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Additional Quest Articles
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Article 1 of 112
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Message From Dr. Catalona About How and Why PSA Testing Saves Lives: To QUEST Readers, My Patients and Their Families
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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...
/quest/Winter2011/article1.html
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Article 2 of 112
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Public and Professional Reactions to U.S. Preventive Services Task Force Recommendations on PSA Screening
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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 3 of 112
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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.
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By (prepared by Cecilia Lacks, PhD)
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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 4 of 112
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An Executive Approach: Managing a Prostate Cancer Diagnosis
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By Cissy Lacks
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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 5 of 112
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Misconceptions About Prostate Cancer Diagnosis
Prostate Cancer is Difficult... But Foregoing PSA Testing & Not Knowing? Unbelievable!
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By Marcy Manning
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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 6 of 112
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Dr. Catalona Gives Ramon Guiteras Lecture: Early Diagnosis of Prostate Cancer Through PSA Testing Saves Lives
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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 7 of 112
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Low, But Rising, PSA Can Predict Poor Prognosis and High-Grade CaP
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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 8 of 112
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Dr. Catalona’s Opinion: Another Bad Use of Dutasteride
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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 9 of 112
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Dr. Catalona Discusses: FDA Approval of Abiraterone Acetate (ZYTIGA)
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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 10 of 112
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Team Building: It’s Not Just A Sports Thing
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By Cissy Lacks
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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 11 of 112
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Prostate Cancer Treatment Outcomes: Men Who Follow Recommended Testing Guidelines Do Better
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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 12 of 112
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Looking To the East for Clues To Inhibit Prostate Cancer Metastasis
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By Cecilia Lacks, PhD
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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 13 of 112
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On the Go:
One Fast Recovery
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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 14 of 112
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PSAV Is A Useful Tool
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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 15 of 112
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FDA Panel Recommends Against Drugs For Prostate Cancer Prevention
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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 16 of 112
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Dr. Patrick Walsh Explains: FDA Advisory Panel Rejects Proscar and Avodart to Reduce Risk of Prostate Cancer
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By Dr. Patrick Walsh
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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 17 of 112
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Genetics and Prostate Cancer: The Continuing Search for Risk Markers
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By Cecilia Lacks, PhD
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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 18 of 112
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Follow-up Is Everything: The True Number Needed to Screen & Treat To Save A Life with PSA Testing
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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.)
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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 19 of 112
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Nanotechnology:
Determining a PSA Level That Will Define a “No Evidence of Disease”
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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.
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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 20 of 112
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Which Prostate Cancers Are Aggressive and Which Aren’t?
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By Cecilia Lacks, PhD
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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 21 of 112
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How Long Can Surgery Be Safely Delayed In Men With Low Risk Prostate Cancer?
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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 22 of 112
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Nanotechnology: Helping To Make Better Treatment Decisions After A Radical Prostatectomy
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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 23 of 112
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PSA Velocity Risk Count Helps Identify Clinically Significant Prostate Cancer
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By (This article is prepared for QUEST readers from a study* presented at a recent AUA meeting.)
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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 24 of 112
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Pressure Socks and Early Walking Prevent Blood Clots After RP
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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...
/quest/Winter2010/article6.html
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Article 25 of 112
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Avodart© No Different From Finasteride: It Also Might Mask High-Grade Prostate Cancer.
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By William J. Catalona, MD
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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 26 of 112
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AUA Releases New PSA Guidelines
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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 27 of 112
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Digital Rectal Exam: An Important Part of Prostate Cancer Screening
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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 28 of 112
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PSA Velocity: Helpful for All Men Over Age 40
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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 29 of 112
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Editorial Comment: USPSTF Makes PSA Screening Recommendations Without Urology Representative
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By William J. Catalona
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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 30 of 112
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Two PSA Test Standards Are Causing Problems in Screening for Prostate Cancer
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By William J. Catalona, MD
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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...
quest/quest_spring09_5.htm
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Article 31 of 112
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Not Using Cipro
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By Dr. Patrick Walsh, MD
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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 32 of 112
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Drop in Prostate Cancer Mortality Rates
During PSA Screening Era
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By Cecilia Lacks, PhD
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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 33 of 112
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A Critical Analysis of Two Randomized Trials
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By Patrick C. Walsh, M.D.
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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 34 of 112
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Two Recent PSA Screening Studies
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By William J. Catalona, MD
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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 35 of 112
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The PSA Story:
It’s A Lot More Than a PSA Score
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(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...
quest/Spring04/quest_spring04_1.asp
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Article 36 of 112
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The Finasteride Controversy: Questions About Safety Remain
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By by William J. Catalona, MD
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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 37 of 112
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It’s Not Your Father’s PSA Test Anymore
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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 38 of 112
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Active Monitoring Has Its Risk
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By by William J. Catalona, MD
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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 39 of 112
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Genetics and Aggressive Prostate Cancer
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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 40 of 112
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The Wrong Call on Prostate Cancer Screening
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By by William J. Catalona, MD
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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 41 of 112
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Radiation After RP: To Do or Not To Do
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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 42 of 112
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Dr. Catalona’s Response to Question On: Proton Radiation Therapy As Treatment Alternative
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By Willam J. Catalona, MD
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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 43 of 112
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My Position on Laparoscopic and Robotic Radical Prostatectomy
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By William J. Catalona, MD
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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 44 of 112
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Treatments for Enlarged Prostate: Dr. Catalona’s Response
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By Dr. Catalona
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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 45 of 112
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Dr. Catalona’s Recommended Guidelines for PSA Screening
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By William J. Catalona, MD
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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 46 of 112
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Nutrition News Update:
Multi-Vitamins and Prostate Cancer Risk
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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 47 of 112
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The Controversial Issue of Treating Recurrent Prostate Cancer
Part 1: An Initial Discussion
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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 48 of 112
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Dr. Catalona’s Recommendations for PSA Testing
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By William J. Catalona, MD
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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 49 of 112
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8Q24: A Hot Number on the Hit Parade
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By Cecilia Lacks, PhD
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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 50 of 112
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Nutrition News Updates
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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 51 of 112
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Alleles: Secrets to Cancer Risk
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By Cecilia Lacks, PhD
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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 52 of 112
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Know Your Test: PSA Standardization Dilemma
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By William J. Catalona, MD
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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 53 of 112
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Improving Prostate Cancer Detection
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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
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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 54 of 112
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Hormonal Therapy Explained
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By William J. Catalona, MD
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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 55 of 112
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Active Treatment: Not Active Monitoring
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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.
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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 56 of 112
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Active Monitoring Versus Potential Complications from RRP
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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 57 of 112
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PSA Velocity in Men with Prostatitis
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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 58 of 112
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Recommendations for CaP Testing and Then Treatment
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By William J. Catalona, MD
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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 59 of 112
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Being Overweight Can Affect Prostate Cancer Aggressiveness
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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)
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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 60 of 112
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Watchful Waiting: Outcomes and Treatment Recommendations for Older Men
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By (From Research Summary)
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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 61 of 112
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Perineural Invasion in a Prostate Biopsy Specimen Is Not the Same as PNI in Prostatectomy Specimen
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By (From Research Summary)
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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 62 of 112
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Exploring Genetic Approaches for Diagnosis, Treatment and Cure
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By Cecilia Lacks, PhD
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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 63 of 112
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Benefits exceed risks for PSA in prostate cancer screening
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By Dr. William J Catalona, Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
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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 64 of 112
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Answers to Common Questions About PSA Testing
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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.
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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 65 of 112
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Screening Works: Prostate Cancer Death Rate Drops to Lowest Mark Ever
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By reprinted courtesy of National Prostate Cancer Coalition
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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 66 of 112
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Healthy Cholesterol Levels Could Lower Prostate Cancer Risk
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By (Dr. Catalona Responds to Reports in the News.)
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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 67 of 112
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Digital Rectal Exam is Worth Doing
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By (Dr. Catalona Responds to Reports in the News.)
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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 68 of 112
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Underdiagnosis More of a Problem In Prostate Cancer Than Overdiagnosis
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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. ...
quest/quest_Winter06_11.asp
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Article 69 of 112
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Dr. Catalona’s Recommended Guidelines for PSA Screening
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By William J. Catalona, MD
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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 70 of 112
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Underdiagnosis and Overdiagnosis of Prostate Cancer
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By (Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)
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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 71 of 112
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Predicting “Clinically Insignificant Prostate Cancer”
With Combined PSA density and Biopsy Features
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By (Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)
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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 72 of 112
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Adjuvant Radiation Therapy After Radical Prostatectomy
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By (Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)
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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 73 of 112
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Dr. Catalona’s Response to DaVinci Robotics
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By William J. Catalona, MD
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“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 74 of 112
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Early Detection of Prostate Cancer:
Saving Lives Or Overtreating
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By Dr. Willian J. Catalona
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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...
quest/quest_spring06_1.asp
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Article 75 of 112
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PSA Dilemma: Test Results and What Should Be Done About Them
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By Dr. William J. Catalona
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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 76 of 112
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Signs Of Success
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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 77 of 112
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Reports From Dr. Catalona’s Follow-up Studies
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By Prepared by Cecilia Lacks, PhD
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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 78 of 112
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PSA Tests Are Not All the Same
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By William J. Catalona, MD
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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...
quest/Winter05/quest_winter05_3.asp
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Article 79 of 112
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A Conversation with Dr. Kevin McVary
Enlarged Prostate: Causes, Symptoms and Treatment
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By Cecilia Lacks, PhD
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BPH
Benign (non-cancerous)prostatic hypertrophy– is an enlargement or growth of the area in the prostate gland that is nearest the urethra.
This growth can block or constrict the urethra, causing urination problems.
BPH is one of the most co...
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Article 80 of 112
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Erectile Dysfunction Following Radical Prostatectomy
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By Dr. Arthur L. Burnett
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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...
http://www.drcatalona.com/quest/quest_fall05_1.htm
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Article 81 of 112
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Comparing Treatments for Prostate Cancer: Radical Prostatectomy, Radiotherapy and Hormonal Therapy
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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 82 of 112
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Reports From Dr. Catalona’s Follow-Up Studies
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By William J. Catalona, MD
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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 83 of 112
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Recommended: Eye Exam Before Taking Viagra In High Risk Patients
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By William J. Catalona, MD
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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 84 of 112
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Dr. Catalona Responds to Stories and Studies About Use of PSA Testing and Treatments for Prostate Cancer
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By William J. Catalona, MD
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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...
quest/Winter04/quest_winter04_1.asp
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Article 85 of 112
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Reports From Dr. Catalona’s Follow-Up Studies
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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...
quest/Winter04/quest_winter04_5.asp
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Article 86 of 112
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Importance of PSA 2.5 Threshold for Biopsy
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"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...
quest/Winter04/quest_winter04_6.asp
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Article 87 of 112
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PSA Velocity:
Important New Tool in Fight Against Prostate Cancer
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By William J. Catalona, MD
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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...
quest/Summer04/quest_summer04_2.asp
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Article 88 of 112
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New Results for Postoperative Radiotherapy
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By William J. Catalona, MD
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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 89 of 112
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The PSA Story: Early Detection Is Making a Difference
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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 ...
quest/Summer04/quest_summer04_9.asp
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Article 90 of 112
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Reports from Dr. Catalona's Follow-up Studies
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By William J. Catalona, M.D.
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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...
quest/Spring04/quest_spring04_3.asp
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Article 91 of 112
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Dr. Catalona Comments:
Lowering PSA Threshold to 2.6 Is Sound Practice
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By William J. Catalona, MD
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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 92 of 112
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Tumor Volume and Prostate Cancer
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By William J. Catalona, MD
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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 93 of 112
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Reports From Dr. Catalona's Follow-Up Studies
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By Cecilia Lacks, PhD
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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 94 of 112
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ProPSA:
Possibly a Better Marker for Prostate Cancer
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By William J. Catalona, MD
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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 95 of 112
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PSA Screening: It's A Must
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By William J. Catalona, MD
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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 96 of 112
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PIN and Prostate Cancer:
New Studies Show Less Risk
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By William J. Catalona, MD
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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 97 of 112
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Proscar Is In the News: Dr. Catalona Responds
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By William J. Catalona, MD
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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 98 of 112
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Dr. Catalona Discusses Continence After A Radical Prostatectomy
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By Cecilia Lacks, PhD
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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 99 of 112
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Postoperative Treatment After A Radical Prostatectomy
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By William J. Catalona, MD
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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 100 of 112
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Dr. Catalona Discusses Nerve-Sparing Surgery
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By Cecilia Lacks, PhD
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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 101 of 112
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Recent Prostate Cancer Studies
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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 102 of 112
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Nerve-sparing RRP Preserves Potency and Continence
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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 103 of 112
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Screening for Prostate Cancer:
What's the Controversy All About
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By William J. Catalona, M.D.
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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...
quest/quest_spring2002_1.htm
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Article 104 of 112
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Early Treatment Options for Prostate Cancer
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By William J. Catalona, MD
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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...
quest/quest_winter2001_5.htm
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Article 105 of 112
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Initial Biopsies Miss Many Prostate Cancers
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By William J. Catalona, M.D.
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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 106 of 112
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Help With Obtaining and Maintaining Erections
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By William J. Catalona, M.D.
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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 107 of 112
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Free PSA Test Helps in Prostate Cancer Diagnosis
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By William J. Catalona, M.D.
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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...
/quest/quest_article_v9n3.htm
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Article 108 of 112
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Requirements for Postoperative Radiation Therapy
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By William J. Catalona, M.D.
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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...
/quest/quest_article_v9n4.htm
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Article 109 of 112
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Hormonal Therapy Explained
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By William J. Catalona, M.D.
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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 110 of 112
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Recent Studies Raise Questions About Effectiveness Of Radioactive Seed Implantation
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By William J. Catalona, M.D.
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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...
/quest/quest_article_v8n5.htm
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Article 111 of 112
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Intermittent Hormonal Therapy
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By William J. Catalona, M.D.
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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...
/quest/quest_article_v8n1.htm
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Article 112 of 112
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Postoperative Radiotherapy Improves Cure Rate in High-Risk Prostate Cancer Patients
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By William J. Catalona, M.D.
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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,...
/quest/quest_article_v8n3.htm
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