Prostate Cancer

Science and Clinical Practice

2nd Edition - September 29, 2015
Editors: Jack H. Mydlo, Ciril J. Godec
Language: English
Hardback ISBN:
9 7 8 - 0 - 1 2 - 8 0 0 0 7 7 - 9
eBook ISBN:
9 7 8 - 0 - 1 2 - 8 0 0 5 9 2 - 7

Prostate Cancer, Science and Clinical Practice, Second Edition, continues to be an important translational reference that bridges the gap between science and clinical medicine.… Read more

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Prostate Cancer, Science and Clinical Practice, Second Edition,
continues to be an important translational reference that bridges the gap between science and clinical medicine. It reviews the biological processes that can be implicated in the disease, reviews current treatments, highlights the pitfalls where relevant, and examines the scientific developments that might result in future treatments.

Key chapters from the previous edition have been updated, and a plethora of new chapters describe new concepts of prostate cancer biology and newly developed therapeutics. Each chapter has been written by internationally recognized specialists on prostate cancer epidemiology, genetic susceptibility, cancer metastases, prostate physiology, proteomics, new therapeutics, and clinical trials.

List of Contributors
Preface
Part I: Etiology, Pathology, and Tumor Biology
- Chapter 1: Population Screening for Prostate Cancer and Early Detection
  - Abstract
  - Introduction
  - Specific criticisms of the USPSTF report
  - Screening special at-risk populations
  - Impact of age on prostate screening decisions
  - Screening/risk assessment in young men
  - Screening PSA in older men
  - Conclusions
- Chapter 2: Inflammation and Infection in the Etiology of Prostate Cancer
  - Abstract
  - Introduction
  - Histologic prostatic inflammation and prostate cancer
  - Proliferative inflammatory atrophy
  - Mechanisms of inflammatory carcinogenesis
  - Clinical prostatitis and prostate cancer
  - Infection
  - Prostatic calculi and other physical or chemical irritants
  - Changes in genes associated with infection/inflammation that increase the risk of PCA
  - Diet and prostate cancer risk
  - Biomarkers for inflammation and prostate cancer
  - Chemoprevention with ASA or NSAIDs
  - Conclusions
- Chapter 3: Androgen Receptor
  - Abstract
  - Introduction
  - Androgen receptor structure and function
  - Androgen receptor and the prostate
  - Androgen receptor activity in castration-resistant prostate cancer
  - Conclusions
- Chapter 4: Novel Research on Fusion Genes and Next-Generation Sequencing
  - Abstract
  - Recurrent translocations in prostate cancer
  - Spectrum of point mutation and copy number alterations in prostate cancer
  - Conclusions
- Chapter 5: Should Gleason Score 6 Still Be Called Cancer?
  - Abstract
  - Introduction
  - Molecular characteristic of Gleason pattern 3 versus 4
  - Natural history of treated Gleason 6 cancer
  - Natural history of untreated Gleason 6 cancer
  - Undergrading
  - Nomenclature
  - Conclusions
- Chapter 6: High Grade Prostatic Intraepithelial Neoplasia and Atypical Glands
  - Abstract
  - Introduction
  - High-grade prostatic intraepithelial neoplasia
  - Atypical small acinar proliferation
  - Conclusions
- Chapter 7: Prostate Cancer in the Elderly
  - Abstract
  - Introduction
  - The magnitude of prostate cancer in elderly men
  - Pathologic characteristics
  - PSA screening and diagnosis with prostate biopsy
  - Treatment
  - Patient preferences and treatment practice patterns in the elderly with prostate cancer
  - Fitness for prostate cancer treatment in the elderly
  - Treatment of prostate cancer in elderly patients
  - Conclusions
- Chapter 8: Prostate Cancer and Other Primary Malignancies
  - Abstract
  - Background
  - Prostate cancer and bladder cancer
  - Prostate cancer and kidney cancer
  - Prostate cancer and colorectal cancer
  - Treatment of multiple malignancies
- Chapter 9: Biopsy Prophylaxis, Technique, Complications, and Repeat Biopsies
  - Abstract
  - Biopsy prophylaxis
  - Biopsy technique and specimen processing
  - Complications
  - Repeat biopsies
  - Conclusions
- Chapter 10: Total and Free PSA, PCA3, PSA Density and Velocity
  - Abstract
  - Introduction
  - PSA
  - PSA Density
  - PSA Velocity
  - PCA3
- Chapter 11: Imaging in Localized Prostate Cancer
  - Abstract
  - Introduction
  - Ultrasound
  - Magnetic resonance imaging
  - MR spectroscopic imaging
  - PET/CT
  - Conclusions
Part II: Genetic Susceptibility and Hereditary Predisposition, Screening, and Counseling
- Chapter 12: Prostate Cancer Prevention: Strategies and Realities
  - Abstract
  - Introduction
  - Chemoprevention
  - Lifestyle factors in prostate cancer prevention
  - The future of prostate cancer prevention
  - Acknowledgment
- Chapter 13: Prostate-Specific Antigen Screening Guidelines
  - Abstract
  - What is PSA?
  - What is the natural history of prostate cancer?
  - Are prostate cancer treatments effective?
  - Is prostate-specific antigen an effective screening test?
  - Are there risks associated with PSA screening?
  - What advice should physicians give their patients?
  - Future directions and research needs
Part III: Epidemiology
- Chapter 14: Cancer of the Prostate: Incidence in the USA
  - Abstract
  - Introduction
  - Modern trends in prostate cancer diagnosis in the United States
  - Risk factors for the development of prostate cancer
  - Future of prostate cancer incidence in the United States
- Chapter 15: International Trends in Prostate Cancer
  - Abstract
  - Incidence rates of prostate cancer
  - PSA screening
  - Genetic links
  - Mortality
  - Conclusions
- Chapter 16: Race, Ethnicity, Marital Status, Literacy, and Prostate Cancer Outcomes in the United States
  - Abstract
  - Epidemiology
  - Prostate cancer disparity in African-American men
  - Marital status and prostate cancer outcomes
  - The impact of literacy and numeracy
  - Strategies to reduce disparity in high-risk populations
- Chapter 17: Hereditary Prostate Cancer
  - Abstract
  - Introduction
  - Epidemiologic studies of family history and prostate cancer risk
  - Segregation and linkage studies
  - Genome-wide association studies in prostate cancer
  - Next-generation sequencing in prostate cancer
  - Direct to consumer genetic testing
  - Conclusions
- Chapter 18: Neuroendocrine Prostate Cancer
  - Abstract
  - Introduction
  - Neuroendocrine cells in the healthy prostate
  - Neuroendocrine differentiation in prostate cancer
  - Clinical challenges and opportunities
  - Conclusions
- Chapter 19: Breast and Prostate Cancers: A Comparison of Two Endocrinologic Malignancies
  - Abstract
  - Introduction
  - History
  - Epidemiology
  - Risk factors
  - Screening
  - Prevention
  - Endocrinology
  - Molecular cross talk
  - Management
  - Advanced disease
  - Dormancy
  - Discussion
Part IV: Prevention of Prostate Cancer
- Chapter 20: Heart Healthy = Prostate Healthy and S.A.M. are the Ideal “Natural” Recommendations for Prostate Cancer
  - Abstract
  - Key points
  - Introduction
  - Primary prevention trials utilizing a pharmacologic agent – the untold story
  - Notable dietary supplement cancer prevention trials – the untold story
  - Multivitamins and other dietary supplements – less is more
  - Lifestyle matters (heart healthy = prostate healthy)
  - The importance of S.A.M. (statins, aspirin, and/or metformin) and prostate cancer
  - Conclusions – solving the diet and supplement debate
- Chapter 21: Effects of Smoking, Alcohol, and Exercise on Prostate Cancer
  - Abstract
  - Introduction
  - Cigarette smoking
  - Alcohol
  - Physical activity
  - Conclusions
- Chapter 22: Environmental and Occupational Exposures and Prostate Cancer
  - Abstract
  - Introduction
  - Agent Orange
  - Pesticides and farming
  - Endocrine disruptors
  - Vitamin D and sunlight
  - Metals
  - Rubber manufacturing
  - Whole body vibration
  - Other exposures
  - Conclusions
- Chapter 23: Level-1 Data From the REDUCE Study and the PCPT Data
  - Abstract
  - Introduction
  - Incidence
  - Factors for increased risk of prostate cancer
  - 5-alpha-reductase inhibitors
  - The Prostate Cancer Prevention Trial (PCPT)
  - Reduction by Dutasteride of Prostate Cancer Events (REDUCE)
  - The controversy
  - Conclusions
Part V: Conservative Management
- Chapter 24: Decision Support for Low-Risk Prostate Cancer
  - Abstract
  - Introduction
  - Defining indolent prostate cancer
  - Individualized predictions
  - Which prediction model to use?
  - Clinical applicability
  - Future perspectives
  - Conclusions
- Chapter 25: Active Surveillance: Rationale, Patient Selection, Follow-up, and Outcomes
  - Abstract
  - Introduction
  - Background
  - The rationale for surveillance: the natural history and molecular biology of low-grade prostate cancer
  - Genetic features of low-grade prostate cancer
  - Metastatic potential
  - Who is a candidate?
  - Surveillance follow-up protocols
  - Conclusions
Part VI: Surgery
- Chapter 26: Preoperative Risk Assessment
  - Abstract
  - Introduction
  - Life expectancy
  - Predictors of final pathology
  - Partin Tables
  - Preoperative predictors of biochemical recurrence
  - D’Amico criteria
  - CAPRA score
  - Stephenson nomogram
  - Preoperative predictors of mortality
  - The use of pretreatment imaging to predict outcomes
  - Conclusions
- Chapter 27: Is Surgery Still Necessary for Prostate Cancer?
  - Abstract
  - Stage migration: increased incidence of localized prostate cancer
  - Comparative effectiveness research (CER) among different approaches
  - Challenges to CER among treatments for localized PCa
  - Risk stratification of localized PCa
  - Comparing oncological outcomes: RCTs and observational studies
  - Comparing HRQOL
  - Comparing costs: who pays?
  - High-risk disease and surgery as part of a multimodal approach
  - Salvage RP
  - Conclusions
- Chapter 28: Indications for Pelvic Lymphadenectomy
  - Abstract
  - Introduction
  - Risk stratification for performing pelvic lymphadenectomy
  - Anatomic extent of pelvic lymphadenectomy
  - Does pelvic lymph node dissection confer a therapeutic benefit (i.e., a survival advantage)
  - Can preoperative imaging aid the decision process to perform LND?
  - Conclusions
- Chapter 29: The Surgical Anatomy of the Prostate
  - Abstract
  - The prostate
  - Seminal vesicles
  - Fasciae
  - Pelvic musculature
  - Neuroanatomy
  - Vascular anatomy
- Chapter 30: Radical Retropubic Prostatectomy
  - Abstract
  - Introduction
  - Indications and contraindications
  - Operative technique
  - Radical prostatectomy additional considerations
  - Postoperative complications
  - Outcomes
  - Conclusions
- Chapter 31: Radiation-Resistant Prostate Cancer and Salvage Prostatectomy
  - Abstract
  - Radiotherapy for prostate cancer
  - Detection of a recurrence after radiotherapy
  - Postradiotherapy prostate biopsy when recurrence is strongly suspected
  - Imaging studies to detect a recurrence after radiotherapy
  - Salvage radical prostatectomy
  - Complications and quality of life
  - Conclusions
- Chapter 32: Postradical Prostatectomy Incontinence
  - Abstract
  - Introduction
  - Epidemiology and pathophysiology of urinary incontinence after radical prostatectomy
  - Evaluation of men with postprostatectomy incontinence
  - Conservative therapy
  - Surgical planning
  - Urethral bulking agents
  - Periurethral constrictors
  - Continence balloon device
  - Perineal slings
  - Artificial urinary sphincter
  - Stem cell therapy
  - Conclusions
- Chapter 33: Prognostic Significance of Positive Surgical Margins and Other Implications of Pathology Report
  - Abstract
  - Introduction
  - Positive surgical margins
  - Tertiary Gleason pattern
  - Lymphovascular invasion
  - Seminal vesicle invasion
  - Lymph node positive disease
  - Conclusions
  - Acknowledgment
- Chapter 34: Open Versus Robotic Prostatectomy
  - Abstract
  - Introduction
  - Surgical technique
  - Factors influencing outcomes
  - Functional outcomes
  - Cost consideration
  - Conclusions
- Chapter 35: The Technique of Robotic Nerve-Sparing Prostatectomy
  - Abstract
  - Introduction
  - Historical perspective
  - Evolution of nerve-sparing with robotic surgery
  - Vattikuti Institute prostatectomy
  - Conclusions
- Chapter 36: Anterior Approach to Robotic Radical Prostatectomy
  - Abstract
  - Introduction
  - Patient selection
  - Patient setup
  - Access
  - Surgical steps
  - Postop
  - Conclusions
- Chapter 37: Posterior Approach to Robotic-Assisted Laparoscopic Radical Prostatectomy
  - Abstract
  - Introduction
  - Relevant anatomy
  - Posterior approach procedure
  - Discussion
  - Conclusions
- Chapter 38: The Technique of Robotic Nerve Sparing Prostatectomy: Extraperitoneal Approach
  - Abstract
  - Introduction
  - The technique
  - Special considerations
- Chapter 39: Clinical and Pathologic Staging of Prostate Cancer
  - Abstract
  - Introduction
  - Clinical staging of prostate cancer
  - Pathologic staging of prostate cancer
- Chapter 40: Management of Bladder Neck Contracture in the Prostate Cancer Survivor
  - Abstract
  - Introduction
  - Epidemiology and pathophysiology
  - Management of BNC
  - Stress urinary incontinence after BNC therapy
  - Conclusions
- Chapter 41: Reimbursement for Prostate Cancer Treatment
  - Abstract
  - Introduction
  - Economics of open versus robotic radical prostatectomy
  - Economics of radiation therapy for prostate cancer
  - Conclusions
Part VII: Radiation Therapy
- Chapter 42: Fundamentals of Radiation Treatment for Prostate Carcinoma – Techniques, Radiation Biology, and Evidence Base
  - Abstract
  - Introduction
  - Fundamentals of radiotherapy
  - Overview of radiation biology
  - Treatment options in radiotherapy
  - Acknowledgments
- Chapter 43: Radiation with Hormonal Therapy
  - Abstract
  - Introduction
  - Types of androgen deprivation therapy used with radiation therapy
  - Treatment of high-risk prostate cancer with radiation therapy
  - The benefit of androgen deprivation therapy in combination with radiation therapy
  - Dose-escalated radiotherapy and androgen deprivation therapy
  - Androgen deprivation therapy and radiotherapy after prostatectomy
  - Side effects of androgen deprivation therapy
  - Conclusions
- Chapter 44: Brachytherapy for Prostate Cancer: An Overview
  - Abstract
  - Introduction
  - Brief historical background of prostate brachytherapy
  - Technical aspects and sequencing of brachytherapy for prostate cancer
  - LDR-BT: clinical outcomes
  - HDR-BT: clinical outcomes
  - Follow-up after prostate brachytherapy
  - Conclusions
- Chapter 45: Intensity Modulated Radiotherapy and Image Guidance
  - Abstract
  - Introduction
  - Conformal radiation therapy: from conventional 2D to 3D-CRT to IMRT
  - Dose escalation
  - Target delineation
  - Prostate motion
  - Image guidance
  - Conclusions
- Chapter 46: Proton Beam Therapy
  - Abstract
  - Introduction
  - Historical perspective
  - Physics rationale
  - Clinical evidence
  - Evolving applications and considerations
- Chapter 47: Radiotherapy After Radical Prostatectomy: Adjuvant Versus Salvage Approach
  - Abstract
  - Introduction
  - Adjuvant radiotherapy
  - Salvage radiotherapy
  - Future directions
  - Conclusions
- Chapter 48: Emerging Modalities in Radiation Therapy for Prostate Cancer
  - Abstract
  - Introduction
  - Identification of patients for radiation therapy
  - Target identification
  - Hypofractionation
  - Future combined modality treatment
  - Adaptive radiation therapy
  - New treatment modalities
Part VIII: Clinical Dilemmas
- Chapter 49: Management of PSA Recurrences After Radical Prostatectomy
  - Abstract
  - Introduction
  - Definition and natural history
  - Diagnostic work-up
  - Treatment options
  - Conclusions
- Chapter 50: Salvage Therapy for Locally Recurrent Prostate Cancer After External Beam Radiation Therapy
  - Abstract
  - Introduction
  - Evaluation
  - Local salvage treatment options
  - Investigational modalities
  - Systemic therapy
  - Conclusions
- Chapter 51: Management of Locally Advanced (Nonmetastatic) Prostate Cancer
  - Abstract
  - Introduction
  - Treatment options
  - Conclusions
  - Acknowledgments
Part IX: Advanced Prostate Cancer
- Chapter 52: Androgen Deprivation Therapy: Appropriate Patients, Timing to Initiate ADT, and Complications
  - Abstract
  - Introduction
  - Androgen deprivation therapy
  - Combination therapy
  - Timing
  - General complications of ADT
  - Conclusions
- Chapter 53: Bone Health in Prostate Cancer
  - Abstract
  - Introduction
  - Bone physiology and metabolism
  - ADT-associated osteoporosis and fractures
  - Detection and prevention of ADT-associated osteoporosis and fractures
  - Biology of bone metastasis in prostate cancer
  - Development of bone metastasis
  - Imaging for bone metastasis
  - Novel biomarkers for bone metastasis
  - Prevention of bony metastasis
  - Localized therapy with EBRT
  - Management of bone pain
  - Treatment and management of acute spinal cord compression and pathologic fractures
  - Prevention of skeletal-related events in prostate cancer
  - Bone-targeted agents
  - Receptor activator of nuclear factor-kappa B (RANK) signaling pathway inhibitors
  - Radiopharmaceuticals (systemic “bone-seeking” agents)
  - Disease modifying agents
  - Novel and emerging therapies
  - American Urologic Association guideline recommendations for optimal bone health in prostate cancer
  - Practical management for optimal bone health
- Chapter 54: Castration Resistant Prostate Cancer: Role of Chemotherapy
  - Abstract
  - Introduction
  - FDA-approved chemotherapy regimens for mCRPC
  - Other chemotherapy regimens for mCRPC
  - When to start chemotherapy?
  - Duration of chemotherapy
  - The future of chemotherapy in mCRPC
  - Conclusions
- Chapter 55: Antiandrogen Monotherapy in the Treatment of Prostate Cancer
  - Abstract
  - Introduction
  - The androgen receptor
  - Androgen-dependent and androgen-independent prostate growth
  - Steroidal antiandrogens
  - Nonsteroidal antiandrogens
  - Antiandrogen monotherapy
  - Commentary
  - Conclusions
- Chapter 56: Sipuleucel-T – A Model for Immunotherapy Trial Development
  - Abstract
  - Introduction
  - Elucidating the mechanism of action of sipuleucel-T
  - Enhancing immunogenicity
  - Interrogation of the neoadjuvant milieu
  - Using the sipuleucel-T experience as a paradigm for immunotherapy development
  - Incorporating sipuleucel-T in the clinical states paradigm
  - Biomarkers of immune response
  - Conclusions
- Chapter 57: Second-Line Hormonal for Castrate-Resistant Prostate Cancer
  - Abstract
  - Introduction
  - First-generation antiandrogens
  - Estrogens
  - Cyproterone
  - Megestrol acetate
  - Ketoconazole
  - Aminoglutethimide
  - Corticosteroids
  - Second-generation antiandrogens
  - Abiraterone
  - Conclusions
Part X: Cryoablation, HIFU and Focal Therapy
- Chapter 58: Salvage Cryoablation of the Prostate
  - Abstract
  - Introduction
  - Detection of radiorecurrent prostate cancer
  - History of cryosurgery
  - Patient selection for salvage cryoablation
  - Oncological efficacy of salvage cryoablation
  - Focal cryotherapy
  - Complications
  - Conclusions
- Chapter 59: High-Intensity Focused Ultrasound
  - Abstract
  - Introduction
  - How HIFU works
  - Histopathologic changes associated with HIFU
  - Guidelines for the use of HIFU
  - Oncological outcomes
  - Complications of HIFU and quality of life considerations
  - Focal HIFU
  - HIFU in specific settings
  - Management of HIFU failures
  - HIFU: future research
  - Conclusions
- Chapter 60: Focal Therapy for Prostate Cancer
  - Abstract
  - Introduction
  - Goals of focal therapy
  - Candidate selection
  - Methods for disease mapping
  - Modalities for focal treatment
  - Follow-up
  - Limitations of therapy
  - Conclusions
- Chapter 61: Quality of Life: Impact of Prostate Cancer and its Treatment
  - Abstract
  - Introduction
  - The trifecta, the pentafecta
  - Instruments for QOL research
  - Prostate cancer HRQOL studies
  - HRQOL outcomes of prostate cancer treatment
  - Spousal/partner assessment of quality of life (QOL)
  - Impact of quality of life (QOL) changes on overall outcome of treatment
  - Conclusions
- Chapter 62: Impact of Prostate Cancer Treatments on Sexual Health
  - Abstract
  - Erectile dysfunction
  - Anejaculation
  - Orgasm Changes
  - Sexual incontinence
  - Changes in sexual desire
  - Penile length loss
Part XI: Govermental Policies
- Chapter 63: Coding and Billing for Diagnosis and Treatment of Prostate Cancer
  - Abstract
  - Introduction
  - Diagnoses
  - Prostate cancer screening
  - Office consultative services (urological consultations)
  - Diagnostic procedure coding for carcinoma of the prostate
  - Coding for surgical procedures for carcinoma of the prostate
  - Coding for drug management of prostatic carcinoma
  - Other drugs used in the treatment of prostatic carcinoma
  - Coding for pathological services
  - MRI-assisted transrectal ultrasound (for fusion-guided biopsy of the prostate gland)
- Chapter 64: Health Policy for Prostate Cancer: PSA Screening as Case Study
  - Abstract
  - PSA testing: an ongoing dialogue
  - The statistics
  - Policy concerns around PSA screening
  - What considerations should drive prostate cancer policy?
  - Variations in guidelines and recommendations
  - The role of shared decision making (SDM)
  - The way forward
- Chapter 65: Legal Implications of Prostate Cancer Screening
  - Abstract
  - Introduction
  - Prostate cancer screening recommendations: a brief review
  - Clinical practice guidelines: an introduction
  - The legal implications of prostate cancer screening: clinical practice guidelines and medical malpractice law
  - Conclusions
Part XII: New Horizons for Prostate Cancer
- Chapter 66: New Markers for Prostate Cancer Detection and Prognosis
  - Abstract
  - Introduction
  - Who should be biopsied?
  - Who should be rebiopsied?
  - Who should be treated vs monitored?
  - Therapeutic response assessment
  - Conclusions
- Chapter 67: Testosterone Therapy in Hypogonadal Men with Prostate Cancer
  - Abstract
  - Background
  - Testosterone supplementation following definitive therapy for localized prostate cancer
  - Can patients on active surveillance with symptomatic hypogonadism receive testosterone therapy?
  - How is the new thinking being employed in practice?
Subject Index

Jack H. Mydlo

Jack H. Mydlo, MD, FACS, is Professor and Chair of Urology at Temple University School of Medicine. A native of Brooklyn, he went to SUNY Buffalo for undergraduate work and then received his MD degree from SUNY Downstate Medical School in 1981. Following his urology residency at Montefiore Hospital/Einstein College of Medicine in the Bronx, he completed a three-year fellowship at Memorial Sloan Kettering in 1989. He returned to SUNY Downstate Medical School as an Assistant Professor of Urology and progressed to an Associate Professor of Urology. He accepted the position of Professor and Chair of Urology at Temple University Hospital in 2000. He is also the residency program director for the Urology Department.

Dr. Mydlo has published over 100 peer-reviewed articles, several textbook chapters, and has edited two urological textbooks in renal and prostate cancer. His interests include urologic trauma, urologic oncology, and erectile dysfunction. He has lectured in numerous cities over the United States and Europe. He is a member of the American Urological Association as well as a member of the AUA Judicial and Ethics Committee, The Mid-Atlantic Section of the AUA, The Philadelphia Urologic Society, and a fellow of the American College of Surgeons.

Affiliations and expertise

Department of Urology, Temple University Hospital

Ciril J. Godec

Dr. Ciril J. Godec completed Medical School in 1963 in Ljubljana, Slovenia. In 1969, he passed the Urology Board in Ljubljana. In 1972, Dr. Godec completed his Ph.D. on Rehabilitation of the Neurogenic Bladder under the mentorship of Prof. Dimitrievich from Baylor University. In 1972, as a Fulbright Scholar, he researched bladder dysfunction under Dr. Saul Boyarsky, Professor and Chair of Urology at Washington University in St. Louis, Missouri. After delivering a lecture at the University of Minnesota, Dr. Godec was invited to stay and do research work at St. Paul-Ramsey Hospital. In 1979, he passed his Urology Board in the United States, and shortly thereafter, became the Co-Chief of Urology at Hennepin County Medical Center in Minneapolis.

In 1983, Dr. Godec relocated to New York City to become Chair of Urology and local residency coordinator at Long Island College Hospital. In 2000, Dr. Godec became Professor of Urology at Downstate Medical School in Brooklyn, New York. In 2013, he was invited to become the Urology Residency Director and Associate Chief of the Division of Urology at Maimonides Medical Center, the position he still occupies today.

During his career, Dr. Godec has been involved as co-investigator in four NIH grants. He has published 105 articles, five book chapters, 41 abstracts, and numerous presentations at national and international meetings, as well as 60 articles in non-medical newspapers. He has served as a reviewer for Urology and was on editorial boards of two medical journals. In 2003, Drs. Mydlo and Godec edited the first edition of Prostate Cancer.

Dr. Godec has lectured and performed surgery at many medical schools around the world to demonstrate his technique of open bloodless surgery for prostate cancer. At Downstate Medical School in the Department of Urology, he was selected as the Teacher of the Year twice, in 2006 and 2011. In 2015, while at Maimonides Medical Center, he was selected again as the Teacher of the Year.

In 2009, Dr. Godec received a lifetime achievement award from Cobble Hill Medical Center in Brooklyn, where he served as a Board Member until recently. He has been listed in Best Doctors in the US and in New York City, and is also a member of many medical professional societies, including AMA and AUA.

Affiliations and expertise

Department of Urology, Long Island College Hospital

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