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Testosterone and the prostate: Is there really a problem?
True or false? Higher testosterone levels increase the risk of prostate cancer. Although long believed to be true, a growing body of evidence to the contrary is shattering this long-standing dogma—and, the author argues, should change the way urologists manage hypogonadism in the aging male.
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Atrasentan: A novel selective endothelin-A receptor antagonist
Accumulating data have demonstrated that the endothelin axis plays a role in the progression of many malignancies. Endothelin-1, which is produced by prostate cancer cells, can stimulate new bone formation. The highest concentration of endothelin-1 is found in patients with hormone refractory metastatic disease. Atrasentan is a member of a new class of drugs called the selective endothelin-A receptor antagonists (SERAs). The safety and efficacy of atrasentan in hormone refractory prostate cancer (HRPC) have been evaluated in several clinical trials.
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Three factors predict death from recurring prostate cancer
Researchers at the Brady Urological Institute at Johns Hopkins have identified three risk factors that help determine whether a patient's risk of death from recurrent prostate cancer is high or low following surgery. This insight will help urologists to better determine whether aggressive or conservative treatment is best for many patients, according to the authors of the study, published in JAMA (2005; 294:433-9).
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Improving the efficacy of ESWL
The Dornier HM3 remains the "gold standard" lithotripter. The authors re-examine the concepts behind the initial success of the HM3 and explore new ESWL techniques and adjunctive procedures that may at last lead to increased effectiveness of ESWL while still decreasing morbidity, pain, and the incidence of side effects.
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