Search

The article discusses the effectiveness of the digital rectal examination (DRE) as a screening test for prostate cancer. It concludes that the DRE is not a useful screening test for prostate cancer and that other methods, such as multi-parametric magnetic resonance imaging (mpMRI), are more effective. The article also highlights the concerns and barriers associated with the DRE, including cultural stigma and the potential for triggering trauma in individuals who have experienced sexual abuse. The future of prostate cancer screening is discussed, with the need for further research and evidence to inform screening practices. Overall, the article suggests that the DRE should not be routinely used as a screening test for prostate cancer. [Extracted from the article]

Objectives: To establish current uro‐oncology practice in the management of sexual dysfunction (SD) following radiotherapy (RT) and/or androgen deprivation therapy (ADT) to treat prostate cancer. To identify differences in approach to the management of SD according to disease stage. Subjects and methods: A 14‐question mixed methods survey was designed to assess the current UK practice. Closed‐ and open‐ended questions were used to quantify results while allowing participants to expand on answers. The survey was distributed to members of the British Uro‐Oncology Group at the 2019 annual meeting. Results: Surveys were completed by 63 uro‐oncologists attending the annual meeting of the British Uro‐Oncology Group (response rate 66%). The major issue highlighted was a difference in approach to managing SD according to disease stage. More than half of the participants (56%) said 'advanced stage of disease' was a barrier to discussing SD. Clinicians were less likely to discuss SD, take baseline assessments, refer to a specialist clinic or offer rehabilitation when dealing with patients with advanced disease. Only a minority said that the management of SD was primarily their responsibility (11%). Nearly all clinicians (92%) had access to SD clinics; however, the majority of clinicians did not routinely refer patients. Conclusions: This study shows that men with advanced prostate cancer need better support in managing SD. Patients receiving long‐term ADT are less likely to be offered any kind of help or intervention. Specific guidance on managing SD in this cohort may result in improvements in sexual function, emotional well‐being, quality of life, mental health and confidence. [ABSTRACT FROM AUTHOR]

Introduction: The inter-fraction motion of pelvic ± para-aortic (PA) nodal volumes in prostate cancer patients with involved nodes is yet to be quantified and the optimal IGRT strategy for these patients is currently unknown., Methods: A single-centre retrospective evaluation was performed investigating inter-fraction motion in the prostate and involved nodal volumes of patients receiving pelvic ± PA nodal irradiation. Patients were selected for inclusion if they; were undergoing prostate + pelvic node +/- PA node radiation for prostate cancer with involved lymph nodes and had received daily online CBCT scans. The planning CT and subsequent CBCT images from each treatment fraction were selected for analysis., Results: Out of 567 CBCTs, from 20 patients, there were no incidences where independent lymph node displacement was >0.5 cm from planning volumes. Lymph node motion relative to prostate was >0.5 cm on 15 occasions out of 567 scans (2.6%). Where the difference between prostate and lymph nodes was >0.5 cm, this was always a result of the rectum causing variation in the prostate position, not a change in nodal position., Discussion: These results suggests that there is limited independent displacement between the involved pelvic ± PA nodal volumes and bony anatomy. Therefore, bony anatomy could be used as a lymph node match surrogate for prostate patients receiving nodal irradiation for active disease. The results also suggest additional emphasis should be placed on bowel preparation in these patients to reduce the risk of geographical miss., Conclusion: In conclusion, the results of this evaluation suggests that there is limited independent displacement between the involved pelvic ± PA nodal volumes and bony anatomy. This provides evidence to trials investigating the role of pelvic ± PA nodal irradiation to ensure appropriate margins and IGRT strategies are used when investigating this further., (Copyright © 2024. Published by Elsevier Inc.)