Low Risk PCa Treatment Options

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Comment by Steve Z on May 5, 2009 at 1:43pm

Hi - Guy,

I hope that they do overlap - it didn't make sense to me to treat low-risk cancer (see Information at top of page) with a relatively high risk treatment, but there are certainly others who see it differently. Sorry that the discussions have been so brief - it appears that I'm in the minority.

How to deal with prostate cancer is a very personal decision - good luck with yours.

Comment by Guy75 on May 5, 2009 at 12:47pm

Hi folks

just wanted to add a comment on the group, which seems like a great idea/addition. However (my kids always expect a "BUT" and this is no different :-) some of the discussion seems to have got very heavy very quickly and not what I was expecting for a discussion of treatment options for low risk PCa (rather than low risk treatment options for PCa - although maybe the two overlap at some point)

Comment by Colby on April 26, 2009 at 10:45pm

FYI: Recent studies show that screenings for prostate cancer may not reduce death rates and may also lead to unnecessary treatment. A medical researcher discusses the latest findings:

http://www.pbs.org/newshour/bb/health/jan-june09/prostate_03-19.html

Comment by Steve Z on April 26, 2009 at 7:15pm

"AUA 2009 - Focal Therapy: Fact or Fiction?
Saturday, 25 April 2009

CHICAGO, IL, USA (UroToday.com) - This talk was presented by Mark Emberton, MD, London Urology Associates.

He explained his belief that improvements in disease characterization and mapping will aid focal therapies. MRI with diffusion weighting was one example he showed. Prostate mapping biopsies are more important to figure out, with confidence, where there is not cancer, so those areas are avoided in treatment.

He defined focal therapy as hemi-ablation or less. He reviewed studies underway for hemi-ablation, which are in phase I. Toxicity was good, with 95% of men having return of erectile function and continence. Biopsies in the treated areas showed no cancer present in 89% at 6 months.

Presented by Mark Emberton, MD at the Annual Meeting of the American Urological Association (AUA) - April 25 - 30, 2009 - McCormick Place Convention Center - Chicago, Illinois, USA."

IMHO, the 89% are likely to be men who would have had unnecessary RPs. About half of them would have had significant side effects from the procedure, which would not have "cured" many of them either.

Comment by Steve Z on March 18, 2009 at 9:29am

Mike recently posted on the main board: "there may be at least three other good options following a positive biopsy if the patient clearly has early stage, low risk disease:

* Treat only the part of the prostate that clearly has cancer (with cryotherapy or with high-intensity focused ultrasound) — if that is possible with a high degree probability
* Use dutasteride or finasteride (a 5α-reductase inhibitor) as systemic therapy to prevent or at least significantly delay progression
* Use active surveillance (or even watchful waiting if you are old enough) and monitor the cancer before you decide what to do, because you may not ever have to do anything more."

See - http://prostatecancerinfolink.net/2009/03/17/and-even-more-on-the-pros-and-cons-of-screening/#comment-3395 - to read more.

Also, UroToday recently posted a brief reviewing current focal PCa therapies that grudgingly supports focal cryo. See - http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2220721 You will need to register to get in, but that is not difficult.

Interestingly, the brief says NOTHING of 3-D mapping transperineal biopsy being used by: focal cryo pioneer Dr. Onik, Dr. Barqawi at the University of Colorado Cancer Center, and clinical trials ongoing at Kettering-Sloan - a clear improvement of the the saturation biopsy techniques described.

Comment by E. Michael D. ("Mike") Scott on February 15, 2009 at 5:47pm

I haven't seen any information posted by anyone who has considered PDT (photodynamic therapy) to date. Does anyone have personal experience of discussing this with their physicians? I am expecting to hear more about this at the upcoming GU Cancers conference in Orlando at the end of the month.

Comment by Ron on February 12, 2009 at 8:36pm

Ditto Peter, HIFU is the best, if you qualify.

One guy here had trouble, sounds like the cooling system in his albatherm treatment wasn't working. egads.

Comment by Peter Wenz on January 28, 2009 at 11:04pm

Since someone mentioned HiFu.... I went to Munich, Germany in 2007 to have it done and it was successful. I have had undetectable PSA ever since, and have NO side effects. 10 year data may not be "in" here in the USA but it IS in the rest of the world where it has been mainstream for over 12 years now. Their results are better than ANY currently available treatment in the USA.

Comment by Steve Z on January 18, 2009 at 7:59am

Mike,

...and more good information, like the link to Cyberknife clinical trials: http://www.clinicaltrials.gov/ct2/results?term=CyberKnife+prostate+cancer and RapidArc clinical trials: http://www.clinicaltrials.gov/ct2/show/NCT00798837.

Comment by E. Michael D. ("Mike") Scott on January 15, 2009 at 3:59pm

Yeah. I know. That's scheduled for tomorrow's news items on the main site.

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