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
👀 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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@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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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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First human bladder transplant performed at UCLA performed with USC Urology’s Dr. Inderbir Gill ✌️#bladdertransplant #uclaurology #uscurology #urosome
uclahealth.org
A UCLA surgical team has performed the first -in-human bladder transplant. The surgery was successfully completed at Ronald Reagan UCLA Medical Center on May 4, 2025. The procedure was part of a UCLA...
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@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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@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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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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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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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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Totally agree with @KaraWattsMD that the DRE is dead but good luck convincing the GPs of this….
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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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@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)
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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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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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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@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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@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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@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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@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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#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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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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