Data Supports A Radical Prostatectomy Option for Some Localized Advanced Prostate Cancer

I have often had men recently diagnosed with advanced, metastatic prostate cancer call me and ask if surgery makes any sense for them to consider. I have never been sure how to respond given that their cancer is known to be already out of their gland. In response to this common question, researchers from the Mayo Clinic in Rochester, Minn., U.S had reported at a past American Urological Association (AUA) annual meeting that a radical prostatectomy (RP) for locally advanced prostate cancer (PCa) is technically feasible and is associated with good five- and 10-year outcomes. Dharam Kauschik, M.D. headed a [...]

The Development of A Novel Blood Biomarker for Detecting AR-V7 and Resistance to Zytiga and Xtandi

At the current AUA Annual Meeting going on in New Orleans, there was a presentation given by Haitao Zhang and colleagues. They described their work developing a novel blood-based assay (test) for detecting androgen receptor (AR) splice variants in men with advanced prostate cancer. Their work relies on the premise that AR-V7 expression underlies resistance to abiraterone (Zytiga) and enzalutamide (Xtandi) (This issue is discussed in many other posts on this blog, additional information s available by searching AR-V7). Their work involved the development of a new blood-based assay to detect AR-V expression without the need for CTC isolation, which [...]


A joint task force composed of members from the American Urological Association (AUA) and the American Society for Radiation Oncology (ASTRO) has presented formal guidelines for the use of adjuvant and salvage radiation after a radical prostatectomy. To construct the Guideline they relied on a systematic review of the literature using the Pubmed, Embase and Cochrane databases (search dates 1/1/90 to 12/15/12) to identify peer-reviewed publications relevant to the use of radiotherapy after prostatectomy. They assigned a rating of the strength of the evidence that was used to draw a conclusion, with a strength rating of A (high quality evidence; [...]

The AUA Issues Specific Guidelines for the Treatment of Men with Castrate Resistant Prostate Cancer

There was a lot of interesting and important presentations at the recent American Urological Association meeting, however the one item that will have the most impact on men with advanced prostate cancer is the new guidelines that were proposed for the treatment of men with castrate resistant prostate cancer. The guidelines were organized by creating six different “indexes” which describe the disease state being treated. The indexes are: 1. Asymptomatic non-metastatic CRPC 2. Asymptomatic or minimally-symptomatic, mCRPC without prior docetaxel chemotherapy 3. Symptomatic, mCRPC with good performance status and no prior docetaxel chemotherapy 4. Symptomatic, mCRPC with poor performance status [...]

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