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Case Records of the Massachusetts General Hospital Genitourinary Cancer Center
These videos focus on difficult clinical situations of genitourinary (GU) cancer patients treated at the Massachusetts General Hospital Genitourinary Cancer Center. Each case is chosen by one of the treating physicians, and discussed among physician specialists in GU cancers; urologists, medical oncologists, radiation oncologists, radiologists, and pathologists. The presentations consist of the patient history, including clinical, radiological and pathological findings; discussion of treatment choice; and review of relevant literature.
In 2012 the United States Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA)-based screening for prostate cancer. While the recommendation remains controversial, it has been associated with a significant decrease in prostate cancer screening and detection. In this presentation we will discuss the case of a 60 year-old male found to have metastatic prostate cancer during evaluation for incidentally discovered hydronephrosis. We will discuss the effects that the USPSTF recommendation has had on PSA-based prostate cancer screening since 2012, anticipated long term effects of the recommendation and treatment options for men who present with advanced stage prostate cancer.
This case discussion was recorded on February 4, 2016.
The landmark work by Charles Huggins (1941) on the importance of androgen manipulation has remained at the cornerstone of managing metastatic prostate cancer. It was not until 2004 that a new era of available treatment options began to emerge. In this presentation we will discuss the case of a 60 year-old male found to have metastatic prostate cancer during evaluation for chest pain. We will elaborate on the management of both castrate sensitive and eventual castrate resistant disease, specifically reviewing first and second line options for CRPC. Lastly, we will discuss newer available options while entertaining next-generation modalities.
This case discussion was recorded on March 3, 2016.
The definition of high-risk prostate cancer is variable and characterizes a heterogeneous disease. Multiparametric MRI can help better select and plan for patients who are interested in surgical therapy. Radical prostatectomy is increasingly being utilized for the treatment of high-risk disease in the U.S. Radical Prostatectomy, and as initial management to multi-disciplinary care, can achieve excellent functional and long-term oncologic outcomes. Genomic testing promises potential personalized decision making for adjuvant therapy strategies.
This case discussion was recorded on April 7, 2016.
We present a female patient with local advanced primary urethral cancer. Although a rare cancer, female urethral cancer is the only GU malignancy more common in women than men. We review the epidemiology and staging of urethral cancer. This middle age patient presented with classis bladder outlet obstructive symptoms with a palpable vaginal mass and alarming endoscopic findings. Imaging, pathology and management is discussed. A multidisciplinary approach is often needed to manage this rare and aggressive disease.
This case discussion was recorded on June 2, 2016.
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