We define the optimal systematic biopsy regimen to detect carcinoma of prostate.A total 483 consecutive patients referred for an abnormal digital rectal examination and/or prostate specific antigen (PSA) 4.0 ng./ml. or greater underwent transrectal ultrasound and biopsy. Lateral biopsies peripheral zone at base mid gland were added routine sextant a 10 zone. Patients with than 50 cc also transition in lobar parasagittal plane. Detection rates various regions assessed. Various schemes then...

Saw palmetto is used by over 2 million men in the United States for treatment of benign prostatic hyperplasia and commonly recommended as an alternative to drugs approved Food Drug Administration.In this double-blind trial, we randomly assigned 225 age 49 years who had moderate-to-severe symptoms one year with saw extract (160 mg twice a day) or placebo. The primary outcome measures were changes scores on American Urological Association Symptom Index (AUASI) maximal urinary flow rate....

Abstract BACKGROUND. Active surveillance followed by selective treatment for men who have evidence of disease progression may be an option select patients with early‐stage prostate cancer. In this article, the authors report their experience in a contemporary cohort cancer were managed active surveillance. METHODS. All initially identified through authors' institutional database. Selection criteria included: prostate‐specific antigen (PSA) <10 ng/mL, biopsy Gleason sum ≤6 no pattern 4 or...

Epidemiological and prospective studies indicate that comprehensive lifestyle changes may modify the progression of prostate cancer. However, molecular mechanisms by which improvements in diet might affect microenvironment are poorly understood. We conducted a pilot study to examine gene expression unique population men with low-risk cancer who declined immediate surgery, hormonal therapy, or radiation participated an intensive nutrition intervention while undergoing careful surveillance for...

Active surveillance (AS) is an option for the initial management of early-stage prostate cancer. Current risk stratification schema identify patients with low-risk disease who are presumed to be most suitable AS. However, some men higher also elect AS; outcomes such have not been widely reported.Men managed AS at University California, San Francisco, were classified as low- or intermediate-risk based on serum prostate-specific antigen (PSA), Gleason grade, extent biopsy involvement, and T...

We assessed the effect of transrectal ultrasound guided prostatic nerve blockade on discomfort associated with systematic needle biopsy prostate.A prospective randomized double-blind study was performed 64 patients requiring prostate. Patients were randomly assigned to receive an injection 5 ml. 1% lidocaine or saline (0.9% sodium chloride) at vascular pedicle 1 side prostate only. They then asked score severity and subsequent biopsies each side.Mean pain scores significantly lower than...

No AccessJournal of Urology1 Jul 1989The Appearance Prostate Cancer on Transrectal Ultrasonography: Correlation Imaging and Pathological Examinations Katsuto Shinohara, Thomas M. Wheeler, Peter T. Scardino ShinoharaKatsuto Shinohara , WheelerThomas Wheeler ScardinoPeter View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)38666-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Preoperative transrectal...

Abstract A method was developed to quantify prostate metabolite concentrations using 1 H high‐resolution magic angle spinning (HR‐MAS) spectroscopy. T and 2 relaxation times (in milliseconds) were determined for the major metabolites an internal TSP standard, used optimize acquisition repetition (TRs) at 11.7 T. At 1°C, polyamines (PAs; 1mean = 100 ± 13, 2mean 30.8 7.4) citrate (Cit; 237 39, 68.1 8.2) demonstrated shortest times, while taurine (Tau; 636 78, 331 71) choline (Cho; 608 60, 393...

PURPOSE: To evaluate endorectal magnetic resonance (MR) imaging and MR spectroscopic for the depiction of locally recurrent prostate cancer after external beam radiation therapy. MATERIALS AND METHODS: Endorectal were performed in 21 patients with biochemical failure therapy cancer. Two readers independently retrospectively reviewed images rated likelihood tumor on a five-point scale. Spectroscopic voxels considered suspicious malignancy if choline level was elevated citrate absent. Receiver...

Abstract The goal of this study was to investigate the use lactate and alanine as metabolic biomarkers prostate cancer using 1 H high‐resolution magic angle spinning (HR‐MAS) spectroscopy snap‐frozen transrectal ultrasound (TRUS)‐guided biopsy tissues. A long‐echo‐time rotor‐synchronized Carr‐Purcell‐Meiboom‐Gill (CPMG) sequence including an electronic reference access in vivo concentrations (ERETIC) standard used determine 82 benign 16 malignant biopsies (mean 26.5% ± 17.2% core). Low (0.61...

Active surveillance is now considered a viable treatment option for men with low-risk prostate cancer. However, little known regarding changes in Gleason grade on serial biopsies over an extended period of time.Men diagnosed cancer between 1998 and 2009 who elected active as initial treatment, 6 or more months follow-up minimum six cores at biopsy, were included analysis. Upgrading downgrading defined increase decrease primary secondary score. Means frequency tables used to describe patient...

No AccessJournal of UrologyClinical Urology: Original Articles1 Dec 1998PROSPECTIVE EVALUATION OF LATERAL BIOPSIES THE PERIPHERAL ZONE FOR PROSTATE CANCER DETECTION JAMES J. CHANG, KATSUTO SHINOHARA, VIVEK BHARGAVA, and JOSEPH C. JR. PRESTI CHANGJAMES CHANG , SHINOHARAKATSUTO SHINOHARA BHARGAVAVIVEK BHARGAVA PRESTIJOSEPH View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62254-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints...

No AccessJournal of UrologyAdult Urology1 Mar 2015Extended Followup and Risk Factors for Disease Reclassification in a Large Active Surveillance Cohort Localized Prostate Cancer Christopher J. Welty, Janet E. Cowan, Hao Nguyen, Katsuto Shinohara, Nannette Perez, Kirsten L. Greene, June M. Chan, Maxwell V. Meng, Jeffry P. Simko, Matthew R. Cooperberg, Peter Carroll WeltyChristopher Welty , CowanJanet Cowan NguyenHao Nguyen ShinoharaKatsuto Shinohara PerezNannette Perez GreeneKirsten Greene...

We assessed whether an association exists between a change in prostate specific antigen and biopsy progression men on active surveillance.A cohort of patients undergoing surveillance for cancer was identified from the urological oncology database at our institution. Multivariate logistic regression performed to determine velocity, defined as ln(prostate antigen) per year, is associated with progression, Gleason upgrade or volume repeat within 24 months diagnosis.A total 241 mean ± SD age 61...

PURPOSE: PC-SPES is an herbal supplement for which there are anecdotal reports of anti–prostate cancer activity. This phase II study was undertaken to assess the efficacy and toxicity in prostate patients. PATIENTS AND METHODS: Thirty-three patients with androgen-dependent (ADPCa) 37 androgen-independent (AIPCa) were treated at a dose nine capsules daily. Clinical outcome assessed serial serum prostate-specific androgen (PSA) level measurement imaging studies. RESULTS: One hundred percent...