However, approximately 13-38% of patients fail to achieve this goal and up to 24% of men may experience temporary testosterone surges (testosterone > 50 ng/dL) during long-term treatment [The timing of measurements is not clearly defined. The examinations used for cancer-related follow-up after curative surgery or RT are discussed below.Measurement of PSA is a cornerstone in follow-up after local treatment. Defining continence as 0-1 pad per day in 120 patients, Dalela Until these results are replicated in larger numbers in a multi-centre setting, it remains too early to recommend RS-RARP over the traditional anterior dissection, Furthermore, no high level evidence is available on high-risk disease, with some concerns that RS-RARP may confer an increased positive margin rate based on the pT3 results. Independent predictors of OM were a higher PSA nadir (HR: 1.46, p 0.013) and seminal vesicle invasion (HR: 3.15, p = 0.047)Metastasis-free survival at 3, 5 and 10 yr. was 68%, 49%, and 22%, respectively.75 men (47%) developed distant metastases after RP (median time to metastases 5.0 yr.; range, 0.5-13 yr.).BCR = biochemical recurrence; FU = follow-up; HR = hazard ratio; mo = months; n = number of patients; OM = overall mortality; PSA = prostate-specific antigen; RT = radiotherapy.Standard imaging with bone scan and MRI has a low pick-up rate for men with a PSA below 2 ng/mL. FU: 36 mo. The EAU is a non-profit organization and funding is limited to administrative assistance and travel and meeting expenses. Men with impaired glucose tolerance and/or diabetes should be referred for an endocrine consultation. Among patients receiving olaparib, 16.4% discontinued treatment secondary to an adverse event, compared to 8.5% of patients receiving enzalutamide/abiraterone. In contrast, mpMRI has yielded excellent results and can be used for biopsy targeting and guiding local salvage treatment [In patients with BCR, imaging has the potential to play a role in detecting both distant metastases and local recurrence. Imaging is only justified in patients for whom the findings will affect treatment decisions, either in case of BCR or in patients with symptoms. However, there were no significant differences in EORTC QLQ-C30/PR-25 scores at 5 years of follow-up when comparing to pre-treatment values [Advise eligible patients for active surveillance, that global quality of life is equivalent for up to 5 years compared to radical prostatectomy or external beam radiotherapy.Discuss the negative impact of surgery on urinary and sexual function, as well as the negative impact of radiotherapy on bowel function with patients.Advise patients treated with brachytherapy of the negative impact on irritative urinary symptomatology at one year but not after 5 years.In men with localised disease, nurse led multi-disciplinary rehabilitation (addressing sexual functioning, cancer worry, relationship issues depression, managing bowel and urinary function problems) provided positive short-term effects (4 months) on sexual function (effect size 0.45) and long-term (12 months) positive effects on sexual limitation (effect size 0.5) and cancer worry (effect size 0.51) [In men with post-surgical urinary incontinence, conservative management options include pelvic floor muscle training with or without biofeedback, electrical stimulation, extra-corporeal magnetic innervation (ExMI), compression devices (penile clamps), lifestyle changes, or a combination of methods. The treatment sections have been completely restructured and evidence summaries and recommendations have been amended throughout the current document.Specific sections of the text have been updated based on systematic review (SR) questions prioritised by the Guidelines Panel. There was a 0.6% incidence of seizures in the enzalutamide group compared to none in the placebo arm.The only bone-specific drug that is associated with a survival benefit is the For men progressing quickly on AR targeted therapy (< 12 months) it is now clear that cabazitaxel is the treatment with the best supporting data. The technical differences are outlined in Table 6.1.11. However, mpMRI findings must be interpreted in the light of the Finally, it must be emphasised that the 'MR pathway' has only been evaluated in patients in whom the risk of csPCa was judged high enough to deserve biopsy. Common toxicities included dysuria, urinary frequency, urinary retention, haematuria, diarrhoea, rectal bleeding and proctitis [Androgen deprivation can be achieved by either suppressing the secretion of testicular androgens or inhibiting the action of circulating androgens at the level of their receptor.
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