Volume 16 Issue 6, June 2019

The FDA’s approval of the first point-of-care total PSA test for prostate cancer has the potential to improve patient care by streamlining PSA testing. However, a Clinical Laboratory Improvement Amendments waiver is needed before this test can be fully integrated into clinical care.

In patients with metastatic renal cell carcinoma, risk stratification according to the Memorial Sloan Kettering Cancer Center or the International Metastatic Renal Cell Carcinoma Database Consortium classification systems is a crucial part of clinical assessment and essential for guiding management. New research has now demonstrated that disagreement in risk-group classification is common and prognostically relevant.

Health-related quality of life encompasses a wide range of experiences and is especially relevant for men with prostate cancer. A recent study reports that across disease stages, overall self-reported health status and urinary and bowel function were good, but sexual function was poor. Overall, men face prostate cancer with resilience.

The PROSPER, SPARTAN, and ARAMIS trials demonstrated the efficacy of enzalutamide, apalutamide, and darolutamide, respectively, to extend metastasis-free survival in men with nonmetastatic castration-resistant prostate cancer. However, questions remain regarding patient selection for these agents, particularly concerning adverse effects, patient PSA doubling time, and cost and formulary considerations.

In the absence of standards of care and defined best treatments for localized prostate cancer, Internet search engines provide patients with first information — or often misinformation. Clinicians need to guide patients to sources of high-quality evidence on focal ablative treatments for prostate cancer.

Urinalysis has long been used as a tool for managing diseases, but 21st century techniques have enabled measurement of metabolomic urinary cancer biomarkers using NMR and mass spectrometry. In this Review, the authors discuss the current status of research developments and offer recommendations to help systematize future research in the field.

The mesenchymal stem cell (MSC) secretome offers numerous advantages over cell-based therapy, with similar therapeutic effects. Here, the authors discuss the preclinical therapeutic promise of the MSC secretome in regenerative urology, highlighting putative mechanisms of action, characterization methods and future perspectives.

In this Consensus Statement, experts in the field detail the current evidence regarding blue light flexible cystoscopy for bladder cancer surveillance and make recommendations regarding its use on the basis of conclusions arrived at during the panel discussions at a consensus meeting.