ObjectiveTo review of the existing literature, current guidelines and standard of practice related to prostate cancer in transgender women, as the transgender population share many of the same healthcare needs as their cisgender counterparts, but may have additional specialist needs.
Materials and methodsWe performed a non-systematic review of the literature, current guidelines and standard of practice related to prostate cancer in transgender women.
ResultsOur search revealed 10 case reports of prostate cancer in transgender women, four specialist opinion papers, six cohort studies, and four systematic reviews. The information in these publications were assimilated to produce a review of prostate cancer in transgender women.
ConclusionThe risk of prostate cancer in transgender women who are not on gender-affirming hormone therapy (GAHT) or who have not had gender-affirming surgery (GAS) and gender non-conforming individuals (who may never commence GAHT or have GAS) is the same as that in the cis male population. In these patients, healthcare professionals need to be able to discuss screening, diagnostic and treatment options considering future wishes for gender-affirming treatment. Prostate cancer incidence in transgender women on GAHT or following GAS is lower than age-matched cis-male counterparts, but diagnosis and treatment is more nuanced. The present review discusses the existing literature about development and incidence of prostate cancer in this population, and makes recommendations about screening, the usefulness of diagnostic tools e.g. prostate-specific antigen and magnetic resonance imaging, and considerations when formulating treatment. Potential directions for future research are discussed, which will hopefully lead to development of robust evidence-based guidelines for the diagnosis and management of prostate cancer in transgender women.
Purpose: To investigate the benefits of a regions of interest atlas for radiation therapists (RTTs) to aid in the identification of male pelvic structures in radiotherapy for prostate cancer, post-prostatectomy.
Methods and materials:Recruiting 35 radiation therapists from the Royal North Shore Hospital, a pretestpost-test study design was employed, with the atlas as the intervention. Using two patient CT data-sets, structure identification was scored as correct or incorrect and RT confidence levels were recorded using a visual analogue scale. The number of years of experience of each RT was also documented. Statistical significance was calculated using the Wilcoxon signed ranks test, paired samples t-test and chi-square tests.Results: A statistically significant improvement was found between the pre-test and post-test in terms of both structure identification (p < 0.001) and confidence (p < 0.001) levels, with use of the atlas. The atlas was of use to staff of varying experience levels. Structures that were not normally used for target volume localisation were the hardest to identify.
Conclusion:Regions of interest atlases should be implemented to help identification of areas of anatomical complexity.
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