Volume 10 Issue 12, December 2013

Post-hoc analysis of phase III data of abiraterone in men with castration-resistant prostate cancer showed that survival did not differ according to patient age (≤75 years versus >75 years). Similar analyses of other agents have reported mixed findings. Should patient age be part of decision making?

The International Bladder Cancer Group has proposed a new definition for disease progression in non-muscle-invasive bladder cancer that includes stage and grade progression. Although this definition will inevitably be subject to changes, it can currently be regarded as the gold standard for future trials, publications and protocols.

A retrospective, single institution study of 450 men with biochemical recurrence after radical prostatectomy included 140 men with androgen deprivation therapy deferred until metastatic disease onset. Metastasis-free survival was an independent predictor of overall survival. This research highlights the need to develop appropriate intermediate end points to expedite prostate cancer treatment.

Very few studies have followed patients with renal cell carcinoma for long enough to characterize late relapses. Newly published research suggests that late-recurring tumours are more likely to be of low nuclear grade and show a better response to first-line targeted therapy than early relapsing cancers.

Transperineal prostate biopsy is re-emerging after decades of being an underused alternative to transrectal biopsy guided by transrectal ultrasonography (TRUS). The authors describe the evolution of both the prostate biopsy techniques, focusing on the clinical implications of the transperineal approach and the potential future directions for prostate biopsy.

Any mass discovered in the testicle might be cancerous and, therefore, every effort must be made to characterize the lesion. This Review highlights modern aspects of clinical examination, the modalities for scrotal imaging, and the surgical techniques used for exploring the testis.

In this Review, Heyns et al. provide an update on the urological complications associated with HIV and AIDS in men treated during the ART era, focusing on papers published within the past decade.

Overcoming male infertility resulting from azoospermia requires the retrieval of viable sperm for use in assisted reproduction. Shin and Turek compare the techniques available for sperm retrieval, and discuss considerations including DNA integrity and the ability to tolerate freezing and thawing of sperm from different anatomical locations.

Sexual dysfunction—including erectile dysfunction, ejaculatory abnormalities and orgasmic disorders—is a commonly reported adverse effect of prostate cancer therapies. In this Perspectives article, Cormie and colleagues make a case for the use of exercise as a therapeutic option to ameliorate sexual dysfunction in prostate cancer survivors.