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Using prostate‐specific antigen screening and nomograms to assess risk and predict outcomes in the management of prostate cancer
Author(s) -
HAMMERER PETER G.,
KATTAN MICHAEL W.,
MOTTET NICOLAS,
PRAYERGALETTI TOMMASO
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06177.x
Subject(s) - prostate cancer , nomogram , medicine , management of prostate cancer , prostate , prostate specific antigen , prostate cancer screening , oncology , cancer , gynecology , quality of life (healthcare) , nursing
In this section there are two reviews concerning prostate cancer, both from the same group of authors. In the first, they describe the combination of nomograms with PSA screening to assess risk and to predict outcomes in the management of prostate cancer. In the second, they indicate how outcomes and quality of life can be optimised in the hormonal treatment of prostate cancer. Botulinum toxin has become very popular in the management of a whole range of conditions both inside and outside the urinary tract. Now it has been extended to prostatic disorders, and the mini‐review presented here has evaluated reports and the authors’ personal experience in the mechanisms of action and clinical efficacy of Botulinum toxin in the prostate. Finally, there is a mini‐review of FISH in bladder cancer, particularly its development, applications, and its potential for the future. We review the role of prostate‐specific antigen (PSA) and the importance of patient education in the management of prostate cancer, based on discussions held at a European symposium on managing prostate cancer. Although PSA is the most widely used serum marker for detecting prostate cancer and for monitoring treatment responses, its use as a diagnostic marker is controversial due to concerns of over‐diagnosis and low specificity. PSA isoforms, as well as PSA doubling time, might improve the specificity for earlier prostate cancer detection and can be used as surrogate markers for treatment efficacy. Patients can differ considerably in the importance they place on health‐related quality of life aspects and fear of cancer progression. Consequently, there needs to be active, educated discussion of risk and outcomes between physicians and patients. Risk assessment tools, e.g. validated nomograms, enable clinicians to improve their decision analysis and form the basis for subsequent discussion of treatment options between the physician and patient, thereby enabling informed consent and appropriate decision‐making.