Localized Prostate Cancer: From the Editor
Nomenclature Matters: What Should the Future Be for Gleason Grade Group 1?
In the case of prostate cancer, prostate specific antigen (PSA)-based early detection and the years-to-decades lead time associated with screening has radically changed the clinical meaning of the diagnosis. Countless research articles and reviews on prostate cancer begin by citing the fact that it is the most common non-cutaneous cancer diagnosed among men in the US and in many other countries.
Active Surveillance: The Standard of Care for Low Risk Prostate Cancer
This change is timely, and particularly notable in contrast to the NCCN guideline, which last year not only reiterated the “very low risk” category but transiently removed “preferred” from its listing of surveillance for “low risk” disease, endorsing prostatectomy and radiation as equivalent alternatives. The NCCN reversed this decision a few months later, and now once again states that surveillance is “preferred,” though with multiple caveats and exceptions. So which guideline is more relevant for contemporary practice?
The Road Ahead for Prostate Cancer Disparity
The year 2020 will be remembered for many reasons, few of them good. But among the fires, floods, locusts, and other natural disasters, two tsunamis have swept the country and the world, unequaled in a generation. The first, of course, is the COVID-19 pandemic; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), the other is a groundswell of support for racial justice unequaled in breadth and impact since the civil rights movement over a half-century ago. Both have been met with breathtaking indifference and incompetence by a federal government whose three branches have been rendered virtually powerless by the small-minded machinations of a reactionary minority.
Localized Prostate Cancer: Screening, Risk, Surveillance, and Treatment
As most who find their way to UroToday.com doubtless already know, prostate cancer remains by far the most common non-cutaneous cancer diagnosed, and the second leading cause of cancer death among American men. Worldwide, prostate cancer is steadily rising in both incidence and mortality, with over a 1.1 million new diagnoses and 300,000 deaths annually. In the United States, in the era of PSA-based early detection efforts,
incidence rates have waxed and waned with shifting guidelines and prevalence of PSA testing. Age-adjusted mortality rates have fallen over 50%—the steepest decline of any cancer except lung cancer—and the best statistical models attribute a substantial majority of this decline to screening and to improvements in treatment for localized disease.