Primary Care

Genitourinary Cancers

Questions discussed in this category

When following active surveillance paradigm, what PSA increase will trigger prostate biopsy?

NCCN states that per an AS paradigm for low risk and FIR prostate cancer, a PSA should not be collected any more than every 6 months, with DRE, mpMRI ...

1 Answer available

How do you manage patients blood pressures while on anti-angiogenic TKIs?

Do you insist on ambulatory/home blood pressures to rule in/out white coat hypertension? Does your practice have a system to log patients' BPs to supp...

1 Answer available

Do you advise Kegels/pelvic floor physical therapy to minimize urinary incontinence when irradiating the prostatic fossa?

If so, for how long afterwards do you think the patient needs to continue the exercises?

1 Answer available

How do you manage dry eye related to Pluvicto Lu-177?

2 Answers available

Do you have recommendations after prostate RT for patients who want to conceive?

Patients in their later 40s with favorable intermediate-risk prostate cancer s/p 7000cGy/28 EBRT only.

1 Answer available

Do you hold anticoagulation prior to prostate brachytherapy?

If so, when do you resume?

1 Answer available

Do you change your monitoring strategy for a high risk prostate cancer after XRT if the initial PSAs have never been very high?

4 Answers available

Do you recommend surveillance for secondary malignancies of the rectum and bladder after prostate XRT?

1 Answer available

Can a patient s/p EBRT for intermediate risk prostate cancer who is clinically and biochemically free of disease safely receive supplemental testosterone therapy?

The serum testosterone is minimally low at 250 and the patient has some fatigue.

1 Answer available

In asymptomatic patients with unfavorable intermediate risk prostate cancer and a PSA <10, how helpful/reliable and clinically useful is bone imaging?

2 Answers available

How do you manage an elderly, high risk prostate cancer patient who refuses any local therapy?

Assume a life expectancy of approximately 5-10 years. What factors would influence your consideration of intermittent ADT vs. watchful waiting?

4 Answers available

Do you recommend a waiting period to conceive after prostate radiation?

1 Answer available

What is the earliest time to check PSA after prostatectomy?

How soon is too soon after surgery to check PSA?

1 Answer available

Can retrograde ejaculation be caused by prostate radiation?

Is there any available therapy?

1 Answer available

What can prostate patients do for sexual function while on ADT?

4 Answers available

Do you measure testosterone in men who will be receiving ADT?

What do you tell men who want to know if their testosterone has recovered?

3 Answers available

How would you treat intermittent hematuria post prostate radiation?

Some patients will go on to develop asymptomatic intermittent hematuria which can persist... In patients with scant hematuria, what's your routine car...

2 Answers available

How would you manage a patient with profound dyspareunia after pelvic radiation for anal cancer?

9 Answers available

Do you adjust PSA for finasteride use when determining prostate cancer stage and risk category?

If this upstages the patient, do you modify treatment recommendations?

1 Answer available

What oral alternatives would you recommend as opposed to injectable GnRH agonists for those who do not wish to come to clinic due to COVID-19?

This applies to both de novo cases and patients who have previously received injectable agents.

1 Answer available

How long after prostate radiation do you recommend waiting for routine screening colonoscopy?

What concerns do you have about a colonoscopy?

3 Answers available

Do you recommend routine dental evaluation for all patients before starting bisphosponates in patients with bone metastases?

1 Answer available

In patients with Stage I seminoma who elect surveillance, how long do you recommend that tumor markers be followed?

Indefinitely seems to be a typical recommendation, but rarely done.

2 Answers available

What type of surveillance plan should one use to follow a young person after orchiectomy for a >3cm pure mature teratoma of the testicle?

1 Answer available

How do you manage significant fatigue caused by androgen deprivation therapy in prostate cancer patients?

2 Answers available

For what patient groups (if any) do you routinely recommend screening colonoscopy prior to radiation for prostate cancer?

3 Answers available

If a man has been on a 5-alpha reductase inhibitor for urinary symptoms prior to prostate radiation therapy, is there value in continuing it after radiation therapy?

In particular, for men who have no strong indication for ADT?

1 Answer available

How would you manage a patient with low risk prostate cancer on active surveillance who develops high risk features but absolutely refuses a repeat biopsy?

In a patient who has a rising PSA, palpable nodule, MRI findings etc., is it ethical to treat the patient with inadequate information and ri...

1 Answer available

How do you manage musculoskeletal pain in men receiving androgen deprivation therapy for non-metastatic prostate cancer?

In patients with new bone pain and without any evidence of bone metastases receiving GnRH agonists, how do you manage pain symptoms?

1 Answer available

What surveillance strategy do you use for patients after resection of localized renal cell cancer?

NCCN guidelines offer suggested schedules for interval imaging and laboratory studies, but also make it clear that the quality of evidence for these r...

1 Answer available

Do you counsel patients on the risk of dementia following androgen deprivation therapy for prostate cancer?

Two retrospective studies from Stanford showed that patients who received ADT had an increased risk of dementia and Alzheimer's. Is this finding ...

3 Answers available

How do you counsel men with prostate cancer on the cardiovascular risks of androgen deprivation therapy?

How might a recent (within 6 months) myocardial infarction affect your recommendations?

1 Answer available

For patients eligible for and considering active surveillance for low-risk prostate cancer, do you routinely use tests for molecular risk stratification?

Are there specific subsets for whom these results should change management?

1 Answer available

At what PSA do you start calculating doubling time post-prostatectomy?

With ultra-sensitive PSA, it's unclear to me whether a doubling from 0.01 to 0.02 or 0.02 to 0.04 is significant. Is there a certain value that you wo...

1 Answer available

Which patients with intermediate and high risk prostate cancer should not receive androgen deprivation therapy?

More specifically, which cardiac risk factors do you look for? Diabetes? Previous MI? Dyslipidemia? Peripheral vascular disease? CHF?

2 Answers available