developed castration-resistant prostate cancer (CRPC). The analysi...

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Article 66 of 315
Study Suggests Genetic Testing for Inherited Mutations Could Benefit Men with Advanced Prostate Cancer
A groundbreaking study found that inherited mutations in DNA-repair genes were unexpectedly common in men with metastatic prostate cancer. The study’s authors say that genetic testing could help target treatment for advanced prostate cancer. Inher...

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Article 67 of 315
New Research Finds Decrease in Prostate Cancer Diagnoses
The Winter 2015 QUEST reported on a study from Vanderbilt University that found a significant drop in new diagnoses of prostate cancer in the period following the USPSTF recommendation against PSA testing. Recently, an additional study came to simila...

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Article 68 of 315
Research at the Cellular Level: Study Identifies Possible Cause of Treatment Resistance in African-American Men
A recent study found that improper functioning of the mitochondria, a cell’s energy source, could help explain why African-American men with prostate cancer do not respond as well to conventional treatment therapies as Caucasian men. Researchers a...

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Article 69 of 315
Four-Fold Higher Risk of Metastases in Men on Active Surveillance with Gleason Pattern 4
The latest research from the Sunnybrook Health Sciences Centre in Toronto suggested that men with Gleason 4 prostate cancer on active surveillance could be at risk for eventual disease spread. The study included 980 men on active surveillance with...

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Article 70 of 315
Determining Ideal PSA Thresholds for Predicting Prostate Cancer
A retrospective analysis assessed the PSA threshold that best predicts future risk of prostate cancer. The study used data from the Veterans Affairs (VA) Health Care System database. Men included in the analysis were age 40 years or older, had a b...

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Article 71 of 315
Top Doctors Make a Difference: Dr. Catalona Receives National Physician of the Year Award
On March 21, Dr. William Catalona received a 2016 Castle Connolly National Physician of the Year Award for Clinical Excellence at the historic Pierre Hotel in New York City. Each year, Castle Connolly Medical Ltd. recognizes both physicians and lead...

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Article 72 of 315
Col. Allen B. West Speaks Out for Prostate Cancer Awareness
The URF is pleased to welcome Col. Allen B. West to its Board of Trustees. Col. West works in public policy and is a retired military serviceman, published author and former U.S. congressman. He has pledged to be a voice in the fight against prostate...

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Article 73 of 315
URF Board Member Jim Sansone Focuses on Family
Jim Sansone knows firsthand that prostate cancer affects the whole family. Nearly 25 years ago, he supported his father, URF board president Anthony Sansone, Sr., through prostate cancer treatment. His father remains healthy today, and now Jim serves...

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Article 74 of 315
PHI as a Better Prognostic Test for African-American Men
A recent study found that the Prostate Health Index (PHI) test could help predict high-grade prostate cancer in African American men. Researchers at Johns Hopkins assessed PHI values in 80 African- American patients with PSA values of 2-10 ng/ml p...

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Article 75 of 315
Long-Term Testosterone Use and Aggressive Prostate Cancer Risk
Testosterone therapy rates are increasing among men, yet some medical experts question its effect on the prostate. However, a new study from the University of Texas Medical Branch found no link between exposure to testosterone during a 5-year peri...

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Article 76 of 315
Study Finds Lack of Monitoring for Men on Active Surveillance
An increasing number of men diagnosed with low-risk prostate cancer are choosing active surveillance in hopes of avoiding side effects of surgery and radiation. However, a new study by UCLA researchers found that less than 5% of men who choose active...

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Article 77 of 315
Enzalutamide vs. Bicalutamide for CRPC: Results from the TERRAIN and STRIVE Trials
New results from two randomized studies compared the efficacy and safety of enzalutamide and bicalutamide for treatment of castration-resistant prostate cancer (CRPC). The TERRAIN trial included 375 patients with asymptomatic or minimally symptoma...

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Article 78 of 315
Radical Prostatectomy Associated with Better Survival Odds
Researchers in Toronto, Canada, reviewed the available studies assessing mortality after prostate cancer treatment with surgery or radiation therapy. They consistently found that men with localized prostate cancer who underwent radiation therapy had ...

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Article 79 of 315
Medicare Proposal to Penalize PSA Testing Draws Criticism
Medicare is considering a penalty for doctors who order routine PSA tests for their patients. The proposed measure is part of a federal effort to define and reward healthcare quality, as well as reduce non-recommended testing. The proposal has prompt...

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Article 80 of 315
Improving Detection with MRI- Ultrasound Fusion Targeted Biopsies
Standard guided biopsies have limited sensitivity for detecting prostate cancer, and a negative biopsy does not always mean prostate cancer is not present. While cancer detection remains an important goal for prostate biopsies, there is also a growin...

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Article 81 of 315
A Link Between Baldness and Prostate Cancer Death
A new study found that male pattern baldness could indicate an increased risk of prostate cancer death. Men with baldness of any kind had a 56% higher risk of prostate cancer death compared to men with no balding. Men with moderate balding had an ...

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Article 82 of 315
Herbal Medicine Safety Concerns for Patients with Cancer
Researchers in Israel reported that for patients with cancer, some herbal medicines could have negative effects on the efficacy and safety of anticancer treatments. The study authors provided a questionnaire to oncology health care professionals i...

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Article 83 of 315
Looking for Active Surveillance Patients: How to Help in the Search for Genetic Risk Markers Signing Up for a Study for Active Surveillance Patients
“Active Surveillance” is a term used for men who have been diagnosed with “low- risk” prostate cancer who have elected not to receive immediate treatment but rather to be monitored to see whether their cancer is more serious than it initially appeare...

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Article 84 of 315
Assessing the Impact of PSA Testing: Looking to the Future
In 1991, Dr. Catalona published an article in The New England Journal of Medicine that was the first to show that prostate-specific antigen (PSA) testing is useful for the early diagnosis of prostate cancer. It was one of the most influential article...

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Article 85 of 315
Prostate Cancer Screening in BRCA1 and BRCA2 Mutation Carriers
Men with mutations in the breast cancer genes BRCA1 and BRCA2 have a higher risk of developing prostate cancer than men who don't carry these genetic mutations. IMPACT is an international study evaluating the use of targeted prostate cancer screening...

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Article 86 of 315
Vanderbilt-led Study Finds Significant Drop in New Prostate Cancer Diagnoses
A new study led by Vanderbilt University Medical Center investigators found new diagnoses of prostate cancer in the U.S. declined 28 percent in the year following the draft recommendation from the United States Preventive Services Task Force (USPSTF)...

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Article 87 of 315
Study Says Mediterranean Diet, Olive Oil Cuts Breast Cancer Risk
Data from the PREDIMED clinical trial found that women who ate a version of the Mediterranean diet supplemented with extra virgin olive oil were 62% less likely to be diagnosed with breast cancer when compared with women who were asked to simply redu...

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Article 88 of 315
Prostate Cancer Update: From the American Urological Association Annual Meeting
New and exciting prostate cancer research focuses on issues that affect both individual patients and the greater population of men at risk for prostate cancer. The Prostate Cancer Update course focused specifically on research that could potentially ...

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Article 89 of 315
The Baber Family Stays Strong and Gives Back
It's been 10 years since Guy Baber was diagnosed with prostate cancer. With the support of his wife, Janice, Guy underwent treatment and is still cancer-free. To help others facing cancer, he started a golf tournament to raise money for both the URF ...

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Article 90 of 315
Exploring Familial Clustering of Breast and Prostate Cancer
A new study examined a possible inherited predisposition for breast and prostate cancer among families. Evidence suggests that someone with a family history of breast or prostate cancer has an increase risk of the same disease, particularly among ...

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Article 91 of 315
Weighing in on Active Surveillance
Active surveillance is form of managing prostate cancer that involves monitoring the growth of the tumor through annual or biennial biopsies. In recent years active surveillance become an increasingly accepted approach. Still, some clinicians remain ...

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Article 92 of 315
Debate Continues Over Breast Cancer Screening
The American Cancer Society (ACS) released new breast cancer screening guidelines in October. This has added to a continuing discussion over balancing the advantages of early detection with the risks of overdiagnosis and overtreatment of breast cance...

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Article 93 of 315
USPSTF Drafts Recommendation for Aspirin Use to Prevent Heart Disease, Colorectal Cancer
In September, the U.S. Preventive Services Task Force (USPSTF) released a draft report saying that a daily dose of aspirin can help prevent both cardiovascular disease and colorectal cancer. This is the first time a major U.S. medical organization ha...

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Article 94 of 315
AUA Updates its Position on Testosterone Therapy
The American Urological Association (AUA) updated its Position Statement on Testosterone Therapy in response to the FDA’s drug safety communication about testosterone therapy and risks of heart attack and stroke. In March the FDA released a drug s...

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Article 95 of 315
Men’s Health Supplements Useless for Prostate Cancer
A new study found that men’s health supplements offered no benefit for men with localized prostate cancer. Men’s health supplements are marketed to men for health benefits, particularly for “prostate health.” Researchers at the Fox Chase Cancer Ce...

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Article 96 of 315
A Message from Dr. Catalona
Dear QUEST Readers, We have worked extremely hard this year on our research program in the clinic, the operating room, and the laboratory. Our program involves collaborators from across the U.S. and around the world. Our work has paid dividends in i...

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Article 97 of 315
Funding a Major Research Project: Prostate Cancer SPORE Grant Awarded
On July 1, 2015, Dr. William Catalona was notified that the National Cancer Institute has awarded a grant of approximately $11 million over 5 years to the Prostate SPORE (Specialized Program of Research Excellence). Dr. Catalona is Principal Investig...

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Article 98 of 315
Decoding the Genetics of a Nation
Dr. Catalona’s research group has a long-standing collaboration with deCODE genetics, Inc. In this collaboration, they discovered the first genetic variant associated with prostate cancer susceptibility in 2006, and helped discover and validate a doz...

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Article 99 of 315
FDA ALERT: Hidden Drugs in Dietary Supplements
According to the U.S. Food and Drug Administration (FDA), some dietary supplements marketed to treat erectile dysfunction or enhance sexual performance may contain prescription drugs or undisclosed ingredients that could be harmful. These products...

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Article 100 of 315
The Stampede Trial: Adding Chemotherapy to Hormone Therapy Improved Survival
The STAMPEDE trial is the largest randomized clinical trial of treatment for men with prostate cancer ever conducted. Recent results from the trial indicated that adding chemotherapy to hormone therapy markedly improved survival for men with advanced...

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Article 101 of 315
Recent Findings in Prostate Cancer Research
New Trial Examines Adding Hormone Therapy to Radiation Treatment Radiation therapy is the standard treatment for men whose prostate cancer returns after radical prostatectomy. However, a new trial found that combining salvage radiation therapy wi...

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Article 102 of 315
Life after Prostate Cancer - Jim McNally: A Life Abroad
Jim McNally spent the majority of his career living abroad. Now in retirement - and fully recovered from prostate cancer - he is enjoying all that Europe has to offer. Forty-five years ago, Jim McNally was a young man who requested a transfer abro...

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Article 103 of 315
Genetic Research: A Way Forward for Prostate Cancer
There is a strong genetic predisposition to prostate cancer, and many scientific studies have identified rare genetic variants that increase the risk of prostate cancer and aggressive forms of the disease. Using these genetic variants to stratify ind...

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Article 104 of 315
Finasteride for Enlarged Prostate and Baldness: Balancing Treatment, Safety, and Side Effects
Finasteride is a drug used to treat hair loss in men (Propecia or generics) or enlarged prostate (Proscar or generics). The drug treats both conditions by blocking the body's production of a male hormone called dihydrotestosterone. Finasteride may he...

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Article 105 of 315
Investigating Agent Orange Exposure and Prostate Cancer
Dioxin is a highly toxic substance found in Agent Orange and some other herbicides. During the Vietnam War, the U.S. military sprayed large amounts of herbicides, including Agent Orange, in Vietnam, Laos, and other places to clear vegetation. Some tr...

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Article 106 of 315
TAMs: Potential Tumor Biomarkers
Tumor-associated macrophages (TAMs) are a type of cell that is found within most tumor masses. Circulating tumor cells (CTC) are shed from a primary tumor and circulate in the bloodstream. Some scientists believe that TAMs derived from primary tumors...

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Article 107 of 315
Lifestyle Choices: High-Fat Western Diet Could Worsen Risks of Prostate Cancer
Anew study at Harvard University offered insight on how diet may help improve the chances of survival for the nearly three million U.S. men living with prostate cancer. The study found that men with prostate cancer who eat a high-fat "Western diet" m...

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Article 108 of 315
The Consequences of a Decline in PSA Testing
From 1992-2011, there was a 47% decrease in prostate cancer mortality. Yet, the 2009 and 2012 recommendations from the U.S. Preventive Services Task Force (USPSTF) discouraged the use of PSA testing to screen men for prostate cancer. Now, current res...

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Article 109 of 315
Antihistamines and Decongestants Can Worsen Symptoms of Benign Prostate Disease
Over-the-counter cold and flu preparations that contain both antihistamines and decongestants can create a “perfect storm” for men with symptomatic benign prostatic hyperplasia (BPH). These products could substantially worsen symptoms of BPH, make it...

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Article 110 of 315
Linking High Vitamin D Levels and Prostate Cancer Risk
At a public conference on vitamin D sponsored by the National Institutes of Health, Dr. Demetrius Albanes (National Cancer Institute) reported on medical literature suggesting that men with the highest levels of vitamin D may have an increased risk o...

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Article 111 of 315
Life after Prostate Cancer: Richard Steiner Sees the World with the Next Generation
As a salesman, Richard Steiner had the opportunity to travel extensively. Fifteen years after recovering frm prostate cancer, he's still exploring- and now he's bringing his great-nephews along for the journey. Fifteen years ago, Steiner went to t...

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Article 112 of 315
Dr. Catalona's Research: Impacting the Lives of Men with Prostate Cancer
Contributions to the URF support Dr. Catalona's groundbreaking research for the early detection, prevention and treatment of prostate cancer. Tests for the early detection of prostate cancer. Dr. Catalona was the first to show that the PSA blo...

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Article 113 of 315
Screening for Lynch Syndrome Genetic Mutations
Lynch syndrome is a hereditary disorder caused by germline mutations in the DNA mismatch repair (MMR) genes MLH1, MSH2, MSH6 and PMS2. Normally, MMR genes repair DNA damage generated during DNA replication. When these genes are mutated, they may fail...

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Article 114 of 315
Using PHI to Reduce Unnecessary Biopsies
Dr. Catalona and other researchers investigated whether the Prostate Health Index (phi) test improved specificity for detecting clinically significant prostate cancer to help reduce prostate cancer overdiagnosis. The team compared the performance of ...

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Article 115 of 315
Not Just a Mustache: A Movember Fundraiser for Prostate Cancer
Tom and Jan Weiland held a Movember fundraiser to raise awareness for prostate cancer and funds for Dr. Catalona's research. The Movember movement involves men growing mustaches during the month of November to raise awareness for men's health and ...

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Article 116 of 315
Low-Risk Prostate Cancer: Upgrading and Upstaging at Biopsy
There is an increased interest in active surveillance due to concern that men diagnosed with low-risk prostate cancer may be over-treated. However, active surveillance criteria could be improved by identifying factors that place men with low-risk dis...

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Article 117 of 315
Intermediate-Risk Cancer: Decreased Survival Rates with Active Surveillance
A new study analyzed 945 patients with prostate cancer managed on active surveillance. Researchers found that men with intermediate-risk cancer had a 3.75 higher chance of dying from prostate cancer than men with low-risk disease within 15 years (11....

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Article 118 of 315
Health Policy and Advocacy for Urology
The winter 2014 issue of QUEST included a Q&A with Dr. Chris Gonzalez, a specialist in reconstructive pelvic surgery. In addition to his surgical responsibilities, Dr. Gonzalez works with the American Urological Association (AUA) as vice chairman...

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Article 119 of 315
FDA Update on Testosterone Replacement Therapy
In March, the U.S. Food and Drug Administration (FDA) determined that prescription testosterone therapy is approved only for men who have low testosterone levels caused by certain medical conditions, not men with agerelated low testosterone. “The ben...

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Article 120 of 315
Risk of Second Cancers in Prostate Cancer Survivors
The current 10-year relative survival rate for men diagnosed with prostate cancer is 99.7%. This long life expectancy could expose patients to the possibility of developing second primary cancers. In 2011, Dr. Catalona and his research team found tha...

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Article 121 of 315
Heritability of Prostate Cancer Higher Than Previously Believed
Prostate cancer is thought to be the most heritable cancer. Positive family history is consistently associated with a 2- to 4-fold increased risk of the disease. Family and twin studies can demonstrate the importance of genetic and environmental fact...

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Article 122 of 315
SPORE: Making Strides in Prostate Cancer Research
Specialized Programs of Research Excellence (SPOREs) are an integral part of the National Cancer Institute’s efforts to promote collaborative and interdisciplinary cancer research. The prestigious SPORE grants fund projects that will result in new an...

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Article 123 of 315
Aspirin May Lower the Risk of Prostate Cancer
A new study found that the use of aspirin and/or other nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with a reduced risk of prostate cancer. Researchers followed 6,390 men who had a PSA of 2.5-10 ng/mL and a negative biopsy result a...

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Article 124 of 315
Obesity and Prostate Cancer
Obesity is increasingly common in the U.S. It is associated with hypertension, diabetes, coronary heart disease and worse survival rates for many cancers. Obesity Increases the Risk of High-Grade Prostate Cancer New research led by Adriana Vida...

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Article 125 of 315
The Time Has Come to Revise the 2013 AUA Prostate Cancer Screening Guidelines
The 2013 American Urological Association (AUA) guidelines for the detection of prostate cancer are untenable for providing optimal care to men younger than 55 years or older than 69, or men at high risk for prostate cancer. Flawed and Incomplete D...

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Article 126 of 315
Chromosome 16: Investigating the Genetic Link Between Breast Cancer and Prostate Cancer
In many families, both prostate cancer and breast cancer are diagnosed among close relatives. However, the major breast cancer genes (BRCA1 and BRCA2) do not appear to explain the clustering of these two cancers within most of these families. Dr. Kat...

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Article 127 of 315
A Big Year for Joe Torre
Baseball legend Joe Torre received some of baseball's highest honors this year, underscoring his contributions to the game. Also, his involvement in a prostate cancer awareness campaign has drawn attention to new advances in treatment. In 1999, Jo...

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Article 128 of 315
Men's Health Q&A: Reconstructive Pelvic Surgery
BH: What types of conditions do you treat in your practice? CG: I specialize in reconstructive pelvic surgery. We generally see men who have an obstruction in their lower urinary tracts due to a urethral stricture or a bladder neck contracture. I ...

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Article 129 of 315
A Novel Approach to Catheter Care
Post-surgical catheters are an annoying but temporary necessity. A patient shared an innovative technique for keeping his catheter in place during a post- operative visit with Dr. Catalona that I observed. The patient was very active professionall...

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Article 130 of 315
A Genetic Link Between Prostate Cancer and Colon Cancer
A number have studies have reported that men with prostate cancer have a higher risk of developing colon cancer and vice versa. A 2010 study at the University of Buffalo found that men with prostate cancer had more abnormal colon polyps than men w...

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Article 131 of 315
A Message From Dr. Catalona
During 2014, my colleagues and I have worked enthusiastically to maintain our highly collaborative prostate cancer research program that involves research collaborators from across the country and around the world. Some of our past accomplishments an...

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Article 132 of 315
Radical Prostatectomy vs. Watchful Waiting: Long-Term Scandinavian Study Favors Surgery
New research published in the New England Journal of Medicine demonstrates that early diagnosis and treatment of prostate cancer reduces suffering and death in men younger than 65 years and the rate of metastatic cancer in older men. The findings com...

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Article 133 of 315
Developments in Prostate Cancer Treatment: Charting a New Course for Men with Advanced Disease
A new randomized trial may change the approach to treating men with metastatic prostate cancer. Researchers found that men with advanced disease who received chemotherapy early in their treatment lived an average of almost 14 months longer than men w...

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Article 134 of 315
Radical Prostatectomy Outcomes in Men Under 50
Researchers examined the outcomes of biochemical recurrence, incontinence and erectile dysfunction in 13,268 European men who had a radical prostatectomy, 443 of which were under age 50 years. The study found than men younger than 50 were more lik...

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Article 135 of 315
Reasons Men Discontinue Active Surveillance
Active surveillance (AS) is a management option for patients with favorable-risk prostate cancer. Drs. Stacy Loeb, M.D., of New York University, Pär Stattin, from the National Prostate Cancer Register of Sweden, and their colleagues reported on data ...

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Article 136 of 315
The Marathon Approach: Dan Murphy on Running and Prostate Cancer
Dan Murphy ran in the 118th Boston Marathon only 15 months after having a radical prostatectomy. From start to finish, Murphy refused to let prostate cancer be a hurdle in his path. Murphy has been a dedicated runner since 1978. He started running...

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Article 137 of 315
The Debate Continues: Cardiovascular Risks of Testosterone Therapy
The Spring 2014 issue of QUEST reported that the FDA is reviewing the risk of stroke, heart attack and death in men taking testosterone products. The review was prompted by the publication of two studies that linked testosterone therapy and increased...

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Article 138 of 315
New NCCN Guidelines: Aiming for the Middle Ground on PSA Testing
In the midst of the debate over PSA testing, the new National Comprehensive Cancer Network (NCCN) Guidelines for Prostate Cancer Early Detection aim to maximize the benefits and minimize the harms of PSA testing. These guidelines are important becaus...

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Article 139 of 315
Health Insurance Status and Prostate Cancer Outcomes
Researchers at the Harvard Medical School and the UCLA Medical Center evaluated the association between insurance status and prostate cancer outcomes in 85,203 men younger than 65 years diagnosed with prostate cancer. Their results underscored the im...

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Article 140 of 315
URF President Anthony F. Sansone, Sr. Receives Prestigious Entrepreneurial Award
June 20, URF Board president Anthony F. Sansone, Sr. was presented with the Lifetime Achievement Award at the Ernst and Young (EY) Entrepreneur Of The YearTM Award in the Central Midwest ceremony. The award recognized Mr. Sansone as an industry leade...

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Article 141 of 315
Examining The Links: Vitamin D Deficiency and Prostate Biopsy
A recent study suggested that vitamin D deficiencies could be a predictor of prostate cancer diagnoses and aggressiveness, especially among African American men. Researchers obtained serum vitamin D levels from 667 men aged 40-79 having prostate b...

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Article 142 of 315
Research Project Comes to Fruition: Prostate Health Index Test Now Available.
In February, Northwestern Memorial Hospital became the first hospital in the US to offer the Prostate Health Index (PHI) test to the public. The test will soon be available throughout the US, giving patients access to a better diagnostic screening to...

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Article 143 of 315
Moving Towards Personalized Medicine: FDA Approves Clinical Use of Genome Sequencer
By Betsy Haberl
For the first time, the US Food and Drug and Administration (FDA) approved a high-throughput DNA sequencing device, also known as a next-generation genomic sequencer, for clinical use. Leaders of the FDA and National Institutes of Health (NIH) say th...

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Article 144 of 315
Testosterone Therapy and Risk of Cardiovascular Events
FDA to Review Risk In January, the US Food and Drug Administration (FDA) announced a plan to review the risk of stroke, heart attack and death in men taking testosterone products. “We have been monitoring this risk and decided to reassess this saf...

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Article 145 of 315
Women's Health Q&A: Urinary Incontinence in Women
A conversation with Dr. Stephanie Kielb of Northwestern Memorial Hospital. Dr. Kielb is an Associate Professor of Urology at the Feinberg School of Medicine and a specialist in neurourology, female pelvic medicine and reconstructive surgery. Be...

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Article 146 of 315
Coach Jim Boeheim: A Voice for Awareness
By Betsy Haberl
Jim Boeheim underwent surgery for prostate cancer at age 56. More than 10 years later, the head coach of the Syracuse University men's basketball team led his team to win their first 25 games in the regular season. He has also been working to raise a...

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Article 147 of 315
Rationale for Baseline PSA Testing Men in their 40s
By Dr. William J. Catalona, M.D.
I recently contributed to an article in ONCOLOGY on the pros and cons of baseline PSA testing for men in their 40s. In the article, I argued that available evidence strongly supports using baseline PSA measurements to identify men who are most likely...

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Article 148 of 315
Recent Findings in Prostate Cancer Research
Two studies published in early 2014 showed inconsistent findings relating to statin use and prostate cancer risk. Statins are drugs frequently used to reduce fat and cholesterol in the blood. Statins, Prostate Cancer and Regular Screening Researc...

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Article 149 of 315
The Debate Continues: Prostate Cancer and Omega-3 Fatty Acids
The Winter 2013 issue of QUEST reported results from a study by Brasky et al that linked high blood levels of omega-3 fatty acids and an increased risk of prostate cancer.1 Critical responses to the study, some of which were published by people who w...

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Article 150 of 315
Developments in Prostate Cancer Treatment: Bone Metastases Treatment with Metastatic Castration-Resistant Prostate Cancer
Hormonal therapy is meant to target or block the production of male hormones, or androgens. Theoretically, hormonal therapy would stop the growth of prostate cancer cells that need androgen to reproduce. However, prostate cancer cells can develop ...

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Article 151 of 315
Remembering Russ Gould
Prostate cancer research has produced many new drugs, treatments, and biomarkers that are available to patients today, and many others are in the pipeline. I believe that the genetic revolution will usher in a new era of prostate cancer manag...

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Article 152 of 315
A Family Matter: Prostate Cancer from a Daughter's Perspective
Jacquelyn Purze was in high school when her father, Kenneth Purze, was diagnosed with prostate and pancreatic cancer. Her two younger sisters were 9 and 15 years old. Their father’s diagnosis and treatment affected the entire Purze family, and th...

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Article 153 of 315
Early Detection Worldwide: International Prostate Cancer Screening Recommendations Recognize Importance of PSA Testing
Recent prostate cancer screening recommendations from the US Preventive Services Task Force (USPSTF) and the American Urological Association (AUA) suggested that PSA testing for prostate cancer should be restricted in certain age groups or stopped al...

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Article 154 of 315
A Forward-Looking Approach
By William J. Catalona, MD
By recommending that PSA testing should be abandoned completely or restricted, the USPSTF and the AUA guidelines are a step in the wrong direction for patient-centered care. If widely implemented, these guidelines would deprive many men of the opport...

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Article 155 of 315
Men’s Health Q&A: Urinary Incontinence after Prostate Cancer Treatment
A conversation with Dr. John Hairston of Northwestern Memorial Hospital Dr. John Hairston is an Associate Professor of Urology at the Feinberg School of Medicine and a member of the Integrated Pelvic Health Program. Betsy Haberl is the editor o...

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Article 156 of 315
Study Links Omega-3 Fatty Acids and Prostate Cancer
Omega-3 fatty acids found in oily fish, such as salmon, and fish oil supplements have been promoted for their health benefits, including anti-inflammatory effects that some believe could help prevent cancer. However, a recent study found that men wit...

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Article 157 of 315
New Study: Fat Intake after Prostate Cancer Diagnosis
A new study examined the amount and types of fat that men consumed after being diagnosed with prostate cancer. Vegetable Fats Men who ate the most vegetable fats after diagnosis had a 36% lower risk of having lethal prostate cancer, and replacin...

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Article 158 of 315
Developments in Prostate Cancer Treatment
Shorter-term Hormone Therapy For patients with high-risk prostate cancer, the current recommended duration of androgen deprivation therapy (ADT), also known as hormone therapy, is 24-36 months. However, researchers at the annual Genitourinary Canc...

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Article 159 of 315
Going the Distance
By Betsy Haberl
Chuck Koeppen has a lot to celebrate. At 67 years old, he continues to coach track and cross country, has a close-knit family, and his prostate cancer has been cured. Koeppen and his wife Cathie (center), and their children (left to right) Charli...

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Article 160 of 315
Cancer Detection Tool Saves Lives
The Large Urology Group Practice Association (LUGPA) released its prostate cancer screening guidelines in response to the recent PSA controversy, saying that data clearly demonstrates that doctors are detecting prostate cancer earlier and thus saving...

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Article 161 of 315
The Growing Evidence Supporting Mid-life PSA Testing
By Daniel Reinhardt
In the US, early detection of prostate cancer through the use of PSA testing has resulted in an 80% decrease of men with metastases at diagnosis and a more than 45% decrease in the age-adjusted prostate cancer mortality rate, compared to the pre-PSA...

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Article 162 of 315
Underreporting of Robotic-Assisted Surgery Complications
Astudy published online in the Journal for Healthcare Quality examined the reporting system for robotic-assisted surgery complications. The researchers crossreferenced reports of robotic-assisted surgery complications in legal documents and the news ...

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Article 163 of 315
Recent Findings in Prostate Cancer Research
European Study: PSA Testing Reduces Prostate Cancer Deaths Recent results from the European Randomized Study of Screening for Prostate Cancer showed that PSA-based screening lowered the risk of prostate cancer mortality by 32% for men who were 55-...

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Article 164 of 315
International Research Group Receives Funding for Genetic Research
The International Consortium for Prostate Cancer Genetics (ICPCG) received a grant for its whole exome sequencing project from the National Cancer Institute (NCI) through 2016. The ICPCG members are conducting whole exome sequencing studies and a gen...

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Article 165 of 315
National Recognition for Northwestern Memorial Hospital and Department of Urology
Northwestern Memorial Hospital Ranked 6th Nationally U.S. News & World Report ranked Northwestern Memorial Hospital 6th in the nation in their most distinguished annual ranking: the Best Hospitals 2013-14 Honor Roll. The annual Best Hospitals l...

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Article 166 of 315
Strung on Hope: Helping to Cure Cancer One Bead at a Time
Sydney Addis and Drew Soffer started Strung on Hope when they were only 15 years old. They make and sell gemstone bracelets, then donate a portion of their profits to cancer organizations. Addis and Soffer are committed to helping cure cancer beca...

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Article 167 of 315
BRCA Genetic Mutations and Cancer Making Medical History: Personalized Medicine in Action
BRCA1 and BRCA2 are human genes that suppress tumors. When these genes function normally, they help prevent uncontrolled cell growth. Research studies have linked harmful mutations of these genes to an increased risk of men and women developing hered...

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Article 168 of 315
American Urological Association (AUA) Issues New Prostate Cancer Screening Guidelines
Prostate Cancer Roundtable Describes Guidance as “Confusing” In May, the American Urological Association (AUA) issued new guidelines for the early detection of prostate cancer. In response, the Prostate Cancer Roundtable released an online statem...

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Article 169 of 315
Where the New AUA Guidelines Went Wrong
By William J. Catalona, MD
My patients frequently ask me why the US Preventive Services Task Force and the AUA do not recommend more widespread PSA screening. Problems with the AUA Approach In my opinion, the AUA guidelines are based on incomplete data and inaccurate es...

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Article 170 of 315
EAU Recommends Baseline PSA
In June, the European Association of Urology (EAU) released new guidelines for the early detection of prostate cancer, including a recommendation to obtain a baseline PSA for men 40-45 years of age. The EAU also recommends adjusting follow-up PSA int...

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Article 171 of 315
Recent Research Findings Regarding Dietary Choices and Prostate Cancer Risk
New studies examine the relationship between dietary choices and prostate cancer risk. Deep-fried Foods and Prostate Cancer Researchers at the Fred Hutchinson Cancer Research Center in Seattle found that regular consumption of fried foods is as...

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Article 172 of 315
Unexpected Outcomes: Life Insurance Applications Lead to Prostate Cancer Diagnoses
By Betsy Haberl
Keith Gray, David Leggott and Mark Mestemacher did not expect anything unusual to happen when they applied for new life insurance policies. After submitting their applications, the insurance company performed routine blood tests. However, instead of ...

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Article 173 of 315
Men’s Health Q&A: Low Testosterone and Testosterone Replacement Therapy
By Dr. Robert Brannigan and Betsy Haberl
A conversation with Dr. Robert Brannigan of Northwestern Memorial Hospital, Male Reproductive Medicine and Surgery, Director of the Andrology Fellowship Dr. Robert Brannigan is an Associate Professor of Urology at Northwestern University’s Feinbe...

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Article 174 of 315
Surgical Robots Under Examination
Last year, more robotic surgeries were performed than ever before. Yet, critics say that heavy marketing is behind their popularity. Many hospitals purchase the expensive robots to stay competitive in the field of high-tech medical care. Surgical...

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Article 175 of 315
Robotic Prostatectomy vs. Conventional Open Prostatectomy
By William J. Catalona, MD
“I do not think robotic surgery is as good or safe as open surgery for curing prostate cancer while preserving sexual and urinary function.” Although long-term cancer cure rates with robotic surgery are not yet available, more patients need salva...

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Article 176 of 315
In Tribute to John O. (Jack) and Tina Niemann
John O. (Jack) Niemann passed away on April 27, and his wife Tina passed away on June 14. Jack served as URF treasurer for 10 years. The URF greatly appreciates the Niemanns’ support of the URF. Jack and Tina were both successful in their professi...

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Article 177 of 315
URF Fundraiser in Florida: Embracing Family, Embracing Life
On February 23, URF president Anthony Sansone, Sr., and his wife Mary Anne hosted the third biennial Urological Research Foundation Fundraiser to support research for prostate cancer. The event took place in Palm Beach Gardens, Florida, and was a suc...

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Article 178 of 315
Starting A major Research Project: Using Genetic Lessons To Manage Prostate Cancer Treatments
Dr. Catalona and his research collaborators are starting a major research project to learn more about how genetics affects the aggressive behavior and progression of prostate cancer. In the process, they also plan to learn more about who would ben...

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Article 179 of 315
Erectile Rehabilitation After Surgery
In my practice, I recommend an erectile function rehabilitation program that has two phases. The first phase is designed to minimize the damage to the erectile nerves (sometimes called the "cavernosal" nerves) that occurs from the radical prostate...

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Article 180 of 315
Prostate Cancer As An Inherited Disease
By William J. Catalona, MD
A large body of evidence suggests a genetic cause for prostate cancer, a connection stronger than for any other common type of cancer. Some of these genetic factors may be inherited and others may be acquired during life. It is estimated that 4...

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Article 181 of 315
New Agent For Detecting Location of Recurring Prostate Cancer
The FDA approved the production and use of Choline C 11 injections to help detect recurrent prostate cancer. This PET imaging agent is especially useful when PSA levels are increasing after earlier treatment for prostate cancer but conventional im...

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Article 182 of 315
Enlarged Prostate (BPH): Causes, Symptoms and Treatment
By Kevin T. McVary, MD
Dr. Kevin T. McVary is Professor and Chairman of Urology at Southern Illinois University School of Medicine in Springfield, IL and a specialist in prostate diseases and erectile dysfunction Kevin T. McVary, MD ©photo by Cissy Lacks BPH (Benign Pr...

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Article 183 of 315
Affecting Biopsy Decisions: Genetics of PSA Production
By William J. Catalona, MD
The more we know about PSA testing, the more useful the information is, but there is still room for improvement. We now know that some men are high PSA producers and some are low PSA producers. The estimate is that 40-45% of this variability in...

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Article 184 of 315
How They Go Together: Playing Baseball and Making Life Decision
By Cissy Lacks
At age 15, Bill Purdy was a St. Louis Browns batting practice and bullpen catcher. At age 60, Purdy was diagnosed with prostate cancer. Now, at age 75, looking back on both experiences, he said, “Playing baseball helped me with my adult decisio...

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Article 185 of 315
Assessing Prostate Cancer Aggressiveness: Looking At Something New
By Cecilia Lacks, PhD
QUEST has reported often about the need to find a way to distinguish aggressive from non-aggressive prostate cancer in the diagnostic stage. So far, the search is on but the answers are elusive. Now, researchers at Northwestern, using samples f...

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Article 186 of 315
Phi: FDA Approves New Blood Test to Improve Prostate Cancer Detection
It’s been a long wait, but the FDA (U.S. Food and Drug Administration) has announced approval for Phi* (Prostate Health Index), a simple, non-invasive blood test that is 2.5 times more specific in detecting prostate cancer than PSA in patients with P...

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Article 187 of 315
New Treatments Available For Metastatic Castrate-Resistant Prostate Cancer
By William J. Catalona, MD
Dr. Catalona has written articles and answered questions on the topic of hormonal therapy in previous issues of QUEST, but new therapies are rapidly becoming available, and previous articles are no longer up-to-date. This article provides informat...

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Article 188 of 315
What To Do When Study Results Are So Different Radical Prostatectomy Versus Watchful Waiting: Scandinavian vs PIVOT Study
By William J. Catalona, MD
In 2011, the New England Journal of Medicine published updated results on a Scandinavian Study* reporting on: Radical Prostatectomy Versus Watchful Waiting in Early Prostate Cancer. The article concluded that, overall, compared to men managed with...

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Article 189 of 315
“Live Longer or Live Better”: Intermittent Vs. Continuous Hormonal Therapy Is An Issue In Latest Research
Men diagnosed with hormone sensitive metastatic prostate cancer are offered ADT, androgen-deprivation therapy (also called hormone therapy), to slow the progression of the cancer. They are prescribed this therapy, most commonly, after both a radic...

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Article 190 of 315
Current Findings: From Prostate Cancer Research
At the annual meeting of the American Urological Association, Dr. Catalona* presents a prostate cancer update for the year that summarizes significant findings from studies published in peer-reviewed medical journals. QUEST is adapting some inform...

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Article 191 of 315
After Diagnosis: from Emotional to Analytical and Back
By Cissy Lacks
Wheeler Chapman is a numbers man with an analytical background. He’s the founder, president and chief investment officer of Integrated Financial Management, an investment management firm. And he has both bachelor’s and master’s degrees in civil en...

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Article 192 of 315
A Plan to Help Answer the Big Question: What Distinguishes Aggressive from Non-aggressive Prostate Cancer?
Collaboration of SPORE Genetics and Active Surveillance Working Groups on Developing Genetic Markers Useful for Selecting Treatment of Prostate Cancer One of the most important questions currently facing prostate cancer practitioners is: How can w...

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Article 193 of 315
Biggest Benefit to Elderly: PSA Screening Lessens Risk of Metastatic Cancer at Diagnosis
By Cecilia Lacks, PhD
Prostate cancer detected and treated early can result in a possible cure. Metastatic prostate cancer (cancer spread from the prostate to another part of the body) at diagnosis is unfortunately not curable. Then, the only question is how long treat...

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Article 194 of 315
When Enough Is Enough: PSA Screening Conversation and Moving Forward With Prostate Cancer Research
By William J. Catalona, MD
PSA testing is a topic of conversation and controversy in the media because of the recent USPSTF (U.S. Preventive Services Task Force) recommendation against PSA screening. The recommendation for PSA testing by the American Urological Association ...

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Article 195 of 315
PSA After Prostate Cancer Treatment: How It Is Used and What It Means
By William J. Catalona, MD
Interpreting PSA values for followup information after prostate cancer treatment is different from interpreting PSA for prostate cancer screening. And interpreting PSA after treatment is different for those who had removal of their prostate versus...

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Article 196 of 315
Medical Advancements: MDV3100, Abiraterone and Alpharadin
Expanded Access to MDV3100 Access to MDV3100 has been expanded to clinical studies in 10 states. QUEST reported on MDV3100 in its Spring 2011 issue: MDV3100 represents a major advance in the hormonal treatment of patients with apparent castrati...

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Article 197 of 315
Dr. Catalona’s Continuing Research: Phi Stands for Prostate Health Index
In addition to his genetic studies, Dr. Catalona continues research on PSA to develop ways to make PSA testing more predictive for prostate cancer, especially aggressive prostate cancer. His previous studies resulted in refinements such as percent...

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Article 198 of 315
Provenge: The Latest Controversy
By Cecilia Lacks, PhD
Physicians want new treatments to work, especially for patients who no longer respond to existing treatments. Physicians want new treatments to work, especially for patients who no longer respond to existing treatments. It was controversial fro...

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Article 199 of 315
AUA Disputes Panel’s Recommendations on Prostate Cancer Screening
By AUA President Sushil S. Lacy, MD
On May 21, 2012, the *American Urological Association (AUA) released the following statement in response to the U.S. Preventive Services Task Force (USPSTF) recommendation on the use of the prostate-specific antigen (PSA) test. The statement is attri...

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Article 200 of 315
Prostate Cancer Susceptibility Appears Different for Different Races
The AUA (American Urological Association) is outraged at the USPSTF’s failure to amend its recommendations on prostate cancer testing to more adequately reflect the benefits of the prostatespecific antigen (PSA) test in the diagnosis of prostate canc...

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Article 201 of 315
Interpreting Changes in PSA Related to Age-Specific PSA
By adapted for QUEST readers by Cecilia Lacks, PhD
Previous studies have established median* PSA values for men in their 40s, 50s, 60s and 70s. These are 0.7, 0.9, 1.3, and 1.7 ng/mL, respectively. Prior studies have also demonstrated that men who have PSA values above their age-specific median (A...

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Article 202 of 315
PSA Velocity Risk Count Testing: A New Screening Method for Prostate Cancer
New studies* on PSA Velocity (PSAV) suggest that PSAV risk count, the number of times PSAV exceeds a specific threshold, could increase the reliability of screening for prostate cancer and of screening potentially for life-threatening tumors. PSA ...

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Article 203 of 315
Personalized PSA Testing Using Genetic Information Can Possibly Decrease the Number of Unnecessary Biopsies
By adapted for QUEST readers by Cecilia Lacks, PhD
Brian Helfand; MD, PhD presenting at the recent American Urological Association meeting. At present, while PSA is the best diagnostic tool for early diagnosis of prostate cancer, it is not perfect for cancer detection. Benign conditions also ca...

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Article 204 of 315
What the U.S. Preventive Services Task Force Missed in Its Prostate Cancer Screening Recommendation
By William J. Catalona, MD; Anthony V. D’Amico, MD; William F. Fitzgibbons, MD; Omofolasade Kosoko-Lasaki, MD; Stephen W. Leslie, MD; Henry T. Lynch, MD; Judd W. Moul, MD; Marc S. Rendell, MD; and Patrick C. Walsh, MD
reprinted with permission from Annals of Internal Medicine, May 17, 2012 The U.S. Preventive Services Task Force (USPSTF), a panel that does not include urologists or cancer specialists, has just recommended against prostate-specific antigen (PSA)...

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Article 205 of 315
Message From Dr. Catalona About How and Why PSA Testing Saves Lives: To QUEST Readers, My Patients and Their Families
This article material comes from a prestigious lecture Dr. Catalona was invited to deliver at the recent American Urological Association conference: Early Diagnosis of Prostate Cancer Through PSA Testing Saves Lives. (It is available on www.drcatalon...

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Article 206 of 315
Public and Professional Reactions to U.S. Preventive Services Task Force Recommendations on PSA Screening
Obama Requested a PSA Test President Barack Obama recently solicited a Prostate Specific Antigen test to screen for prostate cancer during his yearly physical. White House physician Dr. Jeffrey C. Kuhlman’s report, which was released October 31...

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Article 207 of 315
Research Work Summaries From Dr. Catalona and the URF: The Mission of the Urological Research Foundation is to support research and patient education in prostate cancer.
By (prepared by Cecilia Lacks, PhD)
Dr. Catalona is a prostate cancer surgeon and researcher with a longstanding commitment to research in the areas of biomarkers, prostate cancer genetics, and clinical chemoprevention. He has a long-standing interest in the genetic underpinnings of...

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Article 208 of 315
An Executive Approach: Managing a Prostate Cancer Diagnosis
By Cissy Lacks
At age 69, Bill Smithburg, retired CEO of Quaker Oats, was faced with a decision that would be a personal test of his business acumen. The tennis playing, helicopter skiing, fitness exerciser had a rising PSA but his doctor told him not to worry a...

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Article 209 of 315
Misconceptions About Prostate Cancer Diagnosis Prostate Cancer is Difficult... But Foregoing PSA Testing & Not Knowing? Unbelievable!
By Marcy Manning
After reading information on the URF website, Marcy Manning sent a note to Dr. Catalona about her husband’s experiences with his prostate cancer diagnosis. Dr. Catalona asked if she would be willing to share her thoughts with QUEST readers. She graci...

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Article 210 of 315
Dr. Catalona Gives Ramon Guiteras Lecture: Early Diagnosis of Prostate Cancer Through PSA Testing Saves Lives
Dr. Catalona was invited to give the Ramon Guiteras Lecture at the recent annual meeting of the American Urological Association. This lecture, one of the most prestigious at the conference, is presented in honor of the surgeon who founded the America...

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Article 211 of 315
Low, But Rising, PSA Can Predict Poor Prognosis and High-Grade CaP
Among prostate cancer patients, higher pre-operation PSA levels and higher Gleason scores are often associated with a poorer prognosis after radical prostatectomy. However, some prostate cancer tumors actually secrete less PSA than other tumors an...

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Article 212 of 315
Dr. Catalona’s Opinion: Another Bad Use of Dutasteride
Some of the investigators involved in the dutasteride studies are recommending using the drug to improve the performance characteristics of PSA testing. The method they are proposing reduces the sensitivity of PSA testing and would likely miss o...

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Article 213 of 315
Dr. Catalona Discusses: FDA Approval of Abiraterone Acetate (ZYTIGA)
Abiraterone (ZYTIGA) was approved for use in men who have progressed from hormonal therapy to chemotherapy and then failed chemotherapy. In essence, they are going back to hormone therapy. This seemingly odd sequence, in my opinion, was the eas...

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Article 214 of 315
Team Building: It’s Not Just A Sports Thing
By Cissy Lacks
Jim Corno knows the importance of teamwork. He’s the President of Comcast SportsNet Chicago, a 24-hour regional sports television and online network. The station not only shows the games of the White Sox, Cubs, Blackhawks, and Bulls, but it’s o...

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Article 215 of 315
Prostate Cancer Treatment Outcomes: Men Who Follow Recommended Testing Guidelines Do Better
Men who follow general recommended guidelines for prostate cancer testing show more favorable results when diagnosed with CaP (prostate cancer) than men who do not follow these guidelines. That is, men who have followed guideline principles by hav...

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Article 216 of 315
Looking To the East for Clues To Inhibit Prostate Cancer Metastasis
By Cecilia Lacks, PhD
Rates of prostate cancer death are 10 times lower among Southeast Asians than among those in the United States. One difference between the two groups is diet. Those in the East have soy as a major component of diet. Those in the West do not. Knowi...

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Article 217 of 315
On the Go: One Fast Recovery
Danny Oldfield is Dr. Catalona’s patient from Colorado Springs, Colorado. His operation was in October 2010. Readers might recognize his name because we’ve been featuring his photographs on the front of QUEST. Now, most appropriately, we’re ...

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Article 218 of 315
PSAV Is A Useful Tool
Prostate-Specific Antigen Velocity (PSAV) is used to assist in prostate cancer (CaP) detection and in biopsy recommendations. PSAV is the rate at which PSA levels rise. The NCCN (National Comprehensive Cancer Network) 2010 Guideline for early dete...

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Article 219 of 315
FDA Panel Recommends Against Drugs For Prostate Cancer Prevention
In a recent announcement, the US Food and Drug Administration (FDA) advisory panel voted against changes requested by two drug companies for the use of their drugs: finasteride (Proscar & Propecia) and dutasteride (Avodart & Jalyn), for reducing pros...

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Article 220 of 315
Dr. Patrick Walsh Explains: FDA Advisory Panel Rejects Proscar and Avodart to Reduce Risk of Prostate Cancer
By Dr. Patrick Walsh
In December, 2010 an FDA advisory panel met to evaluate two proposals for the use of 5a reductase inhibitors to reduce the risk of prostate cancer. The panel rejected both voting 17-0 with one abstention that the risks of Proscar outweighed its be...

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Article 221 of 315
Genetics and Prostate Cancer: The Continuing Search for Risk Markers
By Cecilia Lacks, PhD
This article is based upon a study* supported in part by the URF and presented at a recent American Urological Association meeting. The continuing search for risk markers is at the center of genetic studies to refine the early detection of prostat...

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Article 222 of 315
Follow-up Is Everything: The True Number Needed to Screen & Treat To Save A Life with PSA Testing
By (This article is prepared for QUEST readers from a study published in the Journal of Clinical Oncology and introduces readers to a vocabulary important for interpreting recent numbers on prostate cancer screening and prostate cancer mortality.)
Recently reported statistics for two terms connected to the lifesaving effects of PSA testing created widespread misunderstandings among the medical community, the media, and the general public. Changing around the form of an ordinary teakettle make...

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Article 223 of 315
Nanotechnology: Determining a PSA Level That Will Define a “No Evidence of Disease”
By This article is a follow-up to the article in the Winter 2010 QUEST which introduced the research on Nanotechnology to help make better treatment decisions after a radical prostatectomy. The Nanotechnology PSA test described in this material is not commercially available at the present. We include the information to keep readers informed about the latest research in which Dr. Catalona, his research collaborators and the URF are involved and to show the potential impact of this research and of technological advances in the diagnosis, treatment and prevention of prostate cancer.
Using nanotechnology to find trace elements of PSA is a powerful tool, but it doesn't establish the PSA level that gives physicians the information they need to interpret results for recommending additional treatment or not. Establishing a PSA lev...

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Article 224 of 315
Which Prostate Cancers Are Aggressive and Which Aren’t?
By Cecilia Lacks, PhD
Predicting which prostate cancers (CaP) will progress into life-threatening disease remains challenging for doctors. t is easy to tell a patient that his tumor is potentially life-threatening if there is a lot of cancer found in the biopsy sp...

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Article 225 of 315
How Long Can Surgery Be Safely Delayed In Men With Low Risk Prostate Cancer?
Men with low-risk prostate cancer (CaP) have multiple options for treatment including radical prostatectomy (RP), radiation therapy and active surveillance. Increased acceptance of surveillance, scheduling issues, time spent on researching various...

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Article 226 of 315
Nanotechnology: Helping To Make Better Treatment Decisions After A Radical Prostatectomy
The Nanotechnology PSA test described in this material is not commercially available at the present. We include the information to keep readers informed about the latest research in which Dr. Catalona, his research collaborators and the URF are invol...

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Article 227 of 315
PSA Velocity Risk Count Helps Identify Clinically Significant Prostate Cancer
By (This article is prepared for QUEST readers from a study* presented at a recent AUA meeting.)
Despite considerable refinement in radical prostatectomy and radiation therapy over the past few decades, all treatments for prostate cancer proceed as if a patient’s disease is potentially life threatening. Low-risk prostate cancer is simply not ...

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Article 228 of 315
Pressure Socks and Early Walking Prevent Blood Clots After RP
Blood clots are a cause for concern after invasive surgery and patients are often prescribed low doses of heparin to prevent them; yet, there is no consensus for such a recommendation with a radical prostatectomy (RP). Our study* looked at the rec...

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Article 229 of 315
Avodart© No Different From Finasteride: It Also Might Mask High-Grade Prostate Cancer.
By William J. Catalona, MD
I n May 2009, investigators from an international REDUCE trial sponsored by GlaxoSmith Kline, manufacturer of dutasteride (Avodart®), a drug approved for the treatment of benign prostatic hyperplasia (BPH), reported that their 4-year study showed Avo...

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Article 230 of 315
AUA Releases New PSA Guidelines
I n April of 2009, the American Urological Association (AUA) issued new clinical guidelines regarding early detection of prostate cancer and the PSA test. A summary follows: The AUA recommendation is: The PSA (prostate-specific antigen) test sh...

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Article 231 of 315
Digital Rectal Exam: An Important Part of Prostate Cancer Screening
T he digital rectal exam (DRE) should always be included as part of prostate cancer screening. It is an important predictor for prostate cancer, and in particular, aggressive prostate cancer. The DRE sometimes picks up cancers before a PSA test...

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Article 232 of 315
PSA Velocity: Helpful for All Men Over Age 40
P SA Velocity (PSAV), the change in PSA per year, has become an important tool in early detection of prostate cancer and in distinguishing prostate cancer from benign conditions. In addition, recent studies show a link between PSAV and prostate ca...

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Article 233 of 315
Editorial Comment: USPSTF Makes PSA Screening Recommendations Without Urology Representative
By William J. Catalona
The medical journal, Urology, invited Dr. Catalona to prepare an editorial comment for one of its articles on the topic of recent recommendations for PSA screening from the US Preventive Services Task Force (USPSTF) The reprint follows: T he US Pr...

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Article 234 of 315
Two PSA Test Standards Are Causing Problems in Screening for Prostate Cancer
By William J. Catalona, MD
Two PSA test standards are causing serious problems for early detection of prostate cancer. If patients and their doctors are not aware of the differences in tests, early diagnosis and life-saving treatment could be delayed. The issue involves how PS...

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Article 235 of 315
Not Using Cipro
By Dr. Patrick Walsh, MD
T he use of ciprofloxacin (Cipro) as a test to see whether an elevated PSA level will decrease is controversial. On one hand, clinical experience has shown that if the PSA decreases to previously low levels, it is possible to avoid a prostate biop...

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Article 236 of 315
Drop in Prostate Cancer Mortality Rates During PSA Screening Era
By Cecilia Lacks, PhD
At the end of 2008, the National Cancer Institute published its findings on the incidence of various cancers and cancer-caused deaths with encouraging news regarding most cancers and especially for prostate cancer. The media picked up the drop in ...

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Article 237 of 315
A Critical Analysis of Two Randomized Trials
By Patrick C. Walsh, M.D.
n March 2009, the results of two long awaited trials were published in the New England Journal of Medicine.1,2 One said that screening with PSA reduced deaths from prostate cancer by up to 27% and the other claimed it didn’t work. What are we to b...

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Article 238 of 315
Two Recent PSA Screening Studies
By William J. Catalona, MD
The European Randomized Study of Screening for Prostate Cancer (ERSPC) reported that men who were assigned to be screened had a 20% lower death rate from prostate cancer than men not assigned to be screened. However, screening carried a high risk for...

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Article 239 of 315
The PSA Story: It’s A Lot More Than a PSA Score
(Misop Han, M.D.; Peter H. Gann, M.D., Sc.D.; William J. Catalona, M.D. prepared a paper on PSA and Screening for Prostate Cancer for the journal Medical Clinics of North America. This article is a portion of that paper revised by Cecilia Lacks, PhD...

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Article 240 of 315
The Finasteride Controversy: Questions About Safety Remain
By by William J. Catalona, MD
An article in the New York Times (June 15, 2008) suggested that men might be well advised to take finasteride (Proscar) every day to prevent prostate cancer. I believe that important, unanswered questions remain about the safety and efficacy of fi...

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Article 241 of 315
It’s Not Your Father’s PSA Test Anymore
For more than a decade, PSA (prostate specific antigen) has been approved by the US FDA both as an aid to the early detection of prostate cancer and as a means of monitoring for disease recurrence after treatment. However, PSA elevations can also ...

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Article 242 of 315
Active Monitoring Has Its Risk
By by William J. Catalona, MD
I am not a fan of active monitoring or watchful waiting for men with a life expectancy of 10 years or more. There are several treatment options for men with low volume, low grade prostate cancer. In recent practice, one of them now frequently bein...

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Article 243 of 315
Genetics and Aggressive Prostate Cancer
Brian Helfand, MD, PhD, a urology resident at Northwestern working in Dr. Catalona’s research group, delivered a presentation for the recent American Urological (AUA) Association to answer the question: Do the 3 significant 8q24 prostate cancer su...

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Article 244 of 315
The Wrong Call on Prostate Cancer Screening
By by William J. Catalona, MD
OpEd piece published in the Washington Post, August 26, 2008 Numerous media reports followed a federal task force's announcement this month that there is insufficient medical evidence to assess the risks and benefits of prostate cancer screening i...

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Article 245 of 315
Radiation After RP: To Do or Not To Do
This article is adapted by Cecilia Lacks, PhD, for Quest from two * journal articles on the topic of salvage radiotherapy vs. observation in men who have had a recurrence after a radical prostatectomy as indicated by a detectable and rising PSA. The ...

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Article 246 of 315
Dr. Catalona’s Response to Question On: Proton Radiation Therapy As Treatment Alternative
By Willam J. Catalona, MD
What is your opinion on using proton radiation therapy as an alternative to surgery for the treatment of prostate cancer? I do not recommend proton beam radiation therapy to my patients. I believe surgery is more effective than any form of radi...

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Article 247 of 315
My Position on Laparoscopic and Robotic Radical Prostatectomy
By William J. Catalona, MD
With the advent of laparoscopic and robotic-assisted laparoscopic surgery, and with the wide-acceptance of laparoscopic gall bladder surgery, the appeal of using the technique in radical prostatectomy has been tempting to patients, with unfortunate r...

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Article 248 of 315
Treatments for Enlarged Prostate: Dr. Catalona’s Response
By Dr. Catalona
Q: What procedures or techniques have been shown to have long-term relief or benefits for an enlarged prostate? Can you tell something about Prolieve Thermodilatation System and Green-Light-Photo Selective Vaporization? A: The standard initial tre...

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Article 249 of 315
Dr. Catalona’s Recommended Guidelines for PSA Screening
By William J. Catalona, MD
Differing comments are in the media regarding the use of PSA tests. In this article, Dr. Catalona, whose research developed the use of PSA tests for the early detection of prostate cancer, presents his personal and most recent recommendations for P...

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Article 250 of 315
Nutrition News Update: Multi-Vitamins and Prostate Cancer Risk
The place of diet, vitamins and supplements for prostate health is in limbo. New studies are showing that even foods we thought were helpful, such as those with lycopene, seem to have no benefit. And some of them, such as heavy doses of beta-carot...

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Article 251 of 315
The Controversial Issue of Treating Recurrent Prostate Cancer
Part 1: An Initial Discussion
I am the Secretary of the URF Board and a patient of Dr. Catalona. He performed my radical prostatectomy in September 1997. I’ve written in Quest for over 5 years. I study, write, counsel, and lecture, but I am not a doctor. Background It’s hig...

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Article 252 of 315
Dr. Catalona’s Recommendations for PSA Testing
By William J. Catalona, MD
My feeling is that testing should begin at age 40 but not because prostate cancer is a common problem in 40-year old men – although it does occur in 40-year-old men . One of the things we’re learning about PSA testing is that the trend of the scor...

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Article 253 of 315
8Q24: A Hot Number on the Hit Parade
By Cecilia Lacks, PhD
Researchers are looking for genetic hot spots in prostate cancer patients, and it appears that they found some in a marker area 8q24 (a region labeled 24 on the long arm of chromosome 8). Location, Location, Location "What we're looking for are p...

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Article 254 of 315
Nutrition News Updates
Lycopene Not Useful In Preventing Prostate Cancer Lycopene, thought to be useful in decreasing the risk for prostate cancer, appears to provide no protection at all. The report is disappointing because popular thinking, even among doctors, was ...

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Article 255 of 315
Alleles: Secrets to Cancer Risk
By Cecilia Lacks, PhD
For the past decade, scientists have been attempting to crack the genetic code underlying the development of prostate cancer. While many scientists came up with possibilities, other researchers were seldom able to reproduce their findings. Howe...

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Article 256 of 315
Know Your Test: PSA Standardization Dilemma
By William J. Catalona, MD
In recent years, it has become evident that the same patient, who has more than one PSA test, can have different PSA results if the blood samples were sent to different laboratories. Now, we know these differences in reported values are due primar...

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Article 257 of 315
Improving Prostate Cancer Detection
By Stacy Loeb, MD and William J. Catalona, MD from an article: “PSA Isoforms: The Next Generation of Prostate Cancer Detection” in Clinical Laboratory News, March 2007
PSA Screening Works PSA screening has proved useful in detecting prostate cancer early enough for life-saving treatment. PSA screening has proved useful in detecting prostate cancer early enough for life-saving treatment. In the US, the prop...

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Article 258 of 315
Hormonal Therapy Explained
By William J. Catalona, MD
Dr. Catalona has written articles and answered questions on the topic of hormonal therapy in previous issues of Quest, but recent studies have provided new information. This article updates material previously in Quest on the topic of hormonal therap...

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Article 259 of 315
Active Treatment: Not Active Monitoring
By Stacy Loeb, MD and William J. Catalona, MD, based on a portion of a paper prepared for the Journal of the National Comprehensive Cancer Network.
Recently, active monitoring strategies have received attention as a possible treatment option for men with low-risk prostate cancer who have a life expectancy of more than 10 years. Even though there has been a 32.5% decline in age-adjusted prosta...

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Article 260 of 315
Active Monitoring Versus Potential Complications from RRP
Background: Since the introduction of widespread PSA screening, prostate cancer has become the leading cancer diagnosis in US men. Even though death from prostate cancer has significantly declined in recent years, there is concern that the treatment...

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Article 261 of 315
PSA Velocity in Men with Prostatitis
Background: Many studies have demonstrated the usefulness of PSA Velocity (PSAV) in prostate cancer screening. However, the often dramatic elevations in PSA values observed in men with prostatitis (PR) could potentially cause confusion in the use of...

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Article 262 of 315
Recommendations for CaP Testing and Then Treatment
By William J. Catalona, MD
My research and the research of my colleagues show the most effective and acceptable treatment for prostate cancer is to eradicate the tumor at a very early stage before it has a chance to spread. The risk of unnecessary treatment is low when good...

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Article 263 of 315
Being Overweight Can Affect Prostate Cancer Aggressiveness
By (This information is an adapted version for Quest readers of a medical journal article written by Stacy Loeb, MD; Xiaoying Yu, MD; Robert B. Nadler, MD; Kimberly A. Roehl; Misop Han, MD; Sheila A. Hawkins, MD; and William J. Catalona, MD)
Weight, especially being overweight, is a sensitive topic on its own. Studying whether or not weight – in this case Body Mass Index * – affects or can predict outcomes after radical prostatectomy could be an uncomfortable topic to discuss with patien...

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Article 264 of 315
Watchful Waiting: Outcomes and Treatment Recommendations for Older Men
By (From Research Summary)
Background: Limited information exists on the outcomes of watchful waiting or active monitoring in men with prostate cancer (CaP). We are most interested in determining if older men can skip treatment and do watchful waiting. Question: What were t...

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Article 265 of 315
Perineural Invasion in a Prostate Biopsy Specimen Is Not the Same as PNI in Prostatectomy Specimen
By (From Research Summary)
Background: Many pathologists who examine prostate cancer biopsies believe that perineural invasion* (PNI) is present in all radical prostatectomy specimens if a careful search is made. For this reason, some pathologists do not even report the pre...

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Article 266 of 315
Exploring Genetic Approaches for Diagnosis, Treatment and Cure
By Cecilia Lacks, PhD
The usual way people think about disease is that it comes from a bacteria or virus and sometimes from an environmental agent. The cures are most often medicines that help the immune system fight the invading agents or, in the case of the environme...

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Article 267 of 315
Benefits exceed risks for PSA in prostate cancer screening
By Dr. William J Catalona, Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
MedWire - ASCO Prostate Cancer Symposium (San Francisco, CA, USA) - February 24, 2006: The pros and cons of widespread PSA screening are constantly debated at medical meetings, and clinicians are still divided on whether or not it can reduced overall...

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Article 268 of 315
Answers to Common Questions About PSA Testing
By This information is an adapted version of a medical journal article written by William J. Catalona, MD; Misop Han, MD; and Stacy Loeb, MD.
Should Screening for Prostate Cancer Begin Before 50 years old? We, as well as the National Comprehensive Cancer Network, recommend a baseline PSA test for all men at age 40 years to assess their risk for prostate cancer. A relevant study (Whit...

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Article 269 of 315
Screening Works: Prostate Cancer Death Rate Drops to Lowest Mark Ever
By reprinted courtesy of National Prostate Cancer Coalition
Prostate cancer death rates dropped 32.5 percent in 10 years, according to new reports, possibly as a result of a dramatic increase in early detection. The mortality rate for African American men is the lowest since 1977, but it is still 2.36 times t...

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Article 270 of 315
Healthy Cholesterol Levels Could Lower Prostate Cancer Risk
By (Dr. Catalona Responds to Reports in the News.)
A recent study (Platz, John Hopkins Bloomberg School of Public Health) found that men who took drugs to reduce their cholesterol levels also had a lower risk for prostate cancer. This study also found that men who were diagnosed with prostate canc...

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Article 271 of 315
Digital Rectal Exam is Worth Doing
By (Dr. Catalona Responds to Reports in the News.)
There has been some debate about whether it is still necessary to use the digital rectal exam in prostate cancer screening. Our recent study, (Catalona and Okotie) shows that a significant proportion of patients whose cancers are detected by the r...

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Article 272 of 315
Underdiagnosis More of a Problem In Prostate Cancer Than Overdiagnosis
A small but vocal group of physicians is saying that prostate cancer screening has resulted in overdiagnosis and therefore overtreatment of prostate cancers. The reality is that prostate cancer screening is doing considerably more good than harm. ...

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Article 273 of 315
Dr. Catalona’s Recommended Guidelines for PSA Screening
By William J. Catalona, MD
Differing comments are in the media regarding the use of PSA tests. In this article, Dr. Catalona, whose research developed the use of PSA tests for the early detection of prostate cancer, presents his personal and most recent recommendations for PSA...

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Article 274 of 315
Underdiagnosis and Overdiagnosis of Prostate Cancer
By (Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)
INTRO: In 2005, prostate cancer accounted for approximately one third of new cancer diagnoses in men in the United States. Some men with clinically localized cancer undergo radical prostatectomy, but the final pathology report shows more extensive...

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Article 275 of 315
Predicting “Clinically Insignificant Prostate Cancer” With Combined PSA density and Biopsy Features
By (Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)
INTRO: Active monitoring protocols, including “watchful waiting,” are being increasingly used to avoid unnecessary treatment for men with “clinically insignificant prostate cancer.” QUESTION: Can the PSAD (PSA density), the number of positive biop...

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Article 276 of 315
Adjuvant Radiation Therapy After Radical Prostatectomy
By (Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)
INTRO: New studies are demonstrating that adjuvant radiation therapy improves PSA progression-free survival in men with adverse pathology in their surgical specimen. Adjuvant radiotherapy is given as a precautionary measure in patients who have adver...

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Article 277 of 315
Dr. Catalona’s Response to DaVinci Robotics
By William J. Catalona, MD
“I do not believe the robotic prostatectomy is as safe a cancer operation as open radical prostatectomy.” In my opinion, the robotic prostatectomy (often called the DaVinci prostatectomy) is not as effective as the traditional open prostatectomy f...

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Article 278 of 315
Early Detection of Prostate Cancer: Saving Lives Or Overtreating
By Dr. Willian J. Catalona
No way to know for certain that any tumor is insignificant Some academic centers are moving toward not immediately treating prostate cancer patients who have favorable tumor features (i.e., low Gleason grade and low volume of cancer in biopsy spec...

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Article 279 of 315
PSA Dilemma: Test Results and What Should Be Done About Them
By Dr. William J. Catalona
The goal of prostate cancer screening is to reduce prostate cancer-related suffering through early detection of curable cancers that can cause disability or death. At the same time, the goal is to minimize unnecessary diagnosis, and therefore unne...

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Article 280 of 315
Signs Of Success
Dr. Catalona is presenting the case for early detection of prostate cancer at medical conferences across the United States. QUEST is including information from his presentation in this issue and in upcoming issues. Men 65 years of age and younger ...

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Article 281 of 315
Reports From Dr. Catalona’s Follow-up Studies
By Prepared by Cecilia Lacks, PhD
Age-Specific Risk of Prostate Cancer: Intro: A man's risk of developing prostate cancer increases if his baseline PSA is above the median for his age group. Many physicians consider a PSA level of 2.5 or 4.0 ng/ml a threshold for prostate biopsy. ...

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Article 282 of 315
PSA Tests Are Not All the Same
By William J. Catalona, MD
In recent years, patients, physicians, and clinical laboratories have become increasingly aware of differences in PSA results when the same patient has more than one test and those blood samples have been sent to different laboratories. It is beco...

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Article 283 of 315
Erectile Dysfunction Following Radical Prostatectomy
By Dr. Arthur L. Burnett
Changes in the surgical approach to RRP permit the procedure to be performed with significantly improved outcomes. Expectations are that physical capacity is fully recovered in most patients, but it takes time: from several weeks to 18 months for ret...

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Article 284 of 315
Comparing Treatments for Prostate Cancer: Radical Prostatectomy, Radiotherapy and Hormonal Therapy
Screening is widely used as an aid to early detection of prostate cancer. Early detection increases the opportunity for long-term progression-free survival. Presently, the selection of treatment for early stage prostate cancer involves four choices: ...

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Article 285 of 315
Reports From Dr. Catalona’s Follow-Up Studies
By William J. Catalona, MD
Dr. Catalona and his research collaborators will be delivering their latest research findings at the American Urological Association (AUA) annual meeting. Although the information is technical, the following summaries are written with QUEST reader...

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Article 286 of 315
Recommended: Eye Exam Before Taking Viagra In High Risk Patients
By William J. Catalona, MD
Recently, 14 men were reported to have developed vision loss (completely reversible in some case, permanent in others) in one or both eyes within 36 hours after taking Viagra. In most of these patients, initial symptoms were blurred vision and som...

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Article 287 of 315
Dr. Catalona Responds to Stories and Studies About Use of PSA Testing and Treatments for Prostate Cancer
By William J. Catalona, MD
In the following Questions and Answers, Dr. Catalona responds to questions he hears most often regarding PSA testing, early detection, and prostate cancer treatment. In light of so many confusing and contradictory messages in recent media coverag...

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Article 288 of 315
Reports From Dr. Catalona’s Follow-Up Studies
Dr. Catalona and his research collaborators delivered their research findings at the Prostate Cancer Foundation Annual Scientific Retreat and at the American urological Association (AUA) annual meeting. Although the information is technical, the f...

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Article 289 of 315
Importance of PSA 2.5 Threshold for Biopsy
"In men with a PSA of 2.5-4, it appears that putting off a biopsy is not only postponing the inevitable, but is allowing cancer to grow when it could be taken care of in an earlier and more curable stage. William J. Catalona, MD Baseline or in...

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Article 290 of 315
PSA Velocity:
Important New Tool in Fight Against Prostate Cancer
By William J. Catalona, MD
One of the big but unanswered questions about prostate cancers is: Which ones are aggressive and which ones are not? In a recent study, my research partners and I have found some answers that very likely will change the way prostate cancer is diag...

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Article 291 of 315
New Results for Postoperative Radiotherapy
By William J. Catalona, MD
Several previous articles in QUEST and on the drcatalona.com website address postoperative radiotherapy, but recent reports have increased our knowledge, and this article supplements those previous ones. History In the past, we, and other...

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Article 292 of 315
The PSA Story: Early Detection Is Making a Difference
If there were no effective treatment for prostate cancer, early detection would not be important, but studies are showing that patients treated with a radical prostatectomy have less deaths and less spreading of the cancer compared to those in ...

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Article 293 of 315
Reports from Dr. Catalona's Follow-up Studies
By William J. Catalona, M.D.
Each year, Dr. Catalona and his research collaborators deliver their research findings at the American Urological Association (AUA) annual meeting. In the last issue of QUEST, we summarized findings from recent research projects of Dr. Catalona an...

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Article 294 of 315
Dr. Catalona Comments:
Lowering PSA Threshold to 2.6 Is Sound Practice
By William J. Catalona, MD
Much publicity has been given to a new study suggesting that biopsies should be recommended for men whose PSA tests 2.6 or higher. (We introduced the study in the Fall 2003 QUEST and cover it extensively in this Winter 2003 issue.) Previous pr...

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Article 295 of 315
Tumor Volume and Prostate Cancer
By William J. Catalona, MD
Even when the pathology report after a radical prostatectomy states that it looks like all of the cancer was confined to the prostate gland, some percentage of men have a recurrence of the cancer at a later date. In these instances, although it lo...

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Article 296 of 315
Reports From Dr. Catalona's Follow-Up Studies
By Cecilia Lacks, PhD
Reports From Dr. Catalona's Follow-Up Studies Prepared by Cecilia Lacks, PhD, from Presentation Proposals to the AUA prepared by William J. Catalona, MD and his research collaborators Each year, Dr. Catalona and his research collaborators ...

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Article 297 of 315
ProPSA:
Possibly a Better Marker for Prostate Cancer
By William J. Catalona, MD
PSA testing has revolutionized the early diagnosis and treatment of prostate cancer. Increasing evidence shows that PSA testing is also responsible for the decreasing prostate cancer death rates occurring in the US and other countries. In the U...

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Article 298 of 315
PSA Screening: It's A Must
By William J. Catalona, MD
Prostate cancer has no known means of prevention and no known cure for advanced-stage disease; therefore, the only method for reducing the mortality and morbidity from prostate cancer is to detect it early and treat it effectively. Screening with ...

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Article 299 of 315
PIN and Prostate Cancer:
New Studies Show Less Risk
By William J. Catalona, MD
PIN (prostatic intraepithelial neoplasia), a microscopic finding reported in 5% to 10% of prostate biopsies, has been regarded as a red flag suggesting the possible presence of cancer. However, in recent years, some research groups have found that...

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Article 300 of 315
Proscar Is In the News: Dr. Catalona Responds
By William J. Catalona, MD
RISK USING PROSCAR OR PROPECIA
Q: What information do you have regarding the increased risk of high grade prostate cancer when taking Proscar or Propecia(finasteride)?

A: Proscar is in the family of drugs commonly used to treat or prevent ...

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Article 301 of 315
Dr. Catalona Discusses Continence After A Radical Prostatectomy
By Cecilia Lacks, PhD
One of the most feared side effects of total prostate removal (radical prostatectomy) for treatment of prostate cancer is urinary incontinence, but that fear far outweighs the reality. "Permanent incontinence after a radical prostatectomy occurs i...

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Article 302 of 315
Postoperative Treatment After A Radical Prostatectomy
By William J. Catalona, MD
Doctors and patients alike hope that removing the prostate, a radical prostatectomy (RP), will be a successful, life-long treatment for prostate cancer. Still, patients need to be informed of recommended further testing after the surgery and preve...

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Article 303 of 315
Dr. Catalona Discusses Nerve-Sparing Surgery
By Cecilia Lacks, PhD
Defining a nerve-sparing radical prostatectomy is easy: During the surgical removal of the prostate gland, an attempt is made to spare the two cavernous nerve sheaths (lying slightly underneath and to the sides of the gland) that produce erections. ...

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Article 304 of 315
Recent Prostate Cancer Studies
At a conference focused on prostate cancer treatments and cures, Dr. Catalona presented findings on recent prostate cancer studies. The following are summaries of those presentations: Age Has Impact on Continence After RRP Dr. Catalona complet...

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Article 305 of 315
Nerve-sparing RRP Preserves Potency and Continence
Nerve-sparing RRP (radical prostatectomy) can result in preserving potency and continence with a low complication rate. Complications can be reduced with increasing surgeon experience. The June 19 Wall Street Journal contained an article on ner...

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Article 306 of 315
Screening for Prostate Cancer:
What's the Controversy All About
By William J. Catalona, M.D.
The value of routine screening for prostate cancer has been a recent topic of several articles in prominent newspapers. Some of these articles imply that the screening tests can be as dangerous as the cancers they detect. Screening for prostate ca...

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Article 307 of 315
Early Treatment Options for Prostate Cancer
By William J. Catalona, MD
Different treatment options allow for more success in early treatment of localized prostate cancer. "Watchful Waiting" The most conservative, least invasive treatment for prostate cancer is so-called "watchful waiting," which also includes die...

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Article 308 of 315
Initial Biopsies Miss Many Prostate Cancers
By William J. Catalona, M.D.
The need for repeat prostate biopsies is a common occurrence in men with elevated PSA levels or a suspicious digital examination whose initial biopsies do not show prostate cancer. Dr. Catalona suggested that with the recent ability to perform a l...

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Article 309 of 315
Help With Obtaining and Maintaining Erections
By William J. Catalona, M.D.
The fear of impotence is almost always present in a discussion about the treatment for prostate cancer. If prostate cancer is detected early and patients are treated by an experienced surgeon using nerve sparing techniques, then in the vast majo...

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Article 310 of 315
Free PSA Test Helps in Prostate Cancer Diagnosis
By William J. Catalona, M.D.
A relatively new and helpful addition in the diagnosis of prostate cancer is the free PSA Test. This blood test is done in addition to the PSA Test and the finger (digital) examination. The PSA Test measures a protein in the blood that is produ...

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Article 311 of 315
Requirements for Postoperative Radiation Therapy
By William J. Catalona, M.D.
Postoperative radiation therapy is for patients who have a rising PSA after radical prostatectomy or have adverse findings in their radical prostatectomy pathology report. These adverse findings are extra-prostatic tumor extension, cancer cells...

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Article 312 of 315
Hormonal Therapy Explained
By William J. Catalona, M.D.
This article has been updated, but we are keeping it on the site for background information. Please see article on this website: Hormonal Therapy Explained from the Fall 2007 Quest for Dr. Catalona’s most recent explanation. The following arti...

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Article 313 of 315
Recent Studies Raise Questions About Effectiveness Of Radioactive Seed Implantation
By William J. Catalona, M.D.
After a decade of being abandoned, the implantation of radioactive seeds for prostate cancer has become popular again and is being marketed aggressively in many places. Implantation of radioactive seeds was first popularized in the 1970s, but the lo...

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Article 314 of 315
Intermittent Hormonal Therapy
By William J. Catalona, M.D.
Intermittent Hormonal Therapy is a new, experimental treatment option for prostate cancer. Previous Use of Hormonal Therapy Hormonal therapy is usually effective in the treatment of prostate cancer, especially for patients who have had recurren...

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Article 315 of 315
Postoperative Radiotherapy Improves Cure Rate in High-Risk Prostate Cancer Patients
By William J. Catalona, M.D.
Postoperative radiotherapy improves the chances for cancer-free survival in prostatectomy patients whose pathology report shows adverse findings. Examples of adverse findings are the extension of cancer cells through the capsule of the prostate,...

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