From the Desk of the Editor: Volume 4, Issue 1

Welcome to the current issue of Everyday Urology – Oncology Insights. We begin this issue with our cover story: “Optimizing TURBT and Optical Diagnostics in Bladder Cancer,” authored by Ashish Kamat, MD. Dr. Kamat discusses the crucial importance of performing the optimal TURBT. This is the essential first step in managing newly diagnosed and recurrent bladder cancer, ultimately impacting potential multidisciplinary therapies, for both advanced disease and high risk NMIBC. While transurethral resection of the bladder tumor (TURBT) remains the gold standard ‘first step’ in bladder cancer management (both diagnosis and tumor removal), there can be a high rate of residual tumor left behind after TURBT. He details tips to optimize TURBT as well as a checklist of processes for consideration of prognostic factors.

Optimizing TURBT and Optical Diagnostics in Bladder Cancer

The detection of recurrent tumor is a benchmark by which the success of intravesical agents is determined. Because the U.S. Food and Drug Administration (FDA) will now consider data from single-arm trials for patients with Bacillus Calmette-Guérin (BCG)-unresponsive bladder cancer, the complete response (CR) rates (i.e. absence of disease on biopsy) is a key factor that impacts the success of many registration studies.2,3,4 In addition, several trials in the neoadjuvant setting focus on p0 rates, meaning that disease is not detected in the final pathologic specimen.5 Since the extent of disease detected depends on the quality of the cystoscopy and an optimally performed TURBT can achieve P0 in up to 15% of patients even without enhanced cystoscopy,5 – clearly this has the potential to impact result. 

Immuno-Oncology: The Urologist's Role

Published in Everyday Urology - Oncology Insights: Volume 4 Issue 1
This is an extraordinary time in urology. After decades of relative stagnation, patients with urothelial carcinoma are receiving approved immuno-oncologic drugs that significantly extend survival and are safer and more tolerable than chemotherapy.  The success of these treatments in metastatic bladder cancer has generated strong interest and promising early results for their use in localized disease.

From the Desk of the Editor: Volume 3, Issue 4

Welcome to the final 2018 issue of Everyday Urology - Oncology Insights. On December 6, 2018, UroToday celebrated its fifteenth year online. Over the years, the site has productively evolved, providing concise and innovative coverage of relevant and clinically important contemporaneous updates in urologic oncology as well as curating cutting edge educational videos and discussions amongst leading experts within the field.

Update on ADT in Advanced Prostate Cancer

Prostate cancer is the leading incident cancer among men, and population growth and aging have fueled a 40% rise in global case burden since 2006.1,2 Despite recent improvements in treatment, patients with locally advanced and advanced prostate cancer experience significant emotional distress, diminished quality of life, and increased risk of cancer-specific mortality.1,2,3

Practice-Changing Applications of Radiology and Nuclear Medicine in Genitourinary Malignancies

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 4
Experts at Harvard Business School first coined the term disruptive innovation to describe how small, poorly resourced companies could successfully challenge larger ones.1 More than two decades later, this concept is central in medicine, where innovations in everything from proteomics and wearables to electronic health records and health economics are upending our status quo.2,41

From the Desk of the Editor: Volume 3, Issue 3

Welcome to Volume 3, Third issue, of Everyday Urology - Oncology Insights. In this issue, the applicability and utility of SpaceOAR® Hydrogel will be reviewed as well as the trials that led to its regulatory approval. SpaceOAR was designed as a means of diminishing rectal radiation toxicity. With a phase III trial reporting a decrease in acute and long-term rectal toxicity, as well as an enhanced patient, reported quality of life outcomes, SpaceOAR is quickly being adopted as a component of prostate cancer radiotherapy. 

Nephrectomy in the Era of Targeted Therapy: Takeaways from the CARMENA Trial

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 3

A 62-year-old man presents with a one-week history of hematuria. Ultrasound and computed tomography identify a 7-cm exophytic anterior left renal tumor, adenopathy, and two
small lung nodules. No bone or central nervous system lesions are detected. His Eastern Cooperative Oncology Group (ECOG) performance-status (PS) and Memorial Sloan-Kettering Cancer Center (MSKCC) scores are 1. The patient asks whether to undergo cytoreductive nephrectomy. What do you tell him? 

Spacers and Prostate Radiation Therapy: What Urologists Should Know

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 4
Radiation has been used to treat prostate cancer since the early 1900s.¹ In recent decades, advances in radiation delivery systems and the advent of computed tomography and magnetic resonance imaging have spurred the development of targeted, high-dose radiotherapy techniques such as intensity-modulated radiotherapy (IMRT), image-guided radiation therapy (IGRT), stereotactic radiation therapies, proton beam

Blue Light Cystoscopy: Insights on Recurrence, Progression, and Clinical Management

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 3

More than 81,000 individuals are diagnosed with bladder cancer in the United States every year, of whom 75% have non-muscle invasive disease.1,2 Unfortunately, half these cases recur despite transurethral resection of bladder tumor (TURBT), and from 5% to 25% of repeated recurrences progress to muscle-invasive disease.3,4,5

Immuno-oncology for Bladder Cancer

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 2
Initial Considerations
From BCG to interferon gene therapy, physicians have treated bladder cancer with immunotherapy for decades. Treatment particulars generally depend on whether bladder cancer is non-muscle invasive, muscle-invasive, or metastatic. About 75% of patients have non-muscle invasive bladder cancer (NMIBC),1 which is considered high-risk if it consists of non-invasive papillary carcinoma (TaHG),

Imaging Controversies for Localized and Advanced Prostate Cancer

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 2
Imaging in prostate cancer (PC) remains a controversial topic that can be challenging to navigate. In this article, I focus on some of the best tools in our current armamentarium: multiparametric prostate magnetic resonance imaging (mpMRI) for local prostate cancer (PC) and positron emission tomography-computed tomography (PET/CT) for advanced disease. In research settings, these modalities often overlap, but here I take a more practical approach by focusing on the use of PET/CT for the detection of metastatic disease.

From the Desk of the Editor: Volume 3, Issue 2

Welcome to Volume 3, Issue 2 of Everyday Urology – Oncology Insights. This edition’s cover story by Phillip Koo, MD, Imaging Controversies for Localized and Advanced Prostate Cancer explores the challenging topic of imaging modalities for Prostate Cancer. He discusses the use of multiparametric magnetic resonance imaging (mpMRI) as well as positron emission tomography-computed tomography (PET/CT), C-11 Choline, and 18F-Fluciclovine for both localized and advanced prostate cancer disease management. Dr. Koo also reviews the ability of scoring systems, such as the Prostate Imaging Reporting and Data System (PIRADS) as well as similar tools to enhance stratification assessments and interdisciplinary communication.

From the Desk of the Editor: Volume 3, Issue 1

Welcome to the first issue of the 2018: Everyday Urology- Oncology Insights. The start of the year has ushered in significant advancements and therapeutic approvals for GU oncology management. Along with these recent developments presented at the 2018 ASCO GU meeting, we anticipate additional and important presentations at upcoming major meetings. 

An Unmet Need is Met: (The PROSPER Study): Evaluating the Safety and Efficacy Study of Enzalutamide in Patients with Nonmetastatic Castration- Resistant Prostate Cancer

Published in Everyday Urology - Oncology Insights: Volume 3, Issue 1
For men with non-metastatic, castration-resistant prostate cancer (nmCRPC), who are invariably at risk of metastasis, the PROSPER trial clearly demonstrated that combining enzalutamide to androgen-deprivation therapy (ADT) resulted in prolonging metastasis-free survival by a median of 22 months compared with ADT plus placebo
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