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Prostate Cancer Patients - Living With Uncertainty:

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What Job, Candide, and Pollyanna Can Teach Cancer Patients About Navigating the Long Journey BLUF (Bottom Line Up Front) Cancer patients face a unique form of suffering: chronic uncertainty that demands sustained coping strategies over months or years. Three classic works of literature—the biblical Book of Job, Voltaire's "Candide," and Eleanor Porter's "Pollyanna"—offer different frameworks for responding to undeserved suffering. Job demands answers and accountability; Candide rejects cosmic justifications and focuses on practical action; Pollyanna maintains psychological resilience through deliberate focus on what remains good. Modern research on cancer patient psychology, resilience, and meaning-making suggests that patients often need elements from all three approaches at different points in their journey. Recent studies show that neither forced optimism nor passive acceptance produces the best outcomes—instead, "flexible coping" that adapts ...
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New Study Reveals Hidden Lymph Node Cancer Despite Clear PSMA PET Scans

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Pelvic Lymph Node Staging With PSMA PET in Prostate Cancer: Surgical Validation With Implications for Radiotherapy Planning - Ozen - The Prostate - Wiley Online Library BLUF (Bottom Line Up Front): A Turkish surgical study found that 12% of prostate cancer patients with negative PSMA PET scans still had microscopic cancer in their pelvic lymph nodes when examined after surgery. This important finding suggests that even advanced imaging can miss small amounts of cancer spread, which has significant implications for treatment planning—particularly for patients considering radiation therapy instead of surgery. The Promise and Limitations of Modern Imaging PSMA PET/CT scanning has revolutionized how doctors detect prostate cancer spread. This advanced imaging technique uses a radioactive tracer that attaches to prostate-specific membrane antigen (PSMA), a protein highly expressed on prostate cancer cells. When cancer has spread to lymph nodes, these scans can often detect it far better...
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ESMO Revises Early Prostate Cancer Diagnosis and Monitoring

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ESMO Revises Early Prostate Cancer Diagnosis and Monitoring ESMO Issues Major Update to Prostate Cancer Diagnosis and Treatment Guidelines BLUF (Bottom Line Up Front): The European Society for Medical Oncology has released updated clinical practice guidelines that fundamentally change how prostate cancer is diagnosed and monitored, emphasizing safer biopsy procedures, precision imaging before tissue sampling, and aggressive early treatment for high-risk biochemical recurrence. The new recommendations prioritize multiparametric MRI before biopsy, mandate the safer transperineal biopsy approach, and introduce combination androgen deprivation therapy with enzalutamide for patients with rapidly rising PSA after initial treatment—even without visible metastases. A Paradigm Shift in Prostate Cancer Care The European Society for Medical Oncology (ESMO) has comprehensively revised its clinical practice guidelines for localized prostate cancer and biochemical recurrence, representing one of...
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Active Surveillance for Prostate Cancer:

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Current Opinion in Urology A Proven Strategy Gains Ground BLUF (Bottom Line Up Front): Active surveillance has evolved from a controversial "watch and wait" approach into the gold standard treatment for low-risk prostate cancer, with mounting evidence supporting its expansion to carefully selected intermediate-risk patients. Recent research confirms that properly monitored men can safely defer treatment for years—or even indefinitely—while maintaining excellent cancer control outcomes and avoiding the significant side effects of immediate surgery or radiation. From Skepticism to Standard of Care Just two decades ago, most men diagnosed with prostate cancer faced an immediate choice: surgery or radiation. The notion of deliberately monitoring cancer without treating it seemed counterintuitive, even dangerous. Today, active surveillance represents one of the most significant paradigm shifts in prostate cancer management. "Active surveillance is considered the treatmen...
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