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Recent Advances in Prostate Cancer: What the Patients needs to know 2008

Recent Advances in Prostate Cancer: What the Patients needs to know 2008. Per-Anders Abrahamsson Department of Urology Malmö University Hospital Malmö, Sweden Europa Uomo, Milan, March 29,2008. Incidence. Mortality. Prostate Cancer: the 1980s. PSA: Anatomical Radical prostatectomy.

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Recent Advances in Prostate Cancer: What the Patients needs to know 2008

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  1. Recent Advances in Prostate Cancer:What the Patients needs to know 2008 Per-Anders Abrahamsson Department of Urology Malmö University Hospital Malmö, Sweden Europa Uomo, Milan, March 29,2008

  2. Incidence Mortality

  3. Prostate Cancer: the 1980s • PSA: • Anatomical Radical prostatectomy Stamey et al, NEJM 1987; Walsh et al, Prostate 1983

  4. G.D. Chisholm Chisholm, BJU 1993

  5. SPCG 4 Holmberg et al, NEJM 347: 781, 2002 Steineck et al, NEJM 347: 790, 2002

  6. SPCG-4: Mortality Cumulative incidence of death from prostate cancer (%) Radical prostatectomy Watchful waiting p = 0.01RR = 0.56 Years to follow-up No. at risk Radical prostatectomy 347 343 332 284 210 118 Watchful waiting 348 341 326 279 198 104 Watchful waiting < 65 years Radical prostatectomy < 65 years Radical prostatectomy ≥65 years Watchful waiting ≥ 65 years Cumulative incidence of death from prostate cancer (%) Years to follow-up Bill-Axelson A, et al. N Engl J Med. 2005;352:1977-84.

  7. Prostate Cancer: the 1990s • Radical prostatectomy • Curative surgical ‘gold standard’ • Watchful waiting • Men with less than 10 years life expectancy • Men with co-morbidities

  8. “ A ROBOT SAVED MY SEX LIFE…” Daily Mail However, We did not anticipate this…

  9. Nor forsee Viagra coming.....

  10. But will the robot really replace the surgical hand?

  11. Robotic-assisted surgery The Future?

  12. Prostate-Specific Antigen • Best cancer marker ever discovered • Used for: • Detection and screening • Prognosis & • Monitoring of prostate cancer

  13. Reality of PSA Testing HEALTHY & BENIGN DISEASE CUT OFF PROSTATE CANCER PSA Ng/mL 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 100.0 20% FALSE NEG. 70% FALSE POS.

  14. Prostate Cancer Potentially Lethal prostate cancer IDEAL SCREENING TEST The Problem……. Normal / BPH

  15. M M DD3...DD3PCA3…PCA3 • PCA3DD3 • (Bussemakers et al., Cancer Res. 59: 5975-79, 1999) • Overexpressed in >95% of PrCa 1 2 3 4 5 6 T B N T N T N T N (kb) 4.0 DD3 2.0 0.6

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