I'm thrilled to be able to share this report from the symposium CAncer or Not Cancer?: Evaluating and Reconsidering GG1 prostate cancer (CANCER-GG1?), out today
@JNCI_Now
When is prostate cancer really cancer?
Hot of the press
@AmericanCancer
2019
#cancerstats
: Prostate cancer mortality up for 1st time since early 1990s, likely due at least in part to plummeting screening rates. Incidence ticking back up a bit, so maybe we're finally heading toward a "smarter screening" consensus...?
I was just sent this from a patient - omg for anyone who thought "prostatectomy comedy" is an oxymoron, give this the next 2.5 minutes of your full attention! Phenomenal. Many thanks
@MarshSongs
.
#pcsm
#prostatecancer
#UroSoMe
via
@YouTube
I'm pretty sure this is, by a wide margin, the most thoughtful and best-researched article I've read yet on
#coronavirus
#covid19
. Big HT
@tomaspueyo
🙌
Coronavirus: Why You Must Act Now by
ICYMI
@AmerUrological
just dropped the new 2022
#prostatecancer
guideline just in time for
#AUA22
. Lots to like despite outdated risk groups persisting.
But “very low risk” is GONE! Active surveillance now preferred for ALL low-risk tumors. 🎉🙌
We can already anticipate the (aging) objections, but the idea of re-branding at least a subset of GS6 seems to be picking up momentum. Feels like the right side of history :)
@uroegg
@aleberlin2
@VickersBiostats
@journotwit
I’m thrilled to be launching a new Center of Excellence on
@urotoday
focused on localized
#prostatecancer
. Opening blog is now live, and lots more content to come soon.
#pcsm
Brought in by a VA pt. So misleading I think it crosses the line into lies. Show me ANY study proving CLINICAL superiority 🦗Shame on
@nyulangone
! This is proton-level false claims 🙄
@LoebStacy
@daviesbj
@DrSpratticus
Really fantastic talk from
@thomashopemd
on game-changing
#PSMA
PET at
#SUO21
. Clinical pearl I haven’t seen summarized before re: when to think possible false pos:
Burned off my post-victory euphoria geeking out over some national data. Here's county level
#covid19
deaths per capita since Sept as a function of how the county voted for Trump v. Biden. Adjusted analyses to come soon...
I'm not judging I'm just sayin'!
#MedTwitter
ICYMI: This paper from
@JaneNguyen44
and Jesse McKenney on rethinking Gleason grading is a really big deal. Splitting all patterns into "favorable" and "unfavorable" amounts to the best biomarker I think I've ever seen for
#prostatecancer
.
New from
@Histo_Journal
: Proposal for an optimised definition of adverse pathology (unfavourable histology) that predicts metastatic risk in prostatic adenocarcinoma independent of grade group and pathological stage
➡️
@BritishDivIAP
@JaneNguyen44
Reiter: Even at UCLA center of excellence, MRI misses 20% of GS 8, 20% of >2cm tumors. MRI is a good adjunct to, NOT replacement for TRUS bx. PIRADS is still just inadequate. Go ahead & chuck tomatoes!
#historywillbeonmyside
#urs18
#pcsm
ICYMI (I did): very important study from
@thomashopemd
@CalaisJeremie
finding very high false-positive rate for "low-volume metastatic" disease on bone scan, using PSMA PET as gold standard.
Meaning STAMPEDE H may be wrong, and studies of M1 local tx MUST be repeated in PSMA era.
If you thought PSMA PET always led to stage migration, you might want to think again. At initial staging over half of patients with bone mets on bone scan were negative on PSMA PET. Sometimes increased accuracy leads to fewer mets! Check it out from JNM:
New Article online: Use of
#prostate
systematic and targeted
#biopsy
on the basis of multiparametric
#MRI
in biopsy-naive patients—the paired
#diagnostic
MRI-FIRST study
Here's the 2018 update (
@AmericanCancer
super on-the-ball this year!): Likely gratis,
@USPSTF
prostate cancer incidence down to 1970s levels, and it's back up to
#2
source of male cancer mortality.
#pcsm
#prostatecancer
Letter to the editor re: PSA screening, from
@SigridCarlsson
,
@jimhumd
, and me in response to last month's editorial . No love from
@nejm
- so here it is for all you Urotwitterati!
#pcsm
The future of modern PSA screening is still bright
(1/a few)
Don't skip the history sessions at
#aua19
! Bedwetting alarm c.1900: tie a toad to the penis. Can't make this stuff up. Where's the visual abstract?? 🐸🍆🚫🛌🌊
End of an era today... my, and
@anobelodisho
's, last cases on the
@IntuitiveSurg
Si! I don't usually get nostalgic for machines that aren't cars, but this has been a workhorse since
@pcarroll_
brought it in when I was a resident. 1000s of pts have passed under it, it'll be missed
MRI has a role to play, but reports of the imminent demise of systematic biopsy have been greatly exaggerated! Huge kudos
@michaelahdootmd
et al on this one.
@nejm
#pcsm
MRI-Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis
@AmerUrological
One thing I’ll say is how happy I am to see so many urology _residents_ speaking up here including our crew
@ucsfurology
. YOU are the future of urology and this organization.
Get loud, be heard!
#UroRes
#urotwitter
#prostatecancer
at the turn of the decade: incidence "recovering" as screening policy seeks a rational middle ground. Mortality rates fortunately seem to be at a plateau rather than continuing to rise...
#pcsm
@AmericanCancer
Cancer statistics 2023 are out - thank you
@ACSNews
.
#prostatecancer
rates up sharply, partly due to rising screening, but the % of advanced dz at diagnosis is also rising. Mortality still flat, hopefully will begin falling again with smarter screening.
New
#USPSTF
"C" recommendation re:
#prostatecancer
screening finalized.
Still many errors and flaws in their evidence review and interpretation, but this is clearly a step in the right direction.
#pcsm
What a city! Thanks so much again
@Uroweb
for the chance to join you at
#EAU22
. It was a fantastic meeting, and SO good to see so many old and new friends in person. Hope to meet you in Milan next time :)
@DGlaucomflecken
Seriously? You really don't know better? The violence is not "toward" medical facilities and patients. The violence is _because_ craven Hamas builds missile launchers and ammo depots in hospitals and hides behind the patients. And sometimes blows up their own hospitals.
Heddy Hricak, one of absolute global leaders in prostate MRI, makes clear that MRI can improve biopsy performance but *cannot* replace biopsy for elevated PSA or in early active surveillance.
#probase18
#pcsm
Here's the inevitable outcome of prostate MRI-mania -- a "Prostate center" run by a radiologist taking cash for all kinds of unproven tx, with no urologist anywhere in sight 🙄 HT
@uroegg
#pcsm
More evidence at
#aua22
(from PRIAS) that confirmatory biopsy is important early in
#activesurveillance
even if MRI is negative (esp if PSAD high). Validates
@CChuMD
paper last year in
@EUplatinum
SO TRUE! Someone needs to PROVE that *community-based* PIRADS is more reliable than a well-done TRUS. Till then we're just wasting $millions. mpMRI may be biggest naked emperor in urology right now.
#imho
#pcsm
The extent of variation in prostate MRI interpretation across radiologists is alarming. Uros should know how your radiologist(s) performs, work with them to improve, and learn to read our own prostate MRI.
via
@urotoday
@EurUrolFocus
A long time ago in a galaxy far,far away it was asserted that finasteride use in PCPT would be bad cuz it caused high grade cancer. New 18yr data shows it ain’t so: fin users had better OS. Thx to SWOG for truth. FDA 5ARI black box warning should disappear
Now out in
@EurUrolFocus
:
How Often Does Magnetic Resonance Imaging Detect Prostate Cancer Missed by Transrectal Ultrasound?
Spoiler alert: sometimes, but not very often! Great work
@aherlema
and Maya Overland
@UCSFUrology
#pcsm
An al fresco journal club
@UCSFUrology
— warm SF spring evening and fantastic literature insights from
@spsutkaMD
as she wraps up a too-short visit to SF :)
Seems like
@ASCO
#gu19
pretty severely lowballed expected interest in data interpretation controversies session 🙄. It’s covering critical topics, should have been a main session! (Or at least a double room)
@jenniferrrider
Beautiful to see tens of thousands packing the Mall plus more on-line, standing against
#antisemitism
and in support of the hostages still in Gaza. Unlike the displays on the other side, no violence, no calls for murder or genocide.
#BringThemHome
#HamasisISIS
#IStandwithIsreal
I know this doesn’t change anything today, and that still we have long hard months in front of us. But this 0.5cc of hope feels like the turning of the tide. Huge, heartfelt thanks to
@moderna_tx
,
@CDCgov
, and especially everyone at
@SFVAMC
!