Surgery (Austin & Northern Health) - Research Publications

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Start date: 2010 × End date: 2019 × Author: Lawrentschuk, Nathan × Author: Perera, Marlon Lakmal × Author: CABARKAPA, SONJA ×

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    Prostate cancer screening with prostate-specific antigen: A guide to the guidelines
    Cabarkapa, S ; Perera, M ; McGrath, S ; Lawrentschuk, N (ELSEVIER INC, 2016-12)
    BACKGROUND: Prostate cancer remains the most common non-skin cancer malignancy in men. Prostate-specific antigen (PSA) is recognized as a biomarker for the diagnosis, monitoring, and risk prediction of prostate cancer. Its use in the setting of prostate cancer screening has been controversial due to the risk of over diagnosis and over treatment. OBJECTIVE: Within Australia, there are inconsistent recommendations surrounding the use of PSA screening in clinical practice. In light of the 2016 PSA-screening guidelines by the major Australian health authorities, the current review aims to highlight the controversies and objectively outline the current recommendations within Australia. DISCUSSION: Health-care authorities across Australia have issued conflicting guidelines for prostate cancer screening culminating in confusion amongst health care practitioners and members of the public alike. A general consensus is held by other countries across the globe but differences amongst the specific details in how to best employ a PSA screening program still exist.
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    Reporting and ideal testosterone levels in men undergoing androgen deprivation for prostate cancer-time for a rethink?
    Cabarkapa, S ; Perera, M ; Sikaris, K ; O'Brien, JS ; Bolton, DM ; Lawrentschuk, N (ELSEVIER INC, 2018-03)
    BACKGROUND: This study aims to review current laboratory reporting strategies across Australia and New Zealand with a view to propose a more useful template for reporting serum testosterone in the context of prostate cancer. MATERIALS AND METHODS: Registered pathology laboratories in Australia and New Zealand were enrolled into the current study. An electronic or a phone survey was utilized to collect data from each participating laboratory. Obtained information included assay utilized, units reported, reference intervals, lowest reported value, and lowest detectable value. To identify recommendations for testosterone testing, a systematic search was performed across Web of Science (including MEDLINE), EMBASE, and Cochrane libraries. RESULTS: Assessment of national pathology laboratories identified significant heterogeneity in the reporting methods. Reports typically used a "normal healthy male of 35 years of age" as a comparator but did not refer to optimal castrate levels, the lowest level that their assay was able to detect, nor did they include appended clinical guidelines relating to the prostate cancer patient cohort. CONCLUSIONS: Across Australia and New Zealand, various methods for testing and reporting serum testosterone exist, while international guidelines remain vague. The fashion in which serum testosterone levels are displayed should be re-evaluated to address the relevant clinical population and reflect an agreed-upon castrate threshold in patients undergoing androgen deprivation therapy.