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February 2017 February2017UrologyTimes.png
How do you approach giving bad news to patients?“Be honest and forthright but try to do it as compassionately as possible,” one urologist advises.
Salvage LND: Complete PSA response achievableSalvage lymph node dissection results in an immediate complete PSA response in about one-third of patients with rising PSA and nodal recurrence following local therapy for prostate cancer, according to German researchers.
When is a patient cured after prostatectomy?"Rather than making a blanket statement regarding continued follow-up, we need to consider the pathologic features commonly known to increase the risk of [prostate cancer] recurrence—concurrent medical problems, the patient’s age at recurrence, PSA doubling time, longevity in the family, etc," writes J. Brantley Thrasher, MD.
Biochemical recurrence risk high 10 years post-RPThe risk for biochemical recurrence of prostate cancer remains relatively high even 10 years after radical prostatectomy, but it does not appear to be influenced by a positive family history of prostate cancer or a family or personal history of other cancer, according to a study analyzing data from the prospective German Familial Prostate Cancer database.
VA: APRNs may practice without oversightIn the wake of heated criticism about lengthy wait times for veterans’ care at Veterans Health Administration hospitals, the U.S. Department of Veterans Affairs has moved to allow advanced-practice registered nurses to practice to their full authority without physician oversight and regardless of individual state law in VA facilities.
‘Smart’ water bottle may help with stone preventionDespite the excruciating nature of kidney stones, many people can't manage to lower their risk by simply drinking more liquid. Now, a new study finds that one potential tool—a water bottle with a built-in consumption sensor and smartphone link—accurately tracks how much people drink.
Guideline adherence down for combination RT-ADTAdherence to guidelines for the use of combination radiation therapy and androgen deprivation therapy in the United States for the treatment of high-risk or locally advanced prostate cancer has decreased over time, according to data presented by Paolo Dell’Oglio, MD.
Post-RT proctitis less likely in ACE inhibitor usersHigh-grade proctitis after radical radiation therapy with neoadjuvant or adjuvant hormonal therapy is significantly less likely in patients taking angiotensin-converting-enzyme inhibitors.
OIG targets IMRT, chronic care payments in 2017Each year, the Office of the Inspector General at the Department of Health and Human Services publishes a summary of its activities and a work plan for the coming year. What follows is a summary of new topics in the FY2017 work plan that may be of interest to urologists.
Can a low-inflammation diet alter prostate health?
‘I can’t keep up’: Pay cuts, prior authorization take their toll
A scribe’s view: ‘Committed to delivering efficient care’Ashley Li, BS, chief scribe in the University of California, San Francisco’s urologic oncology and melanoma departments, says urology scribes help streamline patient care.
Scribes slash EMR burdenUrologists who view electronic medical record documentation as a burden are turning to scribes. Scribes, many say, relieve them of that burden, freeing urologists and other providers to focus on patient care.
mpMRI could reduce biopsies, improve diagnosisUsing multi-parametric magnetic resonance imaging to triage men with high serum PSA could save about one-fourth of patients from having transrectal ultrasound-guided prostate biopsy, according to a recent study.
Adding hormone therapy to salvage RT found efficaciousThe addition of hormonal therapy in post-RP is “practice changing,” study author says.
Selling your practice: How to determine its valueThis article will discuss the concept of practice valuation and how to go from abstraction to dollars or how to make dollars and “cents” of the process of putting a dollar value on a urologic practice.
Top 10 tips for getting your finances in orderGetting your finances in order can be overwhelming; here are a few good places to start. Plus, find out if it’s too late to make an IRA contribution.
Patient sues after stapler misfire leads to rectal tear
Urology FDA approvals of 2016Urology-related FDA approvals from 2016 encompassed drugs and devices for prostate cancer, renal cell carcinoma, bladder cancer, stone disease, and more.
Immunotherapy approved for advanced urothelial CaNivolumab (Opdivo) is the second in class of immune checkpoint inhibitors approved for advanced bladder cancer—treatments that are having “tremendous responses across a spectrum of cancers,” says Leonard G. Gomella, MD.
Genetic predictors could improve PSA accuracyA recent study has found that genetic predictors of normal PSA levels in healthy men could be used to improve the accuracy of PSA-based prostate cancer screening.
Ureteroscopy: Surgeons show techniques, tips in videosIn these videos, high-volume stone surgeons demonstrate novel approaches to classification, visualization, and treatment of stones.
PD-1 inhibitor benefit possible even after discontinuationPersistent clinical benefit was seen among a small group of patients with metastatic renal cell carcinoma who had to discontinue therapy with the PD-1 inhibitor nivolumab (Opdivo) because of immune-related adverse events, according to a study presented at the Genitourinary Cancers Symposium in Orlando, FL.
Antibiotics may negatively impact immunotherapy outcomesAdministration of broad-spectrum antibiotics in patients with metastatic renal cell carcinoma (RCC) undergoing treatment with immune checkpoint inhibitors may have a negative effect on the efficacy of the immunotherapy drugs, according to the results of a recent retrospective analysis.
Novel bladder Ca agent shows promise in phase II trialAn investigatory bladder cancer agent was associated with a 12-month high-grade recurrence-free survival of 35% for patients with Ta/T1 disease, researchers reported.
Rheumatologic side effects possible with immunotherapiesCancer patients taking certain immunotherapy drugs may be more susceptible to developing autoimmune joint and tissue diseases, including inflammatory arthritis, according to a recent study.
Cyclosporine shows efficacy in refractory IC patientsOral cyclosporine can offer a safe and effective treatment option for refractory interstitial, even in patients who have been on chronic narcotic medications and particularly in those with Hunner’s lesions, according to the findings of a study presented by Cleveland Clinic urologists at the 2016 AUA annual meeting in San Diego.
VA rule on APRNs places veterans’ health first“The evidence is clear: Not only can APRNs practice independently, they can do so effectively and without sacrificing quality of care,” writes SUNA President Gwendolyn Hooper, PhD, APRN.
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