Not a urologist but I study urology: prostate cancer screening, biopsy, treatment & harm reduction. Also dabble in regulatory affairs. Opinions are my own.
Vancouver Adj @USC VP @PROCEPT
Joined August 2021
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John Rewcastle, PhD retweeted
Fantastic overview of cribriform and IDC prostate cancer by our very own @ruimmbernardino
Congrats 🎉 @CleClinicUro @ricautor @drjkaouk @JaneNguyen44
Our multicentre review in Nature Reviews Urology addresses an important topic: IDC and cribriform #ProstateCancer - aggressive patterns often missed on biopsy, with major implications for risk stratification and treatment.
rdcu.be/27xcFzpbzLPa
John Rewcastle, PhD retweeted
mm pattern 4 on biopsy far superior predictor of prostate cancer outcome than stage, grade, PSA, cores. We show using mm criteria rather than "favorable intermediate risk" would increase the number of US men eligible for active surveillance by >50,000. bjui-journals.onlinelibrary.…
John Rewcastle, PhD retweeted
My point is the story is not yet over and declaring radiation the ‘New Gold Standard’ based on ProtecT 15-year results is a bit rich. Also need to take into account ProtecT non-compliance with allocation rates of 28% (RP), 24% (RT) and 16% (AM).
John Rewcastle, PhD retweeted
I caution early celebration – perhaps wait for the 20 year ProtecT publication. The 15-year report had a sneak peek at PCa specific death between 15 and 20 years. For radiation was 7 times higher than prostatectomy and 3.5 times higher than active monitoring.
John Rewcastle, PhD retweeted
I was a PGY3 coming back from @UroOnc meeting, @wandering_gu told me to get Twitter to stay current about urology
Boy, I do not like the state of CaP discourse on this app right now. work (and life) is hard enough, can’t we all just be professional and reasonable?
The Phoenix (nadir+2) BDFS definition is no longer relevant and should not be used clinically or in the literature. In Roach et al, the Kestin validation data was 78% GG1 and salvage ADT ≠ clinical failure. The high NPV is a result of a low event rate and relevant events ignored.
John Rewcastle, PhD retweeted
I have 2 foundational issues with this paper and its ability to show a difference: Phoenix has a sensitivity of ~65% (see Roach et al table) meaning it has a high false negative rate. Failures are missed! Four years is early to be looking at Mets free. There is little interpretable here.
John Rewcastle, PhD retweeted
Is the theory that IDC and Cribriform are MRI visible? That would complete the loop here (and skip over Bx sampling error)
John Rewcastle, PhD retweeted
Excellent study! High specificity and sensitivity on final path - UH on biopsy is currently high specificity low sensitivity: relevant for GG2 on the threshold of AS candidacy. So important with the backdrop that PROTECT long term hadn’t stratify by current risk groups.
If you’re going to establish a new #prostatecancer treatment do it right from the get go. Not just one RCT but two. finance.yahoo.com/sectors/he…
John Rewcastle, PhD retweeted
American Express: "This call will be monitored and recorded for quality assurance and training purposes."
Me: "Ok, in that case I will also record the call."
American Express: "Ok in that case if you are recording the call, we cannot proceed."
🙄
John Rewcastle, PhD retweeted
🚨 LIVE from AUA – @marcojruro is presenting metanalysis of BPH treatment.Congrats to this outstanding urology candidate-soon to be Research Fellow in Cincinnati and future Urology Resident! Proud to support the next generation of innovators. #AUA2026 #Urology #BPH #Endourology – at Washington, DC
My 24th AUA: #AUA26 is in the books. Great clinical science, discussions and progress. Can’t wait until next year!
My favourite slide from #AUA2026 presented by Indy Gill. We need a better solution for localized #prostatecancer
John Rewcastle, PhD retweeted
In as much as all cats are not dangerous (kittens vs. tigers) not all cancer is lethal (GG1 prostate cancer vs. Stage 4 lung cancer)
Any KM curve showing biopsy results from AS or focal therapy should include, on the same graph a freedom from biopsy KM curve! It’s hard to interpret without knowing the denominator. #eau26 #prostatecancer
Aquablation demonstrated noninferior short-term LUTS relief and similar safety compared to LEP, with superior ejaculation preservation and avoidance of SUI in short-term follow-up. #BPH #Aquablation #menshealth pubmed.ncbi.nlm.nih.gov/4163…
John Rewcastle, PhD retweeted
Dr. Inderbir Gill, @USC_Urology discusses how the WATER IV Prostate Cancer trial came about - which compares #Aquablation to Radical Prostatectomy. @PROCEPTRobotics prostatehealthpodcast.com/11…
John Rewcastle, PhD retweeted
I disagree that ProtecT is a low-risk study. A third of the patients were intermediate risk at diagnosis, but it was before MRI. If you diagnosed the ProtecT population today with MRI guided biopsy half would be intermediate-risk.
John Rewcastle, PhD retweeted
Just out in @TheLancet: an overview on current approaches to diagnosis and management of prostate cancer.
sciencedirect.com/science/ar…
