Volume 5 Issue 1, January 2008

In this Viewpoint article, Professor Klotz argues that active surveillance of patients with low-risk prostate cancer, followed by intervention when pre-specified criteria are fulfilled, is an approach that could prevent unnecessary overtreatment of prostate cancer. Professor Klotz describes patients eligible for this approach, the strategy for active surveillance, and the criteria for intervention.

Androgen deprivation therapy (ADT) for prostate cancer is associated with decreased bone mineral density (BMD) in patients. This decreased BMD can lead to an increased risk of fractures and osteoporosis. In this article the author reviews the prevalence of bone loss in this group of patients, and discusses the implications of reduced BMD and what can be done to prevent or reduce bone loss in men undergoing ADT.

Large renal tumors of 7 cm or more in size are associated with important challenges in management. In this Review the authors discuss the different surgical management options for patients with these large tumors. Important complicating factors such as tumor thrombus are discussed and the authors also examine the use of partial nephrectomy in patients with T2 renal tumors.

The process of learning surgical skills is long, complex and involves numerous stages. The authors of this Review discuss the different processes involved in learning and assessing surgical techniques. They highlight the role of surgical simulators in training surgeons in new techniques and how they might help to improve trainee surgeons' performance and patient outcomes.

In this Case Study, Tu et al. report on a 61-year-old man previously treated for prostatic adenocarcinoma who presented with obstructive urinary symptoms and was subsequently found to have ductal carcinoma of the prostate. The authors discuss the difficulty of diagnosing this tumor, and the correct approach to its management.