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John Rewcastle, PhD Profile
John Rewcastle, PhD

@rewcastle_john

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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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@jimhumd
Jim Hu
4 months
👀 Important work on under appreciation of GG1 cancer in the MRI era by @ShuWangMD @EvanSuzman @nyphospital @UTSWMedCenter @WeillCornell: Trends of upgrading and upstaging of grade group 1 prostate ... : Current Urology https://t.co/Ke9wmHnlGM
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@rewcastle_john
John Rewcastle, PhD
4 months
@Prince_Fynnz WTF is this? Image is so incorrect it would be laughable if not intended to educate men on cancer. Facts are wrong throughout: Prostate is not surrounded by the urethra, iCT is not used for prostate cancer screening. It’s not the number one cancer killer in men…
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@rewcastle_john
John Rewcastle, PhD
6 months
Talking about Biden’s #prostatecancer in terms of Gleason scores rather than @IntSocUropath grade groups is a step backwards and an unfortunate missed opportunity for patient education.
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@rewcastle_john
John Rewcastle, PhD
7 months
@apkenigsberg @FocalSociety @FocalOneHIFU @ProfoundMedical I have immense respect for this effort and congratulate Eduard. Unfortunately, interpretation is precluded by (1) randomization broken by crossover (25% in RP arm) and (2) asymmetric primary endpoints. Simply can’t have different primary endpoints for the two arms.
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@rewcastle_john
John Rewcastle, PhD
7 months
@JAMAOnc IMHO this would be more meaningful / relevant if the analysis was based on GG at biopsy not final path. Even better would be to include upgrade rate (Bx to final) evolution over the years.
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@rewcastle_john
John Rewcastle, PhD
7 months
Inderbir Gill of @USCUrology presented the game changing design of WATER IV PCa at #AUA25: a randomized comparison of whole gland Aquablation and prostatectomy. The outcome could fundamentally change the management of #prostatecancer for many men
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@rewcastle_john
John Rewcastle, PhD
7 months
Encouraging results presented for Aquablation in men with prostate cancer #AUA25. Five-year outcomes are from men on active surveillance who had BPH Aquablation for LUTS. Short term data from 2 prospective cancer Aquablation trials. Complete story here: https://t.co/7WEeYRt4xn
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@rewcastle_john
John Rewcastle, PhD
8 months
Concerning learning from #IPFTSmasterclass: ~65k US men have Phoenix failure after PCa RT annually making radio recurrent prostate cancer the 4th most commonly diagnosed US cancer in men! Now, contextualize this with the fact that Phoenix is a surrogate for metastatic disease.
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@rewcastle_john
John Rewcastle, PhD
8 months
Totally agree with @KaraWattsMD that the DRE is dead but good luck convincing the GPs of this….
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@rewcastle_john
John Rewcastle, PhD
8 months
Professor Jonas Hugosson : ‘Screening is a form of surveillance’. Never thought about it like this before but agree it is one end of the spectrum with active surveillance on the other side. #ipftsmasterclass25
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@rewcastle_john
John Rewcastle, PhD
8 months
@gusviani @OncoAlert It frustrates me that RT studies don’t include biopsy in a transperineal biopsy era with the compelling correlation of any Bx+ after Radiation with Phoenix failure (3X), metastasis (3X) and PCa specific death (5X)
Tweet card summary image
pubmed.ncbi.nlm.nih.gov
A positive biopsy after EBRT is associated with a poor prognosis compared to a negative biopsy. The post-EBRT positive biopsy rate is an important measure which provides additional insight when...
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@rewcastle_john
John Rewcastle, PhD
8 months
Adios Madrid and #EAU25. BTW you know you’re in Spain when the directions to the train station involve ‘turn left at the ham museum’
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@rewcastle_john
John Rewcastle, PhD
8 months
Prospective multinational multistudy data from 528 patients showing safety, efficacy, durability and reproducibility of #Aquablation for #LUTS due to #BPH for small, medium and large prostates #EAU25 @DrDeanElterman @Dr_KevinZorn
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@rewcastle_john
John Rewcastle, PhD
8 months
@nikolaosliakos A level of reasonableness needs to be applied - hard to define though. I agree that a safety pad for M1 should be considered part of recovery. Beyond that I can’t get behind - much of the Retizus sparing literature considers a man using a safety pad at M12 continent 🙄
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@rewcastle_john
John Rewcastle, PhD
8 months
@MrJosephNorris Failed may not be the right word in as much as ‘clinically significant’ is no longer the right word (‘actionable disease’ is better). We don’t say AS failed at progression but certainly the man is on the path to more Tx harm. Any ideas on a more appropriate term?
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@rewcastle_john
John Rewcastle, PhD
8 months
@IP_London @Reddy4Urology @LondonProstate1 @FocalSociety Traditional risk classification strategies don’t seem to work for surveillance, radiation or surgery either… they all need to be revisited and updated. At the very least they need to include mpMRI guided biopsy.
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@Urodoc46
Tom O'Hare
8 months
@rewcastle_john Exactly what I think. Calling "continence" 0-1 pads is absolute bullshit. Continence means no leaks ever, no pads
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@rewcastle_john
John Rewcastle, PhD
8 months
#EAU25 in my opinion focal therapy results should be presented with biopsy results on a per patient level not in-field. Patients are treated not just parts of prostates. Continence should be simple pad use, not 0-1 pads. If a man is buying pads a year after Tx are they continent?
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@rewcastle_john
John Rewcastle, PhD
8 months
Trifecta definition comparison but without a clear/consistent or reasonable definition of failure at 1 year and no PRO assessment of erectile function but how many potent per Tx with a median age of 74 years… 🫤
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