Neal Shore

Challenges and Recommendations for Early Identification of Metastatic Disease in Prostate Cancer

Prostate cancer is often associated with metastases to bone and/or soft tissue. The progression to metastatic castrate-resistant prostate cancer is a seminal event in disease progression affecting treatment decisions. A multidisciplinary group was convened to review the currently available imaging guidelines for metastatic disease in prostate cancer and found no consensus on eligibility criteria, type of imaging modality, and the frequency of scanning for detecting metastatic disease. The aim of this review was to present the recommendations from the group to identify optimal strategies for early identification of metastases in patients with prostate cancer.

The best suture for hypospadias

In a study designed to determine the best suture for use in hypospadias surgery, polydioxanone (PDS), chromic catgut, and polyglycolic acid (Dexon) were studied under similar conditions in the penile foreskin of 16 baboons. Gross and microscopic observations were made at intervals of six to forty-eight days. The wounds sutured with catgut were all healed by twenty-four days with complete suture resorption and no evidence of scar formation. Both polyglycolic acid and polydioxanone sutures showed delayed resorption, wound abscesses, and granulomas. Catgut remains the best available suture to use in the penile foreskin. Polyglycolic acid and polydioxanone sutures, because of their prolonged resorption and excess reaction, should not be used in hypospadias surgery.

Balloon Dilation of Upper Ureteral Strictures in Primates

We report the successful creation of ureteral strictures in primates and their successful management by balloon dilation 3 months later without ureteral stenting. This experimental work confirms the sporadic clinical reports of the effectiveness of balloon dilation in the management of ureteral strictures and suggests that ureteral stenting is not necessary for a successful result.

New Markers for Prostate Cancer Detection and Prognosis

Prostate cancer (PCa) is the most commonly diagnosed solid tumor among men in the United States and Europe. Even without treatment, PCa-specific mortality rates at 5 and 10 years remain low. Improvements in optimizing screening, diagnosis, and treatment have resulted in decreasing PCa mortality. Nevertheless, certain challenges still remain for men facing important disease state decisions and there is a need for biomarkers that can help.