Simulation of the effects of molecular urine markers in follow-up of patients with high-risk non-muscle invasive bladder cancer.

A plethora of urine markers for the management of patients with bladder cancer has been developed and studied in the past. However, the clinical impact of urine testing on patient management remains obscure. The goal of this manuscript is to identify scenarios for the potential use of molecular urine markers in the follow-up of patients with high-risk non-muscle-invasive BC (NMIBC) and estimate potential risks and benefits.

Considering the Effects of Modern Point-of-Care Urine Biomarker Assays in Follow-Up of Patients with High-Risk Non-muscle-Invasive Bladder Cancer.

Background: Although a plethora of urine markers for diagnosis and follow-up of patients with bladder cancer (BC) has been developed and studied, the clinical impact of urine testing on patient management remains unclear. The goal of this manuscript is to identify scenarios for a potential use of modern point-of-care (POC) urine marker assays in the follow-up of patients with high-risk non-muscle-invasive BC (NMIBC) and estimate potential risks and benefits.

Methods: To permit comparison between different assays, the results of 5 different POC assays studied in a recent prospective multicenter study including 127 patients with suspicious cystoscopy undergoing TURB were used for this simulation.

Lifestyle aspects in a contemporary middle-European cohort of patients undergoing androgen deprivation therapy for advanced prostate cancer: data from the non-interventional LEAN study.

Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) is associated with significant side effects. With the transition of PCa from a foudroyant course to a chronic disease, managing these side effects has become increasingly important. There is growing evidence that nutritional changes and physical activity are beneficial in these patients.

[Rational follow-up of non-muscle invasive bladder cancer].

Background: Follow-up for non-muscle invasive bladder cancer (NMIBC) is a challenge for urologists that has not been finally resolved. The intensity of follow-up is based on the recurrence and progression behavior of the tumor as well as the patient's individual situation.

Materials And Methods: The following article focuses on the current data situation, the valid German S3 guideline and the available instruments for the detection of relapses and progression, taking into account tumor stages and degree of malignancy.

Effectiveness and Distribution of Testosterone Levels within First Year of Androgen Deprivation Therapy in a Real-World Setting: Results from the Non-Interventional German Cohort LEAN Study.

Background: Observational studies generate information on real-world therapy and complement data from prospective randomized trials. LEAN is an open-label, non-interventional, multi-centre, German cohort study on leuprorelin in routine clinical practice.

Objectives: To extend knowledge on the use, effectiveness, and tolerability of HEXAL/Sandoz leuprorelin (in this article, the term Leuprone® HEXAL® covers Leuprorelin Sandoz® as well) solid implant in patients with prostate cancer (PCa) in a real-world setting.

Eosinophilic cystitis mimicking bladder cancer-considerations on the management based upon a case report and a review of the literature.

The hypereosinophilic syndrome (HES) is a rare disorder characterized by hypereosinophilia and infiltration of various organs with eosinophils. Eosinophilic cystitis (EC), mimicking bladder cancer clinically but also in ultrasound and in radiographic imaging, is one potential manifestation of the HES occurring in adults as well as in children. This case report describes the course of disease in a 57-year-old male presenting with severe gait disorders and symptoms of a low compliance bladder caused by a large retropubic tumor.

Five years retrospective cohort analysis of treatment outcomes of TB-HIV patients at a PEPFAR/DOTS Centre in South Eastern Nigeria.

Background: Human immunodeficiency virus (HIV) associated tuberculosis (TB) remains a major global public health challenge, with an estimated 1.4 million patients worldwide. Co-infection with HIV leads to challenges in the diagnosis and treatment of patients.

[Nutritional prevention of urological tumours].

Through the last decade considerations on the role of vitamins and antioxidants in the primary prevention of genitourinary tumors have changed dramatically. In spite of all efforts, the efficacy of a specific compound has not been proven so far. In consequence, recommendations to use vitamins or other supplements for the primary prevention of urological tumors should be avoided.

[Metabolic syndrome and prostate cancer].

The relationship between metabolic syndrome (MS) and prostate cancer (PCA) is highly complex and harbors multiple facets not least because MS is not a single entity but represents a poorly defined inhomogeneous mixture of different diseases and conditions. Although numerous studies suggest a correlation between MS or components of MS and the development of prostate cancer, current evidence cannot be considered convincing. While diabetes appears to be inversely related to PCA, increased serum levels of triglycerides, cholesterol and insulin-like growth factor 1 (IGF-1) may be predictive for high grade disease.

Skeletal-related events in metastatic prostate cancer and the number needed to treat: a critical consideration.

Purpose: With stage migration induced by early diagnosis of prostate-specific antigen, the course of disease for prostate cancer (PCa) patients has changed. Increasingly, patients undergo long-term androgen ablation with consecutive risks including osteoporosis and pathologic fractures. A recent randomized trial found that the RANK ligand inhibitor denosumab was more effective preventing skeletal-related events in patients with metastatic PCa as compared to treatment with the bisphosphonate zoledronic acid.

Prevention strategies for prostate cancer.

Through the last decade consideration of the role of vitamins and minerals in primary prevention of genitourinary tumors has dramatically changed. Despite all efforts efficacy of a specific compound has not been proven, so far. In consequence, recommendations for a use of vitamins or other supplements with the intention of prostate cancer prevention should be avoided today.

[Supportive options in the treatment of urological tumours].

An ageing society with a consecutive increase of genitourinary malignancies along with remarkable changes in systemic cancer therapy provide the basis for an increasing role of supportive measures. While surgical treatment, radiation or chemotherapy are undergoing subsequent standardisation, supportive measures are still widely used on the basis of personal experience alone. However, effective support is the prerequisite for a successful systemic treatment.

[Chemoprevention of prostate cancer - a plea].

The high disease prevalence, the presentation in older age, a frequently slowly progressing course of disease, and high costs make the diagnosis of and therapy for prostate cancer a special challenge for urologists. Effective prevention of the disease may help to improve some of the problems mentioned above. Two randomised, controlled studies have proved that effective chemoprevention of prostate cancer is viable using 5α-reductase inhibitors (finasteride, dutasteride).

[Prevention of uro-oncological diseases].

During the last decade consideration of the role of vitamins and minerals in primary prevention of genitourinary tumors has changed dramatically. Despite all efforts the efficacy of a specific compound has not yet been proven and as a consequence recommendations for the use of vitamins or other supplements for tumor prevention should no longer be given. In contrast life style modification might be helpful as recent investigations suggested that smoking not only promotes the development of bladder cancer but is also involved in prostate and renal cell carcinogenesis.

[What can medicine expect from health economics?].

Medicine has changed dramatically in the past ten decades thanks to the introduction of innovative diagnostic and therapeutic procedures. However, besides the unmistakable advances achieved in medicine, the costs of all health care systems have risen dramatically. In contrast to the escalation in expenditures, only moderate gains in proceeds have been accomplished.

[Secondary and tertiary prevention of urological tumors].

The amount and quality of available data on secondary and tertiary prevention of urological tumors are to a large extent unsatisfactory. In the areas of nutrition and supplementary diet the consumption of tomatoes and especially tomato products could have a beneficial effect on the course of the disease for patients with prostate cancer, whereas there is evidence that the consumption of foodstuffs containing calcium (milk and milk products) and linolenic acid as well as a fat-rich diet accelerate tumor progression. Despite as yet unsatisfactory data, men with urothelial tumors or prostate cancer should abstain from smoking and undertake sports activities.

[Primary prevention of urologic tumors: prostate cancer].

Assessment of the role of vitamins and micronutrients in the primary prevention of prostate cancer has changed dramatically in the past 10 years. Efforts to confirm the efficacy of a single substance have not yet succeeded. Therefore, such recommendations should at present no longer be given.

[Role of immunocytology in the evaluation of patients with painless gross hematuria].

Objective: Gross hematuria is a highly worrisome episode in a patient's history mainly due to the fact that the prevalence of bladder cancer is significant in this group of patients. In this prospective study the role of immunocytology in the evaluation of patients with gross hematuria was investigated.

Materials And Methods: Ucyt is an immunocytological assay based on microscopic detection of tumor-associated antigens on urothelial cells.

[Risks and prevention of prostate cancer. Commentary on the new S3 guideline].

Acceptance of prostate cancer as an endemic disease was the basis for the decision reached by the guideline committee to devote a chapter to the topic of risks and prevention of prostate cancer. Analysis of the substantial data regarding these subjects, however, shows that a number of apparently accepted risk factors and recommendations for prevention do not withstand subtle assessment. For this reason, only information concerning the risk factors of age and genetic predisposition is obtained from men.

Immunocytology in the assessment of patients with asymptomatic hematuria.

Painless hematuria has remained a diagnostic challenge in daily urological practice. Key problem in the assessment of these patients is the discrimination between malignant and non-malignant conditions. In this prospective study the role of immunocytology in the evaluation of patients with hematuria was investigated.

[Analyses of the role of immunocytology in the differential diagnosis of patients with asymptomatic microhematuria].

Introduction: Discriminating between malignant and nonmalignant conditions remains a challenge in the evaluation of patients with asymptomatic microhematuria. In this prospective study the role of immunocytology in the assessment microhematuria was studied.

Material And Methods: uCyt is a commercially available immunocytological assay based on microscopical detection of tumor-associated antigens in urothelial cells by immunofluorescence.

Immunocytology in the assessment of patients with painless gross haematuria.

Objective: To evaluate, in a prospective study, the role of immunocytology in assessing patients with gross haematuria. Due to the high prevalence of urothelial cancer in this population, a thorough assessment is mandatory to identify all patients with tumours.

Patients And Methods: We used Ucyt (DiagnoCure Inc.

[The Prostate Cancer Prevention Trial (PCPT). Relevance for clinical practice].

The Prostate Cancer Prevention Trial (PCPT) has been the first interventional trial directly aimed at the prevention of prostate cancer. A total of 18,882 men over 55 years with a PSA serum level less than 3.0 ng/ml were randomized to receive either the 5-alpha-reductase inhibitor finasteride 5 mg/day or placebo for 7 years.