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Mary Beth Nierengarten
Becoming an effective healthcare leader
For clinicians who aspire to leadership positions within their healthcare organization, keys to success include the ability to embrace ambiguity, not being afraid to fail, and falling in love with the problem and not the solution.
Cardiologists need to engage in tort reform
Medical liability concerns still rate high on the list of concerns by cardiologists, despite State tort reforms in the past decade that have resulted in fewer claims made against physicians and subsequent decreased malpractice insurance pricing.
Managing hypertension: The knowns and unknowns
Hypertension is a major cause of morbidity and mortality, and the lifetime risk of developing hypertension is high. It is also widely known that treating hypertension reduces morbidity and mortality even in very old persons, and that an important aspect of blood pressure management is lifestyle modification.
Prostate cancer active surveillance criteria may need to be stratified by race
African-American men eligible for active surveillance have a higher risk of advanced cancer on final surgical pathology compared to Caucasian men, suggesting the need for more stringent criteria for active surveillance for African-American men, according to a recently published study.
Partial nephrectomy shows increased survival benefit
A recently published population-based study reinforces prior evidence from retrospective studies of the increased survival benefit of partial nephrectomy over radical nephrectomy, and suggests a cancer-specific survival benefit for nephron-sparing approaches as well.
Imaging technologies reshape prostate cancer treatment
Chicago—Although open radical prostatectomy remains the gold standard of treatment for clinically localized prostate cancer, laparoscopic prostatectomy and, more recently, robot-assisted laparoscopic prostatectomy are rapidly increasing in popularity as alternatives to traditional open prostatectomy techniques.
Oncologists' role in early prostate cancer remains unclear
Chicago—For men diagnosed with early prostate cancer or localized disease, the roles of the urologist, surgical oncologist, and radiation oncologist have been fairly well defined. The role of medical oncologists in managing patients in the early stages of the disease is less clear.
Molecular signatures may predict lethal prostate cancer
Chicago—One of the most difficult issues in the management of prostate cancer is identifying which men with indolent disease are at increased risk of progressing to more advanced disease. Reliance on traditional clinical prognostic factors, including PSA, has provided some guidance on treatment, but all too often, men with indolent disease are over-treated based on an incomplete knowledge of disease risk.
Chemo's benefit in T3 prostate cancer remains to be seen
Chicago—Whether chemotherapy may benefit men with locally advanced prostate cancer is still not known, but it is hoped that clinical trials currently under way may provide some evidence on the potential role of adjuvant or neoadjuvant chemotherapy in this setting.
Coordinated care maximizes advanced prostate cancer outcomes
Chicago—With the evolving definition of advanced prostate cancer that now includes a number of clinical states not previously defined, treatment has also evolved into a multimodal approach. This mandates close cooperation among urologists and medical and radiation oncologists to ensure optimal patient care, according to leading oncologists.