For some men with localized prostate cancer, active surveillance has emerged in recent years as a viable management option. Defined as rigorous monitoring with the option of initiating potentially curative therapy should disease progress, this approach generally has been considered for patients with early, indolent disease (T1c or T2a tumors, a Gleason score of no more than 6, and a PSA level not greater than 10 ng/mL).

The most moving part of the ceremony at which A. Barry Belman, MD, received the 2006 Urology Medal at the American Academy of Pediatrics meeting last October was the series of photos that ac-companied it.

Nephrologist Jean Holley, MD, will never forget Deena and Mary (not their real names), two patients with end-stage renal disease (ESRD) she cared for 20 years ago who asked her to let them die. Deena, a widow in her 70s, had been on hemodialysis for eight years. Mary, who was in her late 40s and severely diabetic, needed to begin dialysis immediately to survive. Deena wanted to stop dialysis; Mary did not want to start. In both cases, refusal would almost certainly lead to death in less than a month.