I thought for this blog I would find some interesting articles in the Journal Of Urology, which I think is Urology’s gold standard journal for the latest urological research and developments
What Are The Latest Developments?
First up is a summary of an article about the latest urological research done performed determine the best treatment for kidney cancer based on the size of the presenting tumor. Their conclusion is that for tumors less than 3cm in size the tumor itself can almost always be removed without removing the entire kidney. For tumors less than 2cm in size a treatment called thermal ablation, which is trying to destroy the tumor with heat is equally as good as partial nephrectomy, which is removing the tumor surgically but leaving the rest of the healthy kidney intact.
I think these conclusions make sense but one still has to adapt to an individual situation. It is possible that a 3cm tumor that is intimate with the main blood vessels of the kidney can interfere with the possibility of saving the noncancerous kidney areas. It is also possible that a tumor much larger than 3cm can be removed safely with a partial nephrectomy if it is situated very peripherally.
Next is a summary of the latest urological research findings about whether prostate biopsies based on MRI images of the prostate are more or less accurate than random biopsies throughout the prostate which has been the standard of care for many years. The conclusion was that the random biopsies do find cancer more than the MRI based biopsies BUT that the finding what they consider significant or potentially threatening cancer was about equal. I think we are evolving towards a system of better random biopsies than in the past to truly map out the entire prostate and the technology for this technique is improving currently as well.
Finally there is an article about whether or not Testosterone supplementation therapy is safe in patients with prostate cancer who either have had an attempt at definitive treatment of the cancer, or also for low risk patients who are observing their cancer in an active surveillance program. The conclusion was that it can be acceptable in either case but very close monitoring and discussion of the risks prior to treatment is required. This seems reasonable and again would have to be tailored to each individual situation.
Be aware that next month there could be a research article that has different findings than these did, and it is up to urologists as a group and as individuals to hash out any conflicts in conclusions until consensus is indisputably, if temporarily reached – Dr. Newman, a Las Vegas urologist