New Orleans—Analyses of overall survival rates among subgroups of men who received radium-223 dichloride (Ra 223; Xofigo) as part of an expanded access program (EAP) suggest factors that may have prognostic significance, including effects of prior and concomitant treatments. Dr. Sartor Further study is needed, however, to confirm these preliminary findings, according to Oliver Sartor, MD. “Taken together, the EAP data indicate the safety and tolerability of Ra 223 outside of the randomized phase III trial setting. Further, these data raise the hypothesis that combining Ra 223 with newer agents such as denosumab [XGEVA], abiraterone [ZYTIGA], and/or enzalutamide [XTANDI] may be preferable to sequential approaches,” said Dr. Sartor, Laborde Professor of Cancer Research, departments of medicine and urology, Tulane School of Medicine, New Orleans. Dr. Sartor was an investigator in ALSYMPCA, the pivotal trial of Ra 223, and treated men in the EAP. The research was p…
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In a small study of men with prostate cancer, researchers found a novel agent combined with positron emission tomography (PET) imaging detected 97% of cancerous lesions. The new modality holds promise but will require validation in a larger cohort of patients in one or more separate institutions, one thought leader told Urology Times. The modality, known as 64Cu-TP3805 PET imaging, consists of TP3805, which latches on to VPAC1 receptors, and Cu-64 (a radiation-emitting copper peptide), that is hooked onto TP3805, according to a press release about the study. “VPAC1 is known to be upregulated in a variety of malignancies, including prostate cancer. The estimates are that there are about 1,000 times more VPAC receptors on prostate cancer than benign prostates,” said study author Edouard J. Trabulsi, MD, of the Prostate Diagnostic Center at the Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia. The study’s senior investigator, Mathew Thakur, PhD, of…
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Dr. Gomez is chief of urology at Hospital del Trabajador and adjunct professor of urology at the Universidad Andres Bello, Santiago, Chile. Bulbomembranous urethral strictures (BMUS) after surgery for BPH are challenging, as the internal sphincter located at the bladder neck has been removed by prostatectomy, and urinary continence now depends on the function of the external sphincter, which is located just at the site of the stricture. Consequently, any attempt at stricture reconstruction may jeopardize continence. For this reason, in most cases these patients are only offered conservative management, such as dilation or internal urethrotomy. Unfortunately, these options are seldom curative and the stricture becomes a chronic condition. Interestingly, anatomic studies have shown that the external sphincter (rhabdosphincter) is separated from the membranous urethra by a sheath of connective tissue, a feature that has previously gone unnoticed (BJU Int 2008; 102:1448-51). Our group dev…
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Robert A. Dowling, MD The matrix of federal statutes, rules, and regulations regarding protected health information (PHI) has created a complicated and confusing landscape for health care providers on the front lines. The HIPAA Privacy and Security Rules, the HITECH Act, the EHR Incentive Program, and state laws and regulations all address certain aspects of PHI, including the rights of patients, the obligations of providers, access to information, and penalties for violations. One practical challenge that urologists and other physicians face every day concerns “requests for medical records” that come from patients and their representatives. In this article, I address common questions and answers on this topic—recently released by the government—to help your office manage this common task in a compliant fashion. Misunderstandings about the HIPAA Privacy Rule may be common among patients and their providers (http://bit.ly/PHIconfusion). On Jan. 7, 2016, the Offi…
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