Pub Date : 2024-02-02DOI: 10.1038/s41585-023-00849-5
Jabril R. Johnson, Nicole Mavingire, Leanne Woods-Burnham, Mya Walker, Deyana Lewis, Stanley E. Hooker, Dorothy Galloway, Brian Rivers, Rick A. Kittles
Prostate cancer is the second most commonly diagnosed non-skin malignancy and the second leading cause of cancer death among men in the USA. However, the mortality rate of African American men aged 40–60 years is almost 2.5-fold greater than that of European American men. Despite screening and diagnostic and therapeutic advances, disparities in prostate cancer incidence and outcomes remain prevalent. The reasons that lead to this disparity in outcomes are complex and multifactorial. Established non-modifiable risk factors such as age and genetic predisposition contribute to this disparity; however, evidence suggests that modifiable risk factors (including social determinants of health, diet, steroid hormones, environment and lack of diversity in enrolment in clinical trials) are prominent contributing factors to the racial disparities observed. Disparities involved in the diagnosis, treatment and survival of African American men with prostate cancer have also been correlated with low socioeconomic status, education and lack of access to health care. The effects and complex interactions of prostate cancer modifiable risk factors are important considerations for mitigating the incidence and outcomes of this disease in African American men. African American men are disproportionately affected by prostate cancer in the USA. In this Review, the authors discuss the complex interplay of modifiable risk factors that might underlie the glaring prostate cancer disparities observed.
{"title":"The complex interplay of modifiable risk factors affecting prostate cancer disparities in African American men","authors":"Jabril R. Johnson, Nicole Mavingire, Leanne Woods-Burnham, Mya Walker, Deyana Lewis, Stanley E. Hooker, Dorothy Galloway, Brian Rivers, Rick A. Kittles","doi":"10.1038/s41585-023-00849-5","DOIUrl":"10.1038/s41585-023-00849-5","url":null,"abstract":"Prostate cancer is the second most commonly diagnosed non-skin malignancy and the second leading cause of cancer death among men in the USA. However, the mortality rate of African American men aged 40–60 years is almost 2.5-fold greater than that of European American men. Despite screening and diagnostic and therapeutic advances, disparities in prostate cancer incidence and outcomes remain prevalent. The reasons that lead to this disparity in outcomes are complex and multifactorial. Established non-modifiable risk factors such as age and genetic predisposition contribute to this disparity; however, evidence suggests that modifiable risk factors (including social determinants of health, diet, steroid hormones, environment and lack of diversity in enrolment in clinical trials) are prominent contributing factors to the racial disparities observed. Disparities involved in the diagnosis, treatment and survival of African American men with prostate cancer have also been correlated with low socioeconomic status, education and lack of access to health care. The effects and complex interactions of prostate cancer modifiable risk factors are important considerations for mitigating the incidence and outcomes of this disease in African American men. African American men are disproportionately affected by prostate cancer in the USA. In this Review, the authors discuss the complex interplay of modifiable risk factors that might underlie the glaring prostate cancer disparities observed.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139660936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-31DOI: 10.1038/s41585-023-00842-y
Elisabeth Grobet-Jeandin, Louis Lenfant, Ugo Pinar, Jérôme Parra, Pierre Mozer, Raphaele Renard-Penna, Constance Thibault, Morgan Rouprêt, Thomas Seisen
Identification of clinically positive pelvic lymph node metastases (cN+) in patients with muscle-invasive bladder cancer is currently challenging, as the diagnostic accuracy of available imaging modalities is limited. Conventional CT is still considered the gold-standard approach to diagnose lymph node metastases in these patients. The development of innovative diagnostic methods including radiomics, artificial intelligence-based models and molecular biomarkers might offer new perspectives for the diagnosis of cN+ disease. With regard to the treatment of these patients, multimodal strategies are likely to provide the best oncological outcomes, especially using induction chemotherapy followed by radical cystectomy and pelvic lymph node dissection in responders to chemotherapy. Additionally, the use of adjuvant nivolumab has been shown to decrease the risk of recurrence in patients who still harbour ypT2–T4a and/or ypN+ disease after surgery. Alternatively, the use of avelumab maintenance therapy can be offered to patients with unresectable cN+ tumours who have at least stable disease after induction chemotherapy alone. Lastly, patients with cN+ tumours who are not responding to induction chemotherapy are potential candidates for receiving second-line treatment with pembrolizumab. Muscle-invasive bladder cancer with clinically positive pelvic lymph nodes is a particular situation at the interface between localized and metastatic disease. In this Review, the authors discuss the advances and challenges of currently available strategies for the diagnosis and treatment of patients with muscle-invasive bladder cancer with clinically positive pelvic lymph nodes.
{"title":"Management of patients with muscle-invasive bladder cancer with clinical evidence of pelvic lymph node metastases","authors":"Elisabeth Grobet-Jeandin, Louis Lenfant, Ugo Pinar, Jérôme Parra, Pierre Mozer, Raphaele Renard-Penna, Constance Thibault, Morgan Rouprêt, Thomas Seisen","doi":"10.1038/s41585-023-00842-y","DOIUrl":"10.1038/s41585-023-00842-y","url":null,"abstract":"Identification of clinically positive pelvic lymph node metastases (cN+) in patients with muscle-invasive bladder cancer is currently challenging, as the diagnostic accuracy of available imaging modalities is limited. Conventional CT is still considered the gold-standard approach to diagnose lymph node metastases in these patients. The development of innovative diagnostic methods including radiomics, artificial intelligence-based models and molecular biomarkers might offer new perspectives for the diagnosis of cN+ disease. With regard to the treatment of these patients, multimodal strategies are likely to provide the best oncological outcomes, especially using induction chemotherapy followed by radical cystectomy and pelvic lymph node dissection in responders to chemotherapy. Additionally, the use of adjuvant nivolumab has been shown to decrease the risk of recurrence in patients who still harbour ypT2–T4a and/or ypN+ disease after surgery. Alternatively, the use of avelumab maintenance therapy can be offered to patients with unresectable cN+ tumours who have at least stable disease after induction chemotherapy alone. Lastly, patients with cN+ tumours who are not responding to induction chemotherapy are potential candidates for receiving second-line treatment with pembrolizumab. Muscle-invasive bladder cancer with clinically positive pelvic lymph nodes is a particular situation at the interface between localized and metastatic disease. In this Review, the authors discuss the advances and challenges of currently available strategies for the diagnosis and treatment of patients with muscle-invasive bladder cancer with clinically positive pelvic lymph nodes.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":15.3,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-24DOI: 10.1038/s41585-024-00858-y
Matteo Santoni, Hideki Takeshita, Francesco Massari, Aristotelis Bamias, Linda Cerbone, Ondrej Fiala, Veronica Mollica, Sebastiano Buti, Angela Santoni, Joaquim Bellmunt
The combination of pembrolizumab and enfortumab vedotin shows promise as a first-line therapy for advanced urothelial carcinoma. Enfortumab vedotin targets nectin-4, in turn enhancing T cell and natural killer cell activity, inhibiting immunosuppressive pathways and impeding tumour evasion. This synergy with pembrolizumab shows potential in enhancing immunotherapy for these patients.
{"title":"Pembrolizumab plus enfortumab vedotin in urothelial cancer","authors":"Matteo Santoni, Hideki Takeshita, Francesco Massari, Aristotelis Bamias, Linda Cerbone, Ondrej Fiala, Veronica Mollica, Sebastiano Buti, Angela Santoni, Joaquim Bellmunt","doi":"10.1038/s41585-024-00858-y","DOIUrl":"10.1038/s41585-024-00858-y","url":null,"abstract":"The combination of pembrolizumab and enfortumab vedotin shows promise as a first-line therapy for advanced urothelial carcinoma. Enfortumab vedotin targets nectin-4, in turn enhancing T cell and natural killer cell activity, inhibiting immunosuppressive pathways and impeding tumour evasion. This synergy with pembrolizumab shows potential in enhancing immunotherapy for these patients.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-18DOI: 10.1038/s41585-023-00846-8
Chalairat Suk-Ouichai, Anna E. Coghill, Matthew B. Schabath, Julian A. Sanchez, Jad Chahoud, Andrea Necchi, Anna R. Giuliano, Philippe E. Spiess
The number of people living with HIV infection has been increasing globally. Administration of antiretroviral therapy is effective in controlling the infection for most patients and, as a consequence, people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. To date, few studies have assessed the risk of genitourinary cancers in PLWH, and robust scientific data on their treatment-related outcomes are lacking. Previous studies have noted that PLWH are at a reduced risk of prostate cancer; however, low adoption and/or availability of prostate cancer screening among these patients might be confounding the validity of this finding. In genitourinary cancers, advanced stage at diagnosis and reduced cancer-specific mortality have been reported in PLWH. These data likely reflect, at least in part, the inequity of health care access for PLWH. Notably, systemic chemotherapy and/or radiotherapy could decrease total CD4+ cell counts, which could, therefore, increase the risk of morbidity and mortality from cancer treatments in PLWH. Immune checkpoint inhibitors have become the therapeutic backbone for many advanced malignancies in the general population; however, most studies validating their efficacy have excluded PLWH owing to concerns of severe adverse effects from immune checkpoint inhibitors themselves and/or related to their immunosuppressed status. To our knowledge, no genitourinary cancer survivorship programme exists that specifically caters to the needs of PLWH. By including PLWH in ongoing cancer trials, we can gain invaluable insights that will help to improve cancer care specifically for PLWH. Antiretroviral therapy means that people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. In this Review, the authors discuss the risk of genitourinary cancers in PLWH, the inequity of health care access and consider how including PLWH in ongoing cancer trials can help to improve cancer care for this population.
{"title":"A clinical overview of people living with HIV and genitourinary cancer care","authors":"Chalairat Suk-Ouichai, Anna E. Coghill, Matthew B. Schabath, Julian A. Sanchez, Jad Chahoud, Andrea Necchi, Anna R. Giuliano, Philippe E. Spiess","doi":"10.1038/s41585-023-00846-8","DOIUrl":"10.1038/s41585-023-00846-8","url":null,"abstract":"The number of people living with HIV infection has been increasing globally. Administration of antiretroviral therapy is effective in controlling the infection for most patients and, as a consequence, people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. To date, few studies have assessed the risk of genitourinary cancers in PLWH, and robust scientific data on their treatment-related outcomes are lacking. Previous studies have noted that PLWH are at a reduced risk of prostate cancer; however, low adoption and/or availability of prostate cancer screening among these patients might be confounding the validity of this finding. In genitourinary cancers, advanced stage at diagnosis and reduced cancer-specific mortality have been reported in PLWH. These data likely reflect, at least in part, the inequity of health care access for PLWH. Notably, systemic chemotherapy and/or radiotherapy could decrease total CD4+ cell counts, which could, therefore, increase the risk of morbidity and mortality from cancer treatments in PLWH. Immune checkpoint inhibitors have become the therapeutic backbone for many advanced malignancies in the general population; however, most studies validating their efficacy have excluded PLWH owing to concerns of severe adverse effects from immune checkpoint inhibitors themselves and/or related to their immunosuppressed status. To our knowledge, no genitourinary cancer survivorship programme exists that specifically caters to the needs of PLWH. By including PLWH in ongoing cancer trials, we can gain invaluable insights that will help to improve cancer care specifically for PLWH. Antiretroviral therapy means that people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. In this Review, the authors discuss the risk of genitourinary cancers in PLWH, the inequity of health care access and consider how including PLWH in ongoing cancer trials can help to improve cancer care for this population.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":15.3,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139489315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.1038/s41585-024-00856-0
The burden of male infertility is often unrecognized and its causes are poorly understood. Efforts to increase awareness and understanding are being undertaken to improve fertility outcomes and overall health for affected men.
{"title":"Focusing on male infertility","authors":"","doi":"10.1038/s41585-024-00856-0","DOIUrl":"10.1038/s41585-024-00856-0","url":null,"abstract":"The burden of male infertility is often unrecognized and its causes are poorly understood. Efforts to increase awareness and understanding are being undertaken to improve fertility outcomes and overall health for affected men.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":15.3,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41585-024-00856-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.1038/s41585-024-00852-4
Maria Chiara Masone
{"title":"Effect of bariatric surgery on sexual function","authors":"Maria Chiara Masone","doi":"10.1038/s41585-024-00852-4","DOIUrl":"10.1038/s41585-024-00852-4","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":15.3,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139474210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.1038/s41585-024-00853-3
Maria Chiara Masone
{"title":"Urinoids — a new tool to study bladder cancer","authors":"Maria Chiara Masone","doi":"10.1038/s41585-024-00853-3","DOIUrl":"10.1038/s41585-024-00853-3","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":15.3,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139474276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-15DOI: 10.1038/s41585-023-00839-7
Sigrid V. Carlsson, Sandro C. Esteves, Elisabeth Grobet-Jeandin, Maria Chiara Masone, Maria J. Ribal, Yao Zhu
The use of English language as the official language in science had an undoubtable role in moving science forward but posed an extra challenge for people whose first language is not English. In this Viewpoint, six non-Native English speakers share their experience as academics, clinicians, researchers and editors who carry out the core tasks of their jobs in a second language, and suggest potential solutions to help overcome issues associated with a linguistic barrier. Their stories show the substantial challenges that non-native English speakers have to face every day regardless of their career status, but also highlight the opportunities that this form of diversity can offer.
{"title":"Being a non-native English speaker in science and medicine","authors":"Sigrid V. Carlsson, Sandro C. Esteves, Elisabeth Grobet-Jeandin, Maria Chiara Masone, Maria J. Ribal, Yao Zhu","doi":"10.1038/s41585-023-00839-7","DOIUrl":"10.1038/s41585-023-00839-7","url":null,"abstract":"The use of English language as the official language in science had an undoubtable role in moving science forward but posed an extra challenge for people whose first language is not English. In this Viewpoint, six non-Native English speakers share their experience as academics, clinicians, researchers and editors who carry out the core tasks of their jobs in a second language, and suggest potential solutions to help overcome issues associated with a linguistic barrier. Their stories show the substantial challenges that non-native English speakers have to face every day regardless of their career status, but also highlight the opportunities that this form of diversity can offer.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":null,"pages":null},"PeriodicalIF":15.3,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41585-023-00839-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139468694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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