Transrectal ultrasonography of the prostate

Transrectal ultrasonography was used to monitor the response of adenocarcinoma of the prostate to radiotherapy before and 6 to 15 months after treatment combining implantation of radioactive gold seeds with external beam irradiation. Data gathered before and after irradiation therapy suggested that the two most sensitive measures for monitoring the primary tumor are the calculated volume of the prostate and the integrity of the prostatic capsule. The calculated volume of the prostate decreased significantly in all patients by 6 months after radiotherapy. The rate and degree of reduction correlated significantly (P less than 0.05) with the histologic grade of the tumor (poorly differentiated tumors shrinking most rapidly), as well as with the outcome of treatment (P less than 0.05). However, there was no such correlation with stage. After treatment, the average number of sites of capsular disruption decreased steadily, reaching 50% of the pretreatment number by 15 months. Transrectal ultrasonography is a practical, inexpensive, noninvasive tool for monitoring the response of prostatic cancer to definitive radiotherapy, and may provide a means of identifying patients who will respond poorly to treatment.

Transrectal ultrasonography for prostatic cancer. II. The response of the prostate to definitive radiotherapy

Fujino

Scardino

1986

Methods of early diagnosis in genitourinary cancer

Guinan

Rubenstein

1987

The commonly employed methods for the early detection of urologic cancers remain the traditional techniques of a carefully performed history and physical examination. Newer developments include, among others, prostate-specific antigen and monoclonal antibodies in prostate cancer, flow cytometry in bladder cancer, computerized axial tomography (CAT) scanning in renal cancer, and ultrasound in testicular cancer. These and other new diagnostic techniques, with further testing and wider use, will hopefully permit the earlier diagnosis of genitourinary cancer.

Urologic cancer

Murphy¹

1988

Self Cite

Cancer prevention and risk reduction in patients with carcinomas of the urinary tract are most easily identified by smoking cessation. Recent assessments of patients with bladder carcinomas show a high percentage of active smokers. Urologic surgeons and those dealing with cancers of the genitourinary tract should recognize such an important factor. In other lifestyle guidelines, the American Cancer Society suggests that those who significantly reduce the fat content of their diet with weight reduction will generally reduce risk factors in a number of cancers, including prostate cancer. Many new diagnostic tests have been introduced since the 1980 conference. Transrectal ultrasonography as a preoperative staging technique has been received with some enthusiasm. Currently, a national program for the testing of the detection of prostate cancer by ultrasound compared with other physical examinations and marker antigens, such as prostate antigen, is underway. The evaluation of renal masses continues to be improved by the use of ultrasonography and computed tomography (CT) scanning. Currently, magnetic resonance imaging (MRI) techniques are believed to have added some improved assessment for particularly large tumors and the question of their vascular extension. Occasionally observed lesions of the adrenal gland without hormonal expression in patients continue to be noticed during evaluations for frequently unrelated diagnoses. The management of such lesions less than 3.5 cm in diameter is believed to be conservative based on their size. Preoperative staging of the bladder has improved with transurethral ultrasonography use and the follow-up with patients has developed more frequently with the widely available urinary cytology. Fine needle aspiration of the prostate gland, lymph nodes, and other urinary tumor masses is increasing in diagnostic use. Flow cytometry has been applied to all lesions of the urinary tract and continues to be a field of clinical investigation. The field of biologic markers in diagnosis, detection, and follow-up evaluation of patients with carcinomas of the urinary tract is a most interesting and progressive one. Currently, the most widely accepted new innovation is the prostate antigen, which was developed by members of the National Prostatic Cancer Project between 1975 and 1986. Other markers offer potential added value in more accurate and earlier diagnosis and detection and correlation with prognostic factors concerning individual groups of patients. Progress in the detection, diagnosis, and management of genitourinary cancer is being achieved, and prevention, although perhaps simplistic in design, can be more readily applied.