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Download or read book Evidence Review of Active Surveillance in Men With Localized Prostate Cancer written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book An Evidence Review of Active Surveillance in Men with Localized Prostate Cancer written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Radical prostatectomy and radiation therapy for prostate cancer have side effects and unclear survival benefits for early stage and low-risk disease. Prostate cancer often has an indolent natural history, making observational management strategies potentially appealing. PURPOSE: To systematically review the role of active surveillance for triggers to begin curative treatment in men with low-risk prostate cancer. Key Questions address changes in prostate cancer characteristics over time, definitions of active surveillance and other observational strategies, factors affecting the offer of, acceptance of, and adherence to active surveillance, the comparative effectiveness of active surveillance with curative treatments, and research gaps. DATA SOURCES: MEDLINE(r), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and existing systematic reviews, evidence reports, and economic evaluations. STUDY SELECTION: Randomized controlled trials and nonrandomized comparative studies of treatments, multivariable association studies, and studies of temporal trends in prostate cancer natural history. Only published, peer-reviewed, English-language articles were selected based on predetermined eligibility criteria. DATA EXTRACTION: A standardized protocol was used to extract details on design, diagnoses, interventions, predictive factors, outcomes, and study validity. DATA SYNTHESIS: In total, 80 studies provided information on epidemiologic trends; 56 on definitions of active surveillance; 42 on factors affecting the offer of, acceptance of, or adherence to observational management strategies; and 26 on comparative effectiveness. Increased diagnosis of early-stage prostate cancer due to prostate-specific antigen (PSA) testing, led to an increase in prostate cancer incidence from the mid-1980s to the mid-1990s. The prostate cancer-specific mortality rate decreased for all age groups from the early-1990s to 1999. Currently, patients are diagnosed with earlier stage and lower risk prostate cancers compared to the pre-PSA era. Over time, a lower proportion of men received observational management versus active treatment, even among those with low-risk disease. There was no standardized definition of active surveillance. Sixteen cohorts used different monitoring protocols, all with different combinations of periodic digital rectal examination, PSA testing, rebiopsy, and/or imaging findings. Predictors that a patient received no initial active treatment generally included older age, presence of comorbidities, lower Gleason score, lower tumor stage, lower diagnostic PSA, and lower disease progression risk group. No trial provided results comparing men with localized disease on active surveillance with surgery or radiation therapy. LIMITATIONS: Because of the nonstandardized usages of the terms "active surveillance" and "watchful waiting" and their intended and often mixed (both curative and palliative) treatment objectives, it was difficult to determine which study patients received active monitoring for triggers indicative of curative treatment and which observation for clinical symptoms indicative of palliative treatment. CONCLUSIONS: More men are being diagnosed with early stage prostate cancer. Whether active monitoring with a curative intent is an appropriate option for these men remains unclear. A standard, universally agreed-upon definition of active surveillance that clearly distinguishes it from watchful waiting and other observational management strategies is needed to help clarify scientific discourse on this topic. Ongoing clinical trials may provide information on the comparative effectiveness of active surveillance compared to immediate active treatment, but will require long term followup.
Author : U. S. Department of Health and Human Services
Publisher : CreateSpace
ISBN 13 : 9781484054628
Total Pages : 344 pages
Book Rating : 4.0/5 (546 download)
Download or read book An Evidence Review of Active Surveillance in Men with Localized Prostate Cancer written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-06 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2011, more than 240,000 men are projected to be diagnosed with prostate cancer, and 33,000 are projected to die from the disease in the United States. In the United States, most cases of prostate cancer are detected via prostate-specific antigen (PSA) screening. The cancer is usually localized, and most tumors have low histological grades and low Gleason scores. Indeed, more than half of prostate cancers detected by PSA screening are expected to be early-stage, low-risk tumors. Such cancers are an infrequent cause of death, and those affected are more likely to die of unrelated causes. A number of immediate active treatment options are available for localized prostate cancer. Most commonly, radical prostatectomy (RP) or radiation therapy (RT), with or without androgen deprivation therapy (ADT), are offered with curative intent. However, the clinical benefit of immediate therapy with curative intent has not yet been demonstrated for localized prostate cancer in a PSA-screened population. It is likely that a large number of men are receiving active treatment with curative intent without much likelihood of obtaining any clinical benefit due to the slow progression of many prostate tumors. Both surgical and radiation treatments result in significant short- and long-term adverse events, including impotence, urinary dysfunction, and other complications. Thus, determination of the appropriate management strategy for early-stage, low-risk prostate cancer is an important public health concern. Active surveillance (AS) and watchful waiting (WW) are two observational followup strategies that forgo immediate therapy in patients with prostate cancer, with the goal of minimizing the morbidities and costs of immediate active treatment for men who may never develop cancer-related symptoms or who are interested in palliative treatments only. AS is curative in intent, and WW is palliative. AS is appropriate in men with disease believed to be indolent and therefore may not require therapy. Because prediction tools are imperfect, these men are monitored closely and treated with curative intent at signs of progression or patient choice. In this way, the considerable adverse effects of treatment are at best avoided, and at least deferred. This approach is to be distinguished from men for whom treatment is deemed inappropriate because of comorbidity; for these men, WW is generally considered, as it offers the option of palliative therapy upon symptomatic disease progression. AS often entails a multifactorial followup of patients—monitoring of PSA values, digital rectal examinations (DRE), prostate imaging, and periodic prostate biopsies—while WW is commonly a relatively passive strategy—with interventions triggered by symptoms. However, there is a continuum of aggressiveness of followup for both AS and WW, as practiced in the community. The objective of this report is to summarize the existing literature regarding the role of AS in the management of early-stage, low-risk prostate cancer. Both the report and the corresponding NIH State-of-the-Science conference are a part of the NIH Consensus Development Program, the purpose of which is to evaluate the scientific evidence on a particular topic and develop a consensus statement that advances research in that area. Key Questions provided to the EPC for systematic review include: 1. How have the patient population and the natural history of prostate cancer diagnosed in the United States changed in the last 30 years? 2. How are active surveillance and other observational management strategies defined? 3. What factors affect the offer of, acceptance, and adherence to active surveillance? 4. What are the comparative short- and long-term outcomes of active surveillance versus immediate treatment with curative intent for localized prostate cancer? 5. What are the research needs regarding active surveillance (or watchful waiting) in localized prostate cancer?
Author : Laurence Klotz
Publisher : Humana Press
ISBN 13 : 3319627104
Total Pages : 250 pages
Book Rating : 4.3/5 (196 download)
Download or read book Active Surveillance for Localized Prostate Cancer written by Laurence Klotz and published by Humana Press. This book was released on 2017-09-29 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt: This fully updated and revised new edition provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in prostate cancer. The book reviews new data about molecular characteristics of the disease, profiles the new grading system for prostate cancer introduced in 2015, and provides new perspectives about imaging of prostate cancer, as well as the role of targeted biopsies. The text summarizes the role of biomarkers and MRI in patient selection and management and details the world wide results of active surveillance. Specific chapters address communication and ethical issues, QOL outcomes, economic aspects, and psycho-social aspects of surveillance. The role of focal therapy for low risk disease is summarized, and the data supporting preventive interventions during surveillance reviewed. This text will serve as a very useful resource for physicians and researchers dealing with, and interested in this common malignancy, as it provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309253365
Total Pages : 126 pages
Book Rating : 4.3/5 (92 download)
Download or read book The Role of Obesity in Cancer Survival and Recurrence written by Institute of Medicine and published by National Academies Press. This book was released on 2012-06-12 with total page 126 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent research suggests that obesity and excess weight can play a prominent role in the incidence and progression of various cancers. Obesity results from an energy imbalance - that is, energy intake that is higher than energy expenditure - could also influence the growth of cancers. Recognizing the impact that current findings on obesity and cancer could have on future cancer prevention and care, the National Cancer policy Forum (NCPF) of the Institute of Medicine (IOM) help a 2-day workshop on "The Role of Obesity in Cancer Survival and Recurrence," in Washington, DC, on October 31 and November 1, 2011. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary reviews each presenter's latest clinical evidence on the obesity-cancer link and the molecular mechanisms that might explain that link. Clinicians, researchers, cancer survivors, and policy makers also discussed potential interventions to counter the effects of obesity on cancer, and research and policy measures needed to stem the rising tide of cancer mortality predicted by an increasingly overweight and older population worldwide. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary explores the complex web of molecular mechanisms that underlie the obesity-cancer link, the ways to design future studies to acquire the information needed to guide patient care, what to advise cancer patients about weight loss, diet, exercise, and other measures to reduce their risk of cancer progression or recurrence and policy suggestions related to research, education, and dissemination of the findings on obesity and cancer.
Author : Amelie G. Ramirez
Publisher : Springer Nature
ISBN 13 : 303029286X
Total Pages : 320 pages
Book Rating : 4.0/5 (32 download)
Download or read book Advancing the Science of Cancer in Latinos written by Amelie G. Ramirez and published by Springer Nature. This book was released on 2019-11-21 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book gives an overview of the sessions, panel discussions, and outcomes of the Advancing the Science of Cancer in Latinos conference, held in February 2018 in San Antonio, Texas, USA, and hosted by the Mays Cancer Center and the Institute for Health Promotion Research at UT Health San Antonio. Latinos – the largest, youngest, and fastest-growing minority group in the United States – are expected to face a 142% rise in cancer cases in coming years. Although there has been substantial advancement in cancer prevention, screening, diagnosis, and treatment over the past few decades, addressing Latino cancer health disparities has not nearly kept pace with progress. The diverse and dynamic group of speakers and panelists brought together at the Advancing the Science of Cancer in Latinos conference provided in-depth insights as well as progress and actionable goals for Latino-focused basic science research, clinical best practices, community interventions, and what can be done by way of prevention, screening, diagnosis, and treatment of cancer in Latinos. These insights have been translated into the chapters included in this compendium; the chapters summarize the presentations and include current knowledge in the specific topic areas, identified gaps, and top priority areas for future cancer research in Latinos. Topics included among the chapters: Colorectal cancer disparities in Latinos: Genes vs. Environment Breast cancer risk and mortality in women of Latin American origin Differential cancer risk in Latinos: The role of diet Overcoming barriers for Latinos on cancer clinical trials Es tiempo: Engaging Latinas in cervical cancer research Emerging policies in U.S. health care Advancing the Science of Cancer in Latinos proves to be an indispensable resource offering key insights into actionable targets for basic science research, suggestions for clinical best practices and community interventions, and novel strategies and advocacy opportunities to reduce health disparities in Latino communities. It will find an engaged audience among researchers, academics, physicians and other healthcare professionals, patient advocates, students, and others with an interest in the broad field of Latino cancer.
Author : Andrew W. Bruce
Publisher : Springer Science & Business Media
ISBN 13 : 1447113985
Total Pages : 363 pages
Book Rating : 4.4/5 (471 download)
Download or read book Adenocarcinoma of the Prostate written by Andrew W. Bruce and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 363 pages. Available in PDF, EPUB and Kindle. Book excerpt: Carcinoma of the prostate increasingly dominates the attention of urologists for both scientific and clinical reasons. The search for an explanation and the prediction of the variable behaviour of the malignant prostatic cell continues unabated. The search for more precise tumour staging and more effective treatment is equally vigorous. Editors Andrew Bruce and John Trachtenberg have assembled acknowledged leaders in prostate cancer to present those areas of direct interest to the clinician. There are a number of other topics that might have been considered but most of these, such as experimental tumour models or biochemical factors affecting cell growth, still lack immediate application for the clinician. Carcinoma of the prostate continues to have its highest incidence in the western world, and the difference in comparison with the incidence in the Far East appears to be real and not masked by diagnostic or other factors. A number of other epidemiological aspects need careful analysis: Is the incidence increasing? Is the survival improving? Is the prognosis worse in the younger patient? Epidemiological data are easily misused and misinterpreted so that a precise analysis of the known facts makes an important opening chapter to this book.
Author : Nelson N. Stone
Publisher : Springer
ISBN 13 : 3319214853
Total Pages : 213 pages
Book Rating : 4.3/5 (192 download)
Download or read book The Prostate Cancer Dilemma written by Nelson N. Stone and published by Springer. This book was released on 2015-10-19 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in early prostate cancer. The book reviews new data about genetic markers, transperineal mapping biopsy and mpMRI, how to apply each of these technologies in patients with elevated PSA, when a prior prostate biopsy performed by the standard TRUS method is negative and in cases where low risk disease is already diagnosed, how to differentiate those men who might harbor more aggressive disease from those who do not. Over 75% of newly diagnosed prostate cancer meets the criteria for low risk disease which has created a dilemma for both patients and clinicians. Active surveillance programs have been initiated and are reviewed. How the new technologies impact surveillance programs is addressed. Clinical stage designation is updated and a new intra-prostatic staging system is discussed. Prostate biopsy techniques utilizing transrectal ultrasound, transperineal mapping, elastography and mpMRI are compared. Finally, utilization of this new technology in the application of focal therapy is reviewed. The Prostate Cancer Dilemma will serve as a very useful resource for physicians and researchers dealing with, and interested in this challenging malignancy. Chapters are written by experts in their fields and include the most up to date scientific and clinical information as well as links to procedural video content.
Author : Roger S. Kirby
Publisher : Karger Medical and Scientific Publishers
ISBN 13 : 1910797375
Total Pages : 138 pages
Book Rating : 4.9/5 (17 download)
Download or read book Fast Facts: Prostate Cancer written by Roger S. Kirby and published by Karger Medical and Scientific Publishers. This book was released on 2017-03-08 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prostate cancer is unusual among solid tumors in that the majority of affected men die with, rather than of, the disease. This presents many challenges to healthcare professionals and patients in terms of deciding if, when and how to intervene in order to control tumor growth and spread, thereby extending survival but without compromising quality of life. This is the ninth edition of 'Fast Facts: Prostate Cancer' since 1996, testament to the rapid changes in the field and the steadily improving outlook for patients. This new edition provides many key updates: • the Gleason grade grouping, which has valuable prognostic value • nomograms to evaluate risk • our rapidly expanding understanding of the genetics and underlying pathogenesis of prostate cancer and the development of genomic tests to help identify those at greatest risk of developing clinically significant disease • the continuing debate about the role of PSA in the screening, detection and monitoring of prostate cancer • advances in imaging techniques, particularly multiparametric MRI, which is improving the accuracy of biopsy and reducing the numbers of negative biopsies • the roles of drugs, surgery and radiotherapy in the treatment of prostate cancer at different stages, and our ever-improving understanding of when and how best to intervene, aided by improving understanding of the risk factors for disease progression. Primarily intended for primary care providers, specialist nurses, junior doctors and allied healthcare professionals, this highly readable resource provides a comprehensive overview of prostate cancer, enabling fully informed discussions with patients about this complex disease. Contents: • Epidemiology and pathophysiology • Diet, lifestyle and chemoprevention • Screening and early detection • Diagnosis, staging and prognostic indicators • Management of clinically localized disease • Managing recurrence after initial therapy • Management of metastatic prostate cancer • Management of castrate-resistant prostate cancer • Survivorship and treatment complications
Author : Martin D. Abeloff
Publisher :
ISBN 13 : 9780443075452
Total Pages : 0 pages
Book Rating : 4.0/5 (754 download)
Download or read book Clinical Oncology written by Martin D. Abeloff and published by . This book was released on 2000 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A must-have reference, this new edition provides practical information on treatment guidelines, details of diagnosis and therapy, and personal recommendations on patient management from experts in the field. Consistently formatted chapters allow for a user-friendly presentation for quick access of key information by the practicing clinician. Completely updated, this new edition includes all of the latest developments in treatment strategies of medical, surgical and radiation oncologists.
Author : Hashim Uddin Ahmed
Publisher : John Wiley & Sons
ISBN 13 : 1405196491
Total Pages : 213 pages
Book Rating : 4.4/5 (51 download)
Download or read book Focal Therapy in Prostate Cancer written by Hashim Uddin Ahmed and published by John Wiley & Sons. This book was released on 2011-12-27 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book comprehensively reviews the potential of focal therapy and discusses why the changing face of prostate cancer warrants a change in the way we treat men with the disease. It deals with the mechanisms by which disease can be localized within the gland and then the different technologies used for focal ablation. Bringing together eminent contributors in one accessible reference, this book introduces focal therapy to all urologists, oncologists, and radiologists who are involved in the treatment of men with prostate cancer.
Author : Patrick C. Walsh
Publisher : Balance
ISBN 13 : 153876363X
Total Pages : 480 pages
Book Rating : 4.5/5 (387 download)
Download or read book Dr. Patrick Walsh's Guide to Surviving Prostate Cancer written by Patrick C. Walsh and published by Balance. This book was released on 2018-05-15 with total page 480 pages. Available in PDF, EPUB and Kindle. Book excerpt: This guide covers every aspect of prostate cancer, from potential causes including diet to tests for diagnosis, curative treatment, and innovative means of controlling advanced stages of cancer.
Author : Mark Scholz
Publisher : Other Press, LLC
ISBN 13 : 1590513851
Total Pages : 305 pages
Book Rating : 4.5/5 (95 download)
Download or read book Invasion of the Prostate Snatchers written by Mark Scholz and published by Other Press, LLC. This book was released on 2010-08-24 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: Every year almost a quarter of a million confused and frightened American men are tossed into a prostate cancer cauldron stirred by salespeople representing a multibillion-dollar industry. In this flourishing business, the radical prostatectomy is still the most widely recommended treatment option. Yet a recent and definitive study in the New England Journal of Medicine concluded that out of the fifty thousand prostate operations performed annually, more than forty thousand are unjustified. But this is no surprise given that 99 percent of all doctors treating this disease are surgeons or radiation therapists. The appalling fact is that men are still being rushed into a major operation that rarely prolongs life and more than half the time leaves them impotent. Invasion of the Prostate Snatchers is a report on the latest thinking in prostate cancer therapy: close monitoring–active surveillance rather than surgery or radiation–should be the initial treatment approach for many men. There are three stages of prostate cancer and this book will provide accurate information about how to distinguish between them: Low-Risk, which requires no immediate treatment; Intermediate-Risk, which will benefit from surgery, radiation, and/or hormonal therapy; and High-Risk, a type that does require immediate treatment with a combination of therapies. In a unique collaboration, doctor and patient provide a wholly new perspective on managing this disease. Ralph Blum’s account of his personal struggle, together with Dr.Mark Scholz’s presentation of newscientific advances, provides convincing evidence that this noninvasive approach can be crucial in preventing tens of thousands of men from being overtreated every year. Invasion of the Prostate Snatchers serves as an indispensable map through the medical minefield of prostate cancer.
Author :
Publisher :
ISBN 13 :
Total Pages : 27 pages
Book Rating : 4.:/5 (822 download)
Download or read book NIH State-of-the-Science Conference Statement on Role of Active Surveillance in the Management of Men with Localized Prostate Cancer written by and published by . This book was released on 2011 with total page 27 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Edouard J. Trabulsi
Publisher : Springer Nature
ISBN 13 : 3030520218
Total Pages : 303 pages
Book Rating : 4.0/5 (35 download)
Download or read book Chemotherapy and Immunotherapy in Urologic Oncology written by Edouard J. Trabulsi and published by Springer Nature. This book was released on 2020-09-29 with total page 303 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is designed to familiarize clinical practitioners in systemic therapy options and medical management of urologic malignancies including prostate cancer, bladder and upper tract urothelial carcinoma, and renal cell carcinoma. Organized by organ system, the text highlights new therapies such as novel forms of androgen deprivation, cytotoxic chemotherapy, immune check point and immunomodulatory agents, and targeted therapies. Written by experts in the field, the book also reviews current chemotherapy and immunotherapy regimens for genitourinary malignancies and discusses indications, outcomes, and toxicities, as well as clinical trial concepts. Each of the book’s chapters offers a bulleted box of clinical pearls on the particular role of the APP. Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider is a resource for urologists, uro-radiologists, medical clinicians and family practitioners alike, familiarizing its audiences with systemic therapy regimens for urologic malignancies, as well as their expected outcomes and side effects.
Author : Omar M. Aboumarzouk
Publisher : John Wiley & Sons
ISBN 13 : 1118863372
Total Pages : 888 pages
Book Rating : 4.1/5 (188 download)
Download or read book Blandy's Urology written by Omar M. Aboumarzouk and published by John Wiley & Sons. This book was released on 2019-05-06 with total page 888 pages. Available in PDF, EPUB and Kindle. Book excerpt: Blandy's Urology, 3rd edition is set to become a classic in its field, the latest edition of one of the most well-loved general urology textbooks for urologists and surgeons alike, successfully combining both general urology and urologic surgery. Its key strength is the unique ‘Blandy way’ of describing urological diseases and their management, consisting of: clear, straightforward, uncomplicated descriptions of disease/conditions, including hundreds of clinical photos an abundance of outstanding drawn surgical diagrams to illustrate best technique in the operating theatre a focus on the most commonly seen problems in the clinic organization of each topic under anatomical headings Especially loved by urology and surgery trainees for its straightforward approach to the speciality and as a preparation for speciality urology exams, consultants and specialists also value it as a handy refresher tool.
