Below the belt

Clinical Brief – August 2nd

The Brief

Today’s brief is all about #ProstateCancer.

Tell me more

Vasectomy was shown to be tied to a 0.6% increase in lifetime risk of prostate cancer but was not associated with the risk of high-grade, advanced or fatal prostate cancer – according to a meta-analysis of 53 studies involving over 14.7 million people.

“At most, there is a trivial association between vasectomy and prostate cancer that is unlikely to be causal; therefore, concerns about prostate cancer should not preclude the use of vasectomy as an option for long-term contraception.”
– Bhindi B, et al.

Translation: Based on these data, vasectomy is unlikely to lead to prostate cancer.

Stepping up on physical activity was linked to significantly lower cancer-specific mortality for elderly men with low-risk prostate cancer, says a cohort study of 12.6k people.

At an average age of 71, men whose weekly activity was equivalent to 5 hours of walking had a 37% lower risk of death as a result of their prostate cancer vs men whose weekly activity fell short of 2.5 hours of walking. However, this trend was only seen in men with low-risk prostate cancer, defined as Gleason 2-7.

Basically, older men with low-risk prostate cancer who were physically active had a lower risk of death as a result of their cancer. Is this the result of exercise? Hard to say. But a 1-hour stroll after dinner can’t hurt, I suppose.

Infection is the most common complication of prostate biopsies, says the American Urological Association.

In a review, rates of infections after biopsies were as high as 1 in 14 cases (0.1% to 7.0%); rates of sepsis were as high as 1 in 33 cases (0.3% to 3.0%). Drug resistant E. coli was seen as “prominent”.

“If infection occurs, actively re-situate the patient and start empiric intravenous treatment with carbapenems, amikacin or second and third generation cephalosporins.”
– Liss MA, et al.

Radical prostate surgery for some men with oligo-metastatic prostate cancer may lead to 7-year progression-free survival of 45%; cancer-specific-mortality-free survival of 82%.

Data on surgery for patients with metastatic prostate cancer is scant. In a retrospective study looking at the patient records of a single hospital in Italy, researchers found that in “well-selected” patients with bone metastases, radical prostatectomy surgery may be an option to consider.

“Our investigation focused on a highly selected cohort with available data on the number and sites of metastases and on the use of additional cancer therapies.”
– Gandaglia G, et al.

Side bar

Did you know that it’s possible to transplant a penis? Check out a review of these three cases. I had no idea…

Also, next time you go under the knife…know that your surgeon is probably rocking out to something like Guns N’ Roses. According to a Spotify x Figure 1 survey, “90% of the surgeons said they listen to music while you’re under the knife”; 49% were listening to rock.

Want to see their play list? Check out their report:

Rock Rules in the Operating Room: Surgeons Prefer Listening to Rock While in Surgery, According to Spotify and Figure 1, the Knowledge-Sharing App for Doctors

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