Active surveillance for prostate cancer: can we modernize contemporary protocols to improve patient selection and outcomes in the focal therapy era?

Current Opinion in Urology
Kae Jack TayThomas J Polascik

Abstract

In the absence of whole gland treatment for prostate cancer, both active surveillance and focal therapy share the common need of requiring a more thorough, detailed and precise analysis of the biological threats within the prostatic parenchyma if one chooses to monitor or selectively eradicate only specific neoplastic targets. In addition, focal therapy utilizes active surveillance post-treatment to monitor the untreated sectors of the prostate. We aim to evaluate the current modalities available to modernize active surveillance protocols in order to distinguish patients who may be safely observed from those who require intervention. Traditional active surveillance protocols by today's standards are rudimentary given the rapidly evolving technologies now available to clinicians. There is growing evidence for the adoption and use of multiparametric MRI and MRI-targeted biopsy to identify and localize prostate cancers of higher stage and grade. In addition, serum markers and prostate tissue DNA, RNA and methylation markers provide novel information that extends beyond Gleason grade to better characterize and define prostate cancer prognosis. Current active surveillance protocols should incorporate these modalities to improve pati...Continue Reading

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Citations

Jun 21, 2016·Future Oncology·Jamie N HoltzRajan T Gupta
Apr 26, 2017·Prostate Cancer and Prostatic Diseases·K J TayT J Polascik
Dec 25, 2016·The Journal of Urology·Judd W Moul
Jun 22, 2017·Expert Review of Anticancer Therapy·Kae Jack TayThomas J Polascik
Jan 19, 2018·Therapeutic Advances in Urology·Malhar P PatelThomas J Polascik
Aug 21, 2018·Current Opinion in Urology·Kae Jack Tay
Jun 7, 2016·The Journal of Urology·Judd W Moul
Oct 13, 2017·Cell Death & Disease·Shibao LiMing Guan
Jul 16, 2019·Carcinogenesis·Marilesia Ferreira De SouzaIlce Mara De Syllos Cólus
Jun 28, 2018·World Journal of Urology·Kae Jack TayThomas J Polascik
Apr 28, 2018·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Ted GanslerEric J Jacobs
Apr 16, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Chau Hung LeeCher Heng Tan

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Methods Mentioned

BETA
biopsies
biopsy
PCR

Software Mentioned

PIVOT

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