workup of microscopic and gross hematuria

Based on the American Urological Association best practice policy statement, the presence of gross hematuria is always an indication for prompt full investigation

Novel concepts in the treatment of localized renal cell carcinoma

The understanding of renal cell carcinoma has undergone significant advances in the past several years. These have included advances in imaging procedures and surgical approaches, allowing for more precise staging, and individualized approaches to therapy. Furthermore, there has been an increase in the diagnosis of incidental tumors and currently the majority of RCCs are incidentally diagnosed on routine imaging procedures. In this manuscript, we review the surgical options for renal cell carcinoma with specific emphasis on the algorithm for approaching these tumors, in order to ensure maximal cancer specific survival, without threatening the overall renal function

Prostate cancer: Diagnostic and therapeutic strategies with emphasis on the role of PSA

Prostate cancer is the most common cancer in man and the second most common cause of death. The disease is uniquely heterogeneous, and includes tumors with moderate or full differentiation that could progress rather slowly, and tumors with poor differentiation that could have a rapid growth and extensive spread beyond the confines of the prostate. In the latter group of patients, and if they are not treated, the cancer becomes incurable and the long-term survival is compromised. The commonly accepted strategy among urologists at present is aimed at early detection of prostate cancer in order to provide curative local therapy. The recognition of prostate specific antigen [PSA] as a serum marker specific for prostate cancer has made this strategy possible. We herein provide an overview on the contemporary diagnostic and therapeutic strategies for prostate cancer, with emphasis on the role of prostate [PSA]. We also discuss the therapeutic options for localized disease

Role of dietary modifcation and vitamins in prostate cancer

Prostate cancer incidence and nutrition are closely connected and show large food-related differences. Lowest cancer incidence in Asian countries is observed under low-calorie, soy-based food. Mediterranean nutrition has cancer protective components [fruit, vegetables, oil, seafood]. The highest cancer incidence in the United States goes along with high-calorie food, red meat and fat ingestion. Changes in lifestyle and nutrition can influence the cancer risk. Dietary supplements and vitamins are in wide use and part of a complementary and alternative medicine

Surgical adrenal diseases

There are four adrenal disorders in which surgery is the treatment of choice pheochromocytoma, Cushing's syndrome due to ACTH-independent adrenal disease [adenoma, carcinoma or autonomous hyperplasia], primary aldosteronism due to an adrenal adenoma and some adrenal non-functional "incidentilomas". In all four categories, the optimal result of surgical intervention depends on the following factors: 1. Definitive diagnosis by accurate biochemical assessment of the functional status of the adrenal lesion. 2. Precise localization of the lesion using simple routine as well as advanced imaging techniques. 3. Adequate preoperative preparation and intra-operative monitoring. 4. Close immediate and long-term postoperative follow-up. In this review, the above factors are briefly summarized for each of the four disorders. A small proportion of adrenal lesions requiring surgery are bilateral and in such situations, special intra- and postoperative care should take into consideration the need for appropriate gluco-corticoid and mineralo-corticoid replacement. The advent of laparoscopic surgery has served to reduce the postoperative morbidity of adrenal surgery and is becoming increasingly the procedure of choice except for large lesions [> 8 cm in diameter]