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The contemporary plea for a more liberal pathological definition of insignificant prostate cancer was recently challenged by Schiffmann and colleagues, who advocate a return to the original, stringent 0.5 ml tumour volume threshold. This cut-off point would render fewer men eligible for active surveillance programmes.
Management of biochemically recurrent prostate cancer can be determined by the use of nomograms based on risk factors, but this approach might not lead to selection of optimal courses of treatment for individual patients. Choline-PET–CT imaging can identify the sites of recurrence in these patients, enabling personalized treatment choices depending on the presence of localized or metastatic disease.
In the field of advanced prostate cancer, a number of therapeutic agents are now available. The sequence of administration of medications with distinct mechanisms of action, toxicities and efficacies, will have a critical role in disease outcomes. The identification of biomarkers predicting response will help to determine the appropriate therapeutic sequence.
Medical intervention for transgender adolescents is a controversial issue but a recently published article describing long-term psychological outcomes using 'the Dutch model' of care should help to silence critics and reassure the growing number of clinicians treating this patient population.
Extracellular vesicles mediate intercellular signalling and are potential sources of cancer biomarkers. Nawaz and colleagues describe the biogenesis of extracellular vesicles, and the methods available for their isolation and characterization. The authors also discuss current research into the identification of vesicle-derived biomarkers for cancers of the prostate, kidney and bladder.
Delayed diagnosis and treatment of penile cancer often result in the development of advanced disease. Shabbir et al. highlight how pooling resources and expertise can help improve disease management and review remaining challenges in prevention, diagnosis, treatment and lymph node staging.