1) Tragic beyond description
2) Never would've thought rates higher rural vs urban (debunked myth)
3) senior author has my favorite last name of all time

Increasing Firearm-Related Deaths among U.S. Black Rural Youths nejm.org/doi/full/10.10…

Some for sure sick of hearing me/us chirp about this...if interested in the semantics of Gleason 6(GG1) or willing to challenge your long-held beliefs, consider a listen.

Comments welcome, particularly if you disagree.

UCSF Grand Rounds youtu.be/Fa0kE7Ptu8s?fe… via YouTube

Worth reading/considering from Adam Kibel and BWH/MGH group. Reminder that temperance and 'less is more' often leads to better patient care (not common traits in our health system).

MRI, Clinical, and Biopsy Findings in Suspected Prostate Cancer jamanetwork.com/journals/jaman…

Extraordinary organization doing phenomenal work.

We fill you up with food/drink, surround you with interesting people in a lively beautiful setting, and we hope you consider supporting IVU.

Please DM or email either of us or [email protected] (Exec Dir) for location.

Until someone shows me compelling data otherwise, proton therapy for prostate cancer is yet another black eye for American health care

Updated Analysis of Comparative Toxicity of Proton and Photon Radiation for Prostate Cancer ascopubs.org/doi/abs/10.120…

Disappointing but here are the data

Could be many things about their lifestyle but perhaps (hopefully) the diet is contributing. We know it’s good for so many other health related reasons…..

OS data on adj pembro for resected RCC presented at GU ASCO

Scientifically valid and important points, worth a listen, delivered in prototypical blustery obnoxious condescending self-serving manner by Vinay Prasad MD MPH

youtu.be/rjX8xRPdZRY?fe… via YouTube

Blow up the Gleason system, it fails many men.

Saw 3 guys this week with a single core of very low volume pattern 4 and it’s Gleason 8.

Other docs won’t discuss surveillance as an option and if they get RT it’s two years ADT (plus median of 2 years after to recover T)

My sense is some men choose surgery over RT due to concerns over secondary malignancy.

If you discuss secondary malignancies of RT (as I do), be fair and explain it appears to be an absolute risk of 0.5-1% at 25 years (many docs don't give risk estimate)

auajournals.org/doi/full/10.10…

Primary take home message:

Why are we held hostage by ratio of pattern 3 to 4 to determine 3+4 (GG2) vs 4+3 (GG3) when prognosis note related to amount of pattern 3?

I see so many perplexing clinical decisions made on this flawed, suboptimal system

pubmed.ncbi.nlm.nih.gov/38278665/

If you take care of testicular cancer patients (or want to in the future), not going to find a more comprehensive review than this......

Dr. Darren Feldman Jack Gleeson

Testicular cancer in 2023: Current status and recent progress acsjournals.onlinelibrary.wiley.com/doi/full/10.33…

It's all about the amount of pattern 4 (and 5). If I (and many others) had their way: downgrade pattern 3 to a 'non-cancer' and every biopsy/prostatectomy gives amount of pattern 4/5.

Andrew Vickers Samson W. Fine, MD Matt Cooperberg European Urology

sciencedirect.com/science/articl…

Impressive/important study #GUASCO24

Should this type of prostate cancer be called cancer? A group of doctors say no wsj.com/health/wellnes… via The Wall Street Journal

'Here we provide a comprehensive overview of the characteristics of GG1 prostatic adenocarcinoma ... all supporting the movement to reclassify GG1 disease as a non-cancerous entity.' Dave Penson Scott Eggener bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bj…

Add another to the list of debunked myths…..reiterating the importance of RCTs and questioning conventional wisdom

Perhaps men in the T arm were far more physically active?!?

Thoughts from Omer Raheem Mohit Khera Abraham Morgentaler, MD ?

nejm.org/doi/full/10.10…

Interesting study/observation; no documented cases of successful legal action for appropriately documented active surveillance of prostate, thyroid, kidney, or breast cancers

Malpractice Trends Involving Active Surveillance Across Cancers pubmed.ncbi.nlm.nih.gov/37747179/

Timothy Daskivich