Cyberknife Procedure Update
Comments
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Margemarge said:Reading this thread is very hard, can people actually learn anything here?
bdhilton writes..."From my perspective, this site is to help guys, not slant the facts or press one treatment or agenda…" However he presses his agenda, calling viper a "troll" etc. Name calling does not a happy well informed forum make.
Let's face it, no one who has a treatment that worked out great is a "troll", they simply want to share their good news and hope it extends to others. News on cyberknife, proton and HIFU is rare, let's not run these men - who have had a good go of it - off! Or, is the agenda here to only accept men who have had a bad go of it (except surgery...)? Of course these men who had good outcomes are slanted, they are happy! viper is years out, to come here and share his info is great, a true kind heart. There will be others who show up who are not happy after cyberknife, if you quit attacking people, we may get to the bottom of the show. Sift all info through your mind, don't tell us what to think about the person.
No one comes here to sell anything, the happy ones come hoping they can help someone find their state of happiness. You, that run off posters, are the ones trying to slant the facts and press treatments, covering up and supressing the new treatments.
Out of 4,000 men who have had cyberknife, only one is here, we need him.
BTW, my doctor told me incontinence is 60% after surgery.
Ovbiously, you did not go to Viper's "info Ad" web site which grossly characterizes other forms of therapy in a rediculous light of sad statistics that are outdated and plain WRONG. Especially to a newbie that has not done his own research. Statistics he posts on his website for both Open and Robotic must be from the surgeons of podunk town USA...certainly not any statistics from the plethera of very good surgeons in the US. I can give out probably 12 surgeons from accross the country that would blow his numbers to pieces with both incontinence and ED percentages. Please research more. Interesting you say your doctor says 60% incontinence after surgery - I would say he's not to up on the reality of what is happening today....Wow then I guess the thousands who were under this doctors care were REALLY lucky
http://nyp.org/news/hospital/robotic-prostate-surgery-study.html
"...Previously, Dr. Badani was a clinical fellow in robotic and laparoscopic urologic oncology at Henry Ford Hospital in Detroit, where the 2,766 procedures followed in the investigation were conducted over a six-year period.
Dr. Badani says, "We found that in highly experienced hands, the results after robotic surgery are outstanding for cancer control, with minimal complications and few side effects of urinary incontinence and sexual dysfunction."
"In addition, blood loss is far less than with traditional surgery. This, along with minimizing trauma to the body tissues, translates into short hospital stays, and more importantly, quick recovery—allowing patients to resume their regular activities, whether that means going for a run or playing 18 holes of golf," adds Dr. Badani, who has personally performed more than 700 of the robotic procedures.
Specific study findings include the following:
•Ninety-three percent (93%) of patients achieved normal urinary function, with a median time of complete control of three weeks.
•Only slightly more than seven percent (7.2%) of patients had recurrence of prostate cancer symptoms (presence of prostate specific antigen, or PSA). Less than one percent (0.5%) of patients died during 71 months of follow-up.
•Nearly 80 percent (79.2%) of patients reported normal sexual function.
This studied 2,766 patients over 6 years....What kind of study is your doctor quoting his 60% incontinence from...hopefully it's not his surgeries...if so...better look for another surgeon. I don't mean to be mean..but give me a bloody break....the stats on Viper's site are just plain pointedly WRONG and a horrible dis-service and this is not to say Cyberkinfe is a bad procedure because I will never say that and hope it becomes the gold standard..but please do not put false and incorrect info regarding the statistics of other treatments to point a golden finger towards the one of your own personal preference = that is worse than no information at all in my honest opinon.
Randy In Indy0 -
RANDYrandy_in_indy said:Marge
Ovbiously, you did not go to Viper's "info Ad" web site which grossly characterizes other forms of therapy in a rediculous light of sad statistics that are outdated and plain WRONG. Especially to a newbie that has not done his own research. Statistics he posts on his website for both Open and Robotic must be from the surgeons of podunk town USA...certainly not any statistics from the plethera of very good surgeons in the US. I can give out probably 12 surgeons from accross the country that would blow his numbers to pieces with both incontinence and ED percentages. Please research more. Interesting you say your doctor says 60% incontinence after surgery - I would say he's not to up on the reality of what is happening today....Wow then I guess the thousands who were under this doctors care were REALLY lucky
http://nyp.org/news/hospital/robotic-prostate-surgery-study.html
"...Previously, Dr. Badani was a clinical fellow in robotic and laparoscopic urologic oncology at Henry Ford Hospital in Detroit, where the 2,766 procedures followed in the investigation were conducted over a six-year period.
Dr. Badani says, "We found that in highly experienced hands, the results after robotic surgery are outstanding for cancer control, with minimal complications and few side effects of urinary incontinence and sexual dysfunction."
"In addition, blood loss is far less than with traditional surgery. This, along with minimizing trauma to the body tissues, translates into short hospital stays, and more importantly, quick recovery—allowing patients to resume their regular activities, whether that means going for a run or playing 18 holes of golf," adds Dr. Badani, who has personally performed more than 700 of the robotic procedures.
Specific study findings include the following:
•Ninety-three percent (93%) of patients achieved normal urinary function, with a median time of complete control of three weeks.
•Only slightly more than seven percent (7.2%) of patients had recurrence of prostate cancer symptoms (presence of prostate specific antigen, or PSA). Less than one percent (0.5%) of patients died during 71 months of follow-up.
•Nearly 80 percent (79.2%) of patients reported normal sexual function.
This studied 2,766 patients over 6 years....What kind of study is your doctor quoting his 60% incontinence from...hopefully it's not his surgeries...if so...better look for another surgeon. I don't mean to be mean..but give me a bloody break....the stats on Viper's site are just plain pointedly WRONG and a horrible dis-service and this is not to say Cyberkinfe is a bad procedure because I will never say that and hope it becomes the gold standard..but please do not put false and incorrect info regarding the statistics of other treatments to point a golden finger towards the one of your own personal preference = that is worse than no information at all in my honest opinon.
Randy In Indy
I CONCUR----NO PROCEDURE IS THE BEST !! IF THAT WERE THE CASE, THERE WOULD ONLY BE ONE PROCEDURE FOR ALL. I HAD DAVINCI SURGERY AND DON'T REGRET MY DECISION. HEY, LOOK AT IT THIS WAY----IF THE PROCEDURE WORKS FOR ME I CONSIDER THAT TO BE THE BEST(FOR ME). ON THE OTHER HAND, SOMEONE COULD HAVE SUCCESSFUL RADIATION,CYBERKNIFE, ETC; AND THAT WOULD BE THE BEST TREATMENT (FOR THEM). TO SAY ONE IS BETTER THAN THE OTHERS IS UNREALISTIC. EACH CASE AND CIRCUMSTANCE ARE UNIQUE TO THE INDIVIDUAL. THATS PROBABLY WHY THERE ARE SO MANY TREATMENTS AVAILABLE !!! JUST MY OPINION====DAN0 -
DanBRONX52 said:RANDY
I CONCUR----NO PROCEDURE IS THE BEST !! IF THAT WERE THE CASE, THERE WOULD ONLY BE ONE PROCEDURE FOR ALL. I HAD DAVINCI SURGERY AND DON'T REGRET MY DECISION. HEY, LOOK AT IT THIS WAY----IF THE PROCEDURE WORKS FOR ME I CONSIDER THAT TO BE THE BEST(FOR ME). ON THE OTHER HAND, SOMEONE COULD HAVE SUCCESSFUL RADIATION,CYBERKNIFE, ETC; AND THAT WOULD BE THE BEST TREATMENT (FOR THEM). TO SAY ONE IS BETTER THAN THE OTHERS IS UNREALISTIC. EACH CASE AND CIRCUMSTANCE ARE UNIQUE TO THE INDIVIDUAL. THATS PROBABLY WHY THERE ARE SO MANY TREATMENTS AVAILABLE !!! JUST MY OPINION====DAN
You are exactly right but what is a crime is someone who posts information that is misleading or worse yet plain wrong....that is exactly what Viper has done with his "INFO AD" web site for Cyber Knife, again Cyber Kinfe may be the best treatment ever but, this site is not for ADVERTISING ones preferences in treatment especially with wrong information about other treatments that will mislead a newbie into thinking a treatment that has actually saved many lives and with very little side affects under the right circumstances is made out to be the wrong choice via listing statistics that are just not the case for the recent advances in a particular treatment. Fighting this beast is daunting enough without adding mis-information to the mix.
Honestly, if CSN looked at Viper's site and with the knowledge that he posted his "INFO AD" in his very first post on here they might just boot him from the site. When I came here I received much help from many people to get me through this fight with the beast...for that I am eternally thankful!!!...and I want to make sure people are given an equally fair chance to recieve the same help I did...not some slanted INFO AD placing a personal choice of treatment on the top above all others. I have no problem with people linking to all the studies in the world about any treatment because everyone can read and make their own mind up...but advertising is WRONG...on this site. It's just that plain and simple for me.
Randy In Indy0 -
yes, Randy keeps onrandy_in_indy said:Dan
You are exactly right but what is a crime is someone who posts information that is misleading or worse yet plain wrong....that is exactly what Viper has done with his "INFO AD" web site for Cyber Knife, again Cyber Kinfe may be the best treatment ever but, this site is not for ADVERTISING ones preferences in treatment especially with wrong information about other treatments that will mislead a newbie into thinking a treatment that has actually saved many lives and with very little side affects under the right circumstances is made out to be the wrong choice via listing statistics that are just not the case for the recent advances in a particular treatment. Fighting this beast is daunting enough without adding mis-information to the mix.
Honestly, if CSN looked at Viper's site and with the knowledge that he posted his "INFO AD" in his very first post on here they might just boot him from the site. When I came here I received much help from many people to get me through this fight with the beast...for that I am eternally thankful!!!...and I want to make sure people are given an equally fair chance to recieve the same help I did...not some slanted INFO AD placing a personal choice of treatment on the top above all others. I have no problem with people linking to all the studies in the world about any treatment because everyone can read and make their own mind up...but advertising is WRONG...on this site. It's just that plain and simple for me.
Randy In Indy
yes, Randy keeps on advertising for surgery, reading only the best reports, only stating his experience, not accepting all the others, who had surgery and it was the worst thing to happen to them, keep on putting others down who just want to share their experience and relate figures they find, the figures and statistics are all over the board, my surgeon said, no one really knows for sure because men won't admit to being in less great shape (then he said, but I think it's 60%) It's easier to just put up with the shape we end up in than complain and get more surgery (the switch).
He isn't selling, he isn't making money, he sees things differently than you, your rose colored glasses are great for you, but they don't always work out. People come here to help themselves or to help others. Plain and simple a "troll" is someone who is obsessed with helping others.0 -
Your Funnymarge said:yes, Randy keeps on
yes, Randy keeps on advertising for surgery, reading only the best reports, only stating his experience, not accepting all the others, who had surgery and it was the worst thing to happen to them, keep on putting others down who just want to share their experience and relate figures they find, the figures and statistics are all over the board, my surgeon said, no one really knows for sure because men won't admit to being in less great shape (then he said, but I think it's 60%) It's easier to just put up with the shape we end up in than complain and get more surgery (the switch).
He isn't selling, he isn't making money, he sees things differently than you, your rose colored glasses are great for you, but they don't always work out. People come here to help themselves or to help others. Plain and simple a "troll" is someone who is obsessed with helping others.
I have not once or ever will try to sell Surgery....Got it! I would bet there is not one other person on here that would agree with you....I have posted nearly 400 posts since Oct 09....you have posted 4 times...and Now you sound like HIFU gal with a new ID...LOL
I call it like I see it...and I am usually right.
Randy In Indy0 -
Calling names again?randy_in_indy said:Your Funny
I have not once or ever will try to sell Surgery....Got it! I would bet there is not one other person on here that would agree with you....I have posted nearly 400 posts since Oct 09....you have posted 4 times...and Now you sound like HIFU gal with a new ID...LOL
I call it like I see it...and I am usually right.
Randy In Indy
yes,
Calling names again?
yes, I've been watching you, and you are great at calling people names, and selling surgery, while others who are just like you who have had another experience aren't allowed to speak without you attacking them.
You sold surgery to others here, I've read them, bdhilton is one.
Don't you see ~ you are what you call others ~ a troll, selling what you know. Let the people here who come to help, actually help...viper has a story, hifu gal did too, HIFU is credible, so is cyberknife, but you dominate and rule, and bdhilton follows your lead.
You have good info and a kind heart that you want others to learn from you, but what you don't realize is that not everyone is going to follow you, nor should they follow viper, they just want info, not your opinion, and not your censoring.
Why is everyone who had a different treatment a threat to you?0 -
No Don't you see????marge said:Calling names again?
yes,
Calling names again?
yes, I've been watching you, and you are great at calling people names, and selling surgery, while others who are just like you who have had another experience aren't allowed to speak without you attacking them.
You sold surgery to others here, I've read them, bdhilton is one.
Don't you see ~ you are what you call others ~ a troll, selling what you know. Let the people here who come to help, actually help...viper has a story, hifu gal did too, HIFU is credible, so is cyberknife, but you dominate and rule, and bdhilton follows your lead.
You have good info and a kind heart that you want others to learn from you, but what you don't realize is that not everyone is going to follow you, nor should they follow viper, they just want info, not your opinion, and not your censoring.
Why is everyone who had a different treatment a threat to you?
Please post anything I have posted in my 400 posts on this site as "selling surgery" Sorry, you cannot be I have not. It is absolutely proposterous that you claim I have sold surgery to BD Hilton..I am sure he will have something to say about that himself...besides he did not even have robotic....Name calling...hmmmm HiFu Gal...is that name calling...You are simply very, very humorous for everyone reading here to see....I call it like I see it. What I wish is that I could identify IP Addresses....now that would be funny to see who has posted under what ID's - there are not many multiple ID posters on this site but Marge...I really believe in my heart...you are.
Where is your picture by the way....please post one so I can see who I am jousting with...lol
Randy In Indy0 -
Randy,randy_in_indy said:No Don't you see????
Please post anything I have posted in my 400 posts on this site as "selling surgery" Sorry, you cannot be I have not. It is absolutely proposterous that you claim I have sold surgery to BD Hilton..I am sure he will have something to say about that himself...besides he did not even have robotic....Name calling...hmmmm HiFu Gal...is that name calling...You are simply very, very humorous for everyone reading here to see....I call it like I see it. What I wish is that I could identify IP Addresses....now that would be funny to see who has posted under what ID's - there are not many multiple ID posters on this site but Marge...I really believe in my heart...you are.
Where is your picture by the way....please post one so I can see who I am jousting with...lol
Randy In Indy
As I stated a few
Randy,
As I stated a few days ago on this specific discussion, I have no interest in participant anymore. Yes it does make me smile that “YOU” converted me to surgery and I am your dupe…
Anyway, I am not here for the likes of marge, viperfred, hifugal, etc… I am here to support the guys and their mates pre and post treatment…
Best to all…0 -
Search for the truth!randy_in_indy said:Dan
You are exactly right but what is a crime is someone who posts information that is misleading or worse yet plain wrong....that is exactly what Viper has done with his "INFO AD" web site for Cyber Knife, again Cyber Kinfe may be the best treatment ever but, this site is not for ADVERTISING ones preferences in treatment especially with wrong information about other treatments that will mislead a newbie into thinking a treatment that has actually saved many lives and with very little side affects under the right circumstances is made out to be the wrong choice via listing statistics that are just not the case for the recent advances in a particular treatment. Fighting this beast is daunting enough without adding mis-information to the mix.
Honestly, if CSN looked at Viper's site and with the knowledge that he posted his "INFO AD" in his very first post on here they might just boot him from the site. When I came here I received much help from many people to get me through this fight with the beast...for that I am eternally thankful!!!...and I want to make sure people are given an equally fair chance to recieve the same help I did...not some slanted INFO AD placing a personal choice of treatment on the top above all others. I have no problem with people linking to all the studies in the world about any treatment because everyone can read and make their own mind up...but advertising is WRONG...on this site. It's just that plain and simple for me.
Randy In Indy
Tried to find the clinical study referenced as " the latest and probably the largest study results of Robotic surgery results" The link provided PR for
NewYork-Presbyterian Hospital on their web page.
The following link is to an abstract by :
Ketan K. Badani, MD Sanjeev Kaul, MD, Mani Menon, MD
The number of patients is 2766 so it seems likely this is the subject study.
http://www3.interscience.wiley.com/journal/116322982/abstract
Results in quotes:
"The mean age of the patients was 60.2 years and the mean prostate-specific antigen (PSA) level at time of diagnosis was 6.43 ng/mL; 42.4% and 64.2% of patients, respectively, had a biopsy and pathologic Gleason sum of 7. The mean surgical and console time was 154 minutes and 116 minutes, respectively. Estimated blood loss was 100 mL; 96.7% of patients were discharged within 24 hours of surgery. At a median follow-up of 22 months, 7.3% of men had a PSA recurrence. The 5-year actuarial biochemical free survival rate was 84%. "
What I find interesting is the recurrence rate at a median of 22 months is 7.3% and 5 year biochemical free survival is 84% . The NewYork-Presbyterian Hospital ad runs the sentence with 7.3% recurrence into the sentence "Less than one percent (0.5%) of patients died during 71 months of follow-up." When I read the "ad" I thought the 71 months follow-up had a recurrence of 7.3% which would not be unexpected from an experienced surgeon. However at 22 months 7.3% is less than exceptional and at 5 years 16% seems poor compared to other modalities.
I would like to have the complete paper to see the peer reviewed data for incontinence etc.
http://jama.ama-assn.org/cgi/content/short/302/14/1557?home This study in JAMA, Oct. 2009 shows a different result than the older NY Presbyterian 2007 "ad"
Here is an article in the NY Times http://www.nytimes.com/2010/02/14/health/14robot.html form Feb 2010.
Men need to take time to understand all treatments so they can make an informed choice.
Trust no one!
There are none so blind as do not wish to see.[1]
[1] Darwin, E. (1794). Zoonomia: or the Laws of organic life. Vol. II, p.244. Third edition (1801). J.Johnson, London0 -
Viper This is my last post about this and YOUviperfred said:Search for the truth!
Tried to find the clinical study referenced as " the latest and probably the largest study results of Robotic surgery results" The link provided PR for
NewYork-Presbyterian Hospital on their web page.
The following link is to an abstract by :
Ketan K. Badani, MD Sanjeev Kaul, MD, Mani Menon, MD
The number of patients is 2766 so it seems likely this is the subject study.
http://www3.interscience.wiley.com/journal/116322982/abstract
Results in quotes:
"The mean age of the patients was 60.2 years and the mean prostate-specific antigen (PSA) level at time of diagnosis was 6.43 ng/mL; 42.4% and 64.2% of patients, respectively, had a biopsy and pathologic Gleason sum of 7. The mean surgical and console time was 154 minutes and 116 minutes, respectively. Estimated blood loss was 100 mL; 96.7% of patients were discharged within 24 hours of surgery. At a median follow-up of 22 months, 7.3% of men had a PSA recurrence. The 5-year actuarial biochemical free survival rate was 84%. "
What I find interesting is the recurrence rate at a median of 22 months is 7.3% and 5 year biochemical free survival is 84% . The NewYork-Presbyterian Hospital ad runs the sentence with 7.3% recurrence into the sentence "Less than one percent (0.5%) of patients died during 71 months of follow-up." When I read the "ad" I thought the 71 months follow-up had a recurrence of 7.3% which would not be unexpected from an experienced surgeon. However at 22 months 7.3% is less than exceptional and at 5 years 16% seems poor compared to other modalities.
I would like to have the complete paper to see the peer reviewed data for incontinence etc.
http://jama.ama-assn.org/cgi/content/short/302/14/1557?home This study in JAMA, Oct. 2009 shows a different result than the older NY Presbyterian 2007 "ad"
Here is an article in the NY Times http://www.nytimes.com/2010/02/14/health/14robot.html form Feb 2010.
Men need to take time to understand all treatments so they can make an informed choice.
Trust no one!
There are none so blind as do not wish to see.[1]
[1] Darwin, E. (1794). Zoonomia: or the Laws of organic life. Vol. II, p.244. Third edition (1801). J.Johnson, London
What I find very transparent is your need to be so scientific in presenting studies yet your ad states these statistics about surgery in a very unscientific way:
• Side effects
o ED, 20 % to 80% risk typical
o Incontinence, 20 to 70% risk typical
How can you state this when a study encompassing 2,677 patients DID NOT FIND INCONTNENCE OR ED EVEN CLOSE TO YOUR LOWEST ABOVE STATED "RISK" Figure of 20% Get real - your website is slanting opinion on treatment options so far from the truth it's nothing short of ludicrous!
CASE CLOSED!
Good luck trying to peddle your deceptive ad for cyberkinfe...you are actually doing what merits Cyberknife has a dis-service in how you go about promoting it. I have been in marketing and sales for over 30 years.
Randy in Indy0 -
Difficult Choices Little Information!viperfred said:Search for the truth!
Tried to find the clinical study referenced as " the latest and probably the largest study results of Robotic surgery results" The link provided PR for
NewYork-Presbyterian Hospital on their web page.
The following link is to an abstract by :
Ketan K. Badani, MD Sanjeev Kaul, MD, Mani Menon, MD
The number of patients is 2766 so it seems likely this is the subject study.
http://www3.interscience.wiley.com/journal/116322982/abstract
Results in quotes:
"The mean age of the patients was 60.2 years and the mean prostate-specific antigen (PSA) level at time of diagnosis was 6.43 ng/mL; 42.4% and 64.2% of patients, respectively, had a biopsy and pathologic Gleason sum of 7. The mean surgical and console time was 154 minutes and 116 minutes, respectively. Estimated blood loss was 100 mL; 96.7% of patients were discharged within 24 hours of surgery. At a median follow-up of 22 months, 7.3% of men had a PSA recurrence. The 5-year actuarial biochemical free survival rate was 84%. "
What I find interesting is the recurrence rate at a median of 22 months is 7.3% and 5 year biochemical free survival is 84% . The NewYork-Presbyterian Hospital ad runs the sentence with 7.3% recurrence into the sentence "Less than one percent (0.5%) of patients died during 71 months of follow-up." When I read the "ad" I thought the 71 months follow-up had a recurrence of 7.3% which would not be unexpected from an experienced surgeon. However at 22 months 7.3% is less than exceptional and at 5 years 16% seems poor compared to other modalities.
I would like to have the complete paper to see the peer reviewed data for incontinence etc.
http://jama.ama-assn.org/cgi/content/short/302/14/1557?home This study in JAMA, Oct. 2009 shows a different result than the older NY Presbyterian 2007 "ad"
Here is an article in the NY Times http://www.nytimes.com/2010/02/14/health/14robot.html form Feb 2010.
Men need to take time to understand all treatments so they can make an informed choice.
Trust no one!
There are none so blind as do not wish to see.[1]
[1] Darwin, E. (1794). Zoonomia: or the Laws of organic life. Vol. II, p.244. Third edition (1801). J.Johnson, London
The following article from the NY Times has over a 100 comments many from patients,
Read their comments http://well.blogs.nytimes.com/2010/02/14/is-robotic-prostate-surgery-really-better/
Men need to know the difference between clinical data and marketing. To suggest "DID NOT FIND INCONTNENCE OR ED EVEN CLOSE TO YOUR LOWEST ABOVE STATED "RISK" is interesting for one who professes to want the truth. My site says "typical" which is supported by limited clinical studies. It does not take the best or worst case for any modality. This dialog is very constructive, http://www.iprostatecancer.com/ next's update will include more links to published data and articles for all modalities. Surgery, all forms of radiation are options that many men have selected and many are very happy, some do regret their choice. Over all men have a much better outcome than our fathers.
The market for prostate cancer is very large which creates an economic bias for all stakeholders which makes our difficult choice, even more difficult. Any procedure that has a learning curve puts some patients at increased risk. Many patients accept the increased risk of side effects during the learning process.
All aspects of PCa are confusing to patients:
a. Should we be evaluated for PCa? If we are not at a point in our life cycle to have any modality why bother to know you have PCa?
b. When diagnosed with PCa , the first Question: is do we have an indolent or aggressive PCa? Answer: There are no test to distinguish between them. The Majority of us with PCa will do fine without therapy. But there is no way to make that determination. A family history of aggressive PCa combined with DRE, PSA doubling time and PSA velocity may be indicators but not definitive.
c. Some of us make the choice to be treated. There are no blind comparative studies and unlikely that there ever will be as we do not want to be put in a therapy the is not our choice. Patients with compromised health issues want the treatment with least risk and most convenient. Younger patients want to maintain their quality of life and life the priority between these are swapped form patient to patient.
d. How do we know what treatment is best for us? Now the process can get more confusing. Marketing to patients for all modalities slant their specific strengths. How do patients separate marketing from clinical studies? If we want to make an informed choice we have to do research and learn how to determine what is marketing/PR and what is a clinical peer reviewed study. Or we could let our urologist make the choice. Most of use will do well with any modality.
Men will do well to understand all options.
To all who have made their choice I wish you well, and to those making the choice search for the option that is best for you.0 -
Here's another article fromviperfred said:Difficult Choices Little Information!
The following article from the NY Times has over a 100 comments many from patients,
Read their comments http://well.blogs.nytimes.com/2010/02/14/is-robotic-prostate-surgery-really-better/
Men need to know the difference between clinical data and marketing. To suggest "DID NOT FIND INCONTNENCE OR ED EVEN CLOSE TO YOUR LOWEST ABOVE STATED "RISK" is interesting for one who professes to want the truth. My site says "typical" which is supported by limited clinical studies. It does not take the best or worst case for any modality. This dialog is very constructive, http://www.iprostatecancer.com/ next's update will include more links to published data and articles for all modalities. Surgery, all forms of radiation are options that many men have selected and many are very happy, some do regret their choice. Over all men have a much better outcome than our fathers.
The market for prostate cancer is very large which creates an economic bias for all stakeholders which makes our difficult choice, even more difficult. Any procedure that has a learning curve puts some patients at increased risk. Many patients accept the increased risk of side effects during the learning process.
All aspects of PCa are confusing to patients:
a. Should we be evaluated for PCa? If we are not at a point in our life cycle to have any modality why bother to know you have PCa?
b. When diagnosed with PCa , the first Question: is do we have an indolent or aggressive PCa? Answer: There are no test to distinguish between them. The Majority of us with PCa will do fine without therapy. But there is no way to make that determination. A family history of aggressive PCa combined with DRE, PSA doubling time and PSA velocity may be indicators but not definitive.
c. Some of us make the choice to be treated. There are no blind comparative studies and unlikely that there ever will be as we do not want to be put in a therapy the is not our choice. Patients with compromised health issues want the treatment with least risk and most convenient. Younger patients want to maintain their quality of life and life the priority between these are swapped form patient to patient.
d. How do we know what treatment is best for us? Now the process can get more confusing. Marketing to patients for all modalities slant their specific strengths. How do patients separate marketing from clinical studies? If we want to make an informed choice we have to do research and learn how to determine what is marketing/PR and what is a clinical peer reviewed study. Or we could let our urologist make the choice. Most of use will do well with any modality.
Men will do well to understand all options.
To all who have made their choice I wish you well, and to those making the choice search for the option that is best for you.
Here's another article from PubMed (I edited out some mish mash)
Radical prostatectomy reduced disease recurrence at 5 years compared with external-beam radiation therapy in 1 small, older trial (14% vs. 39%)
No external-beam radiation regimen was superior to another in reducing mortality.
The Prostate Cancer Outcomes Study reported that urinary leakage ... was more common with radical prostatectomy (35%) than with radiation therapy (12%) or androgen deprivation (11%). Bowel urgency occurred more often with radiation (3%) or androgen deprivation (3%) than with radical prostatectomy (1%). Erectile dysfunction occurred frequently after all treatments (radical prostatectomy, 58%; radiation therapy, 43%; androgen deprivation, 86%).
CONCLUSION: Assessment of the comparative effectiveness and harms of localized prostate cancer treatments is difficult because of limitations in the evidence.
PMID: 18252677 [PubMed - indexed for MEDLINE]
Summation of post RP:
recurrance is 14%
incontinence is 35%
ED is 58%
These figures fit into my own life experience of RP/RRP
Randy is a salesman, he states he has 30 years of experience. We all appreciate Randy's story, but it doesn't mean everyone will have his outcome, it's high time he stop attacking new people here with stories he doesn't know about. I appreciate viper's story, let's not kill the messenger, we need everyone, isn't that what a forum is all about, where else can we learn about the newest treatments??
Good luck to kongo!!!0 -
marge and viper,It appearsmarge said:Here's another article from
Here's another article from PubMed (I edited out some mish mash)
Radical prostatectomy reduced disease recurrence at 5 years compared with external-beam radiation therapy in 1 small, older trial (14% vs. 39%)
No external-beam radiation regimen was superior to another in reducing mortality.
The Prostate Cancer Outcomes Study reported that urinary leakage ... was more common with radical prostatectomy (35%) than with radiation therapy (12%) or androgen deprivation (11%). Bowel urgency occurred more often with radiation (3%) or androgen deprivation (3%) than with radical prostatectomy (1%). Erectile dysfunction occurred frequently after all treatments (radical prostatectomy, 58%; radiation therapy, 43%; androgen deprivation, 86%).
CONCLUSION: Assessment of the comparative effectiveness and harms of localized prostate cancer treatments is difficult because of limitations in the evidence.
PMID: 18252677 [PubMed - indexed for MEDLINE]
Summation of post RP:
recurrance is 14%
incontinence is 35%
ED is 58%
These figures fit into my own life experience of RP/RRP
Randy is a salesman, he states he has 30 years of experience. We all appreciate Randy's story, but it doesn't mean everyone will have his outcome, it's high time he stop attacking new people here with stories he doesn't know about. I appreciate viper's story, let's not kill the messenger, we need everyone, isn't that what a forum is all about, where else can we learn about the newest treatments??
Good luck to kongo!!!
marge and viper,
It appears that you like to “attack” with outdated and slanted stats on surgery in general and dwell on the negative of surgery. It would be appreciated and interesting if you would provide the group the studies and stats (from accredited establishments and recognized creditable physicians) for secondary cancers and delayed issues post treatment such as ED, BM and incontinent caused by the various accepted radiotherapy treatments as well as some of the newer radiotherapy being used (e.g. cyperknife)….
Most of us post surgery guys understand the ‘negative” factors that could statically occur post surgery along with salvage/adjunct radiotherapy and hormones….You state you want to talk about the reality of the treatments so lets hear it presented in a factually manner…Many thanks0 -
Hey Margemarge said:Here's another article from
Here's another article from PubMed (I edited out some mish mash)
Radical prostatectomy reduced disease recurrence at 5 years compared with external-beam radiation therapy in 1 small, older trial (14% vs. 39%)
No external-beam radiation regimen was superior to another in reducing mortality.
The Prostate Cancer Outcomes Study reported that urinary leakage ... was more common with radical prostatectomy (35%) than with radiation therapy (12%) or androgen deprivation (11%). Bowel urgency occurred more often with radiation (3%) or androgen deprivation (3%) than with radical prostatectomy (1%). Erectile dysfunction occurred frequently after all treatments (radical prostatectomy, 58%; radiation therapy, 43%; androgen deprivation, 86%).
CONCLUSION: Assessment of the comparative effectiveness and harms of localized prostate cancer treatments is difficult because of limitations in the evidence.
PMID: 18252677 [PubMed - indexed for MEDLINE]
Summation of post RP:
recurrance is 14%
incontinence is 35%
ED is 58%
These figures fit into my own life experience of RP/RRP
Randy is a salesman, he states he has 30 years of experience. We all appreciate Randy's story, but it doesn't mean everyone will have his outcome, it's high time he stop attacking new people here with stories he doesn't know about. I appreciate viper's story, let's not kill the messenger, we need everyone, isn't that what a forum is all about, where else can we learn about the newest treatments??
Good luck to kongo!!!
I will ask you to be more specific about how it is I am as you say "attacking" people with "stories he doesn't know about". First, what exactly are the "stories" I am attacking people with, and secondly, these so called "stories" what is it I don't know about them???
Please by all means, help me understand what you mean by this.
Have a beautiful day!
Randy in Indy0 -
Margemarge said:Here's another article from
Here's another article from PubMed (I edited out some mish mash)
Radical prostatectomy reduced disease recurrence at 5 years compared with external-beam radiation therapy in 1 small, older trial (14% vs. 39%)
No external-beam radiation regimen was superior to another in reducing mortality.
The Prostate Cancer Outcomes Study reported that urinary leakage ... was more common with radical prostatectomy (35%) than with radiation therapy (12%) or androgen deprivation (11%). Bowel urgency occurred more often with radiation (3%) or androgen deprivation (3%) than with radical prostatectomy (1%). Erectile dysfunction occurred frequently after all treatments (radical prostatectomy, 58%; radiation therapy, 43%; androgen deprivation, 86%).
CONCLUSION: Assessment of the comparative effectiveness and harms of localized prostate cancer treatments is difficult because of limitations in the evidence.
PMID: 18252677 [PubMed - indexed for MEDLINE]
Summation of post RP:
recurrance is 14%
incontinence is 35%
ED is 58%
These figures fit into my own life experience of RP/RRP
Randy is a salesman, he states he has 30 years of experience. We all appreciate Randy's story, but it doesn't mean everyone will have his outcome, it's high time he stop attacking new people here with stories he doesn't know about. I appreciate viper's story, let's not kill the messenger, we need everyone, isn't that what a forum is all about, where else can we learn about the newest treatments??
Good luck to kongo!!!
Marge, thanks for the encouragement.
One thing about all of these studies which I find enormously frustrating is that most never seem to make head-to-head comparisons of treatment options, as indicated in the conclusion for the study you referenced. In the study you cite, for example, you can’t really draw a relevant conclusion because we don’t know the experience level of the surgeon, the state of urinary or ED functionality before treatment, the age of the patient, the staging of the cancer, and so forth. We can’t statistically normalize the study. What we have is basically: A bunch of guys had many different forms of treatment someplace and there were differing results with respect to side effects.
Randy has cited a study in this thread that shows a much different outcome for RP side effects out of NY Presbyterian done in 2007 where the patient cohort had a continence rate of over 90% and sexual function of nearly 80 percent. The caveat is that these were highly experienced surgeons using the Da Vinci machine. Of course, we really don’t know how they defined continence or sexual function but giving them the benefit of the doubt, those are certainly encouraging results for those considering RP.
Outside of NY Presbyterian, some of the large studies that draw upon the VA or Medicare databases show higher rates of RP side effects with respect to incontinence and ED. My personal belief on this is that the experience of the surgeon is the critical factor. As RP has only been approved for PCa treatment for about five years and the number of facilities offering it is growing dramatically, there is obviously a learning curve that comes into play, and Randy has always maintained that a man considering Da Vinci should seek out the most experienced surgeon available. (I heard a commercial on the radio this morning on the way to work touting a new Da Vinci machine at a local hospital – I wondered to myself how much experience the surgeon who fires that baby up for the first time will have had.) If I was going the RP route, I would be on a plane to the most expensive, most highly acknowledged, and most experienced surgeon I could find.
In Cyberknife, for example, my doctor took great pains to tell me that men who have poor sexual function before treatment will have ED issues afterward and those men with enlarged prostates or urinary issues before radiation will have a more difficult recovery than men without symptoms. I suspect there is a similar analog to RP. So, if you look at a VA or Medicare study with men at a more advanced age possessing incumbent ED and urinary issues, the study will report more side effects. I think the studies should pay much more attention to pre-treatment diet, health, and vitality and the impact it has on successful outcomes. BDHilton has made some good points on the importance of diet and exercise to recovery in other threads.
Just about any personal opinion about PCa or treatment options can cite some study or another for justification. I personally believe that flaming someone who cites a particular study that doesn’t fit your personal view of the world is unproductive and stymies the free exchange of information about subjects which many are seeking. A more civilized approach, in my opinion, would be to tactfully disagree and cite your own study and explain why you think it may be more relevant to a particular cancer situation. Personal attacks are not only against website rules; they tend dampen the free exchange of information which might turn out to be instrumental in helping someone find the right path for them. And at the end of the day, I don’t think any specific study is totally authorative by itself -- It’s just another piece of the puzzle we all have to put together as we sift through the myths, folklore, lies, and damn lies on the road to recovery.
I’ve completed all of my preparatory work and start Cyberknife treatment on June 21.0 -
KongoKongo said:Marge
Marge, thanks for the encouragement.
One thing about all of these studies which I find enormously frustrating is that most never seem to make head-to-head comparisons of treatment options, as indicated in the conclusion for the study you referenced. In the study you cite, for example, you can’t really draw a relevant conclusion because we don’t know the experience level of the surgeon, the state of urinary or ED functionality before treatment, the age of the patient, the staging of the cancer, and so forth. We can’t statistically normalize the study. What we have is basically: A bunch of guys had many different forms of treatment someplace and there were differing results with respect to side effects.
Randy has cited a study in this thread that shows a much different outcome for RP side effects out of NY Presbyterian done in 2007 where the patient cohort had a continence rate of over 90% and sexual function of nearly 80 percent. The caveat is that these were highly experienced surgeons using the Da Vinci machine. Of course, we really don’t know how they defined continence or sexual function but giving them the benefit of the doubt, those are certainly encouraging results for those considering RP.
Outside of NY Presbyterian, some of the large studies that draw upon the VA or Medicare databases show higher rates of RP side effects with respect to incontinence and ED. My personal belief on this is that the experience of the surgeon is the critical factor. As RP has only been approved for PCa treatment for about five years and the number of facilities offering it is growing dramatically, there is obviously a learning curve that comes into play, and Randy has always maintained that a man considering Da Vinci should seek out the most experienced surgeon available. (I heard a commercial on the radio this morning on the way to work touting a new Da Vinci machine at a local hospital – I wondered to myself how much experience the surgeon who fires that baby up for the first time will have had.) If I was going the RP route, I would be on a plane to the most expensive, most highly acknowledged, and most experienced surgeon I could find.
In Cyberknife, for example, my doctor took great pains to tell me that men who have poor sexual function before treatment will have ED issues afterward and those men with enlarged prostates or urinary issues before radiation will have a more difficult recovery than men without symptoms. I suspect there is a similar analog to RP. So, if you look at a VA or Medicare study with men at a more advanced age possessing incumbent ED and urinary issues, the study will report more side effects. I think the studies should pay much more attention to pre-treatment diet, health, and vitality and the impact it has on successful outcomes. BDHilton has made some good points on the importance of diet and exercise to recovery in other threads.
Just about any personal opinion about PCa or treatment options can cite some study or another for justification. I personally believe that flaming someone who cites a particular study that doesn’t fit your personal view of the world is unproductive and stymies the free exchange of information about subjects which many are seeking. A more civilized approach, in my opinion, would be to tactfully disagree and cite your own study and explain why you think it may be more relevant to a particular cancer situation. Personal attacks are not only against website rules; they tend dampen the free exchange of information which might turn out to be instrumental in helping someone find the right path for them. And at the end of the day, I don’t think any specific study is totally authorative by itself -- It’s just another piece of the puzzle we all have to put together as we sift through the myths, folklore, lies, and damn lies on the road to recovery.
I’ve completed all of my preparatory work and start Cyberknife treatment on June 21.
I wish you the best starting June 21.........my thoughts and prayers are with you for a positive outcome........which is very probable since you do have a low number.
Ira0 -
Kongohopeful and optimistic said:Kongo
I wish you the best starting June 21.........my thoughts and prayers are with you for a positive outcome........which is very probable since you do have a low number.
Ira
You have done your homework as well if not better than anyone on here and I am just about 100% positive that you will have a very good outcome. Additionally, as Ira stated, your involvement is low and this should mean a very good outcome - but everyone knows it all depends on the individual case and event many times so, here's to the best possible outcome with the least possible side affects!
BTW, you make, as always some very perceptive and poignant points above with regards to all this discussion.
Randy0 -
Randy, you completelyrandy_in_indy said:Kongo
You have done your homework as well if not better than anyone on here and I am just about 100% positive that you will have a very good outcome. Additionally, as Ira stated, your involvement is low and this should mean a very good outcome - but everyone knows it all depends on the individual case and event many times so, here's to the best possible outcome with the least possible side affects!
BTW, you make, as always some very perceptive and poignant points above with regards to all this discussion.
Randy
Randy, you completely misread what I wrote. It’s the new people who have stories, not “you attacking them with your stories.”
My use of the word “story or stories” is referring to the person who writes what happened to him recalling his particular cancer story. Thus ‘Randy’s story‘, and ‘Vipers story‘, ‘new people’s cancer story‘, and in calling these new posters Trolls or sales people, “peddling an unapproved treatment”, that sort of talk, where you slam the poster instead of the treatment, when you know nothing about these new treatments.
The stats I posted above are from a PubMed article which you can look up. They even state “CONCLUSION: Assessment of the comparative effectiveness and harms of localized prostate cancer treatments is difficult because of limitations in the evidence.” Which we all know. However, I find the stats in that study accurate. In my life, my experiences are that surgery is not the easy route that Randy eludes it is, and he should take his own advice and beware recommending it so highly with his “rock star” surgeon and let people with other info from other treatments say what they know, we all have to sift through what it written, let us, don’t condemn what you don’t know, and run off good people. Let’s advance.
Can surgery actually advance? Nothing changes inside the body, the gland is wrapped up in nerves very tightly, I believe the nurse who said the men who have function after surgery just got lucky.
Now, I’m finished with cancer forums, I didn’t come to fight or “joust”, I came to tell my story but find my info won’t be appreciated, much too combative for me here. You are right dbhilton, I am not happy with surgery, wish I’d listened to other ideas. The stats aren’t in for cyber knife, so it seems a good thing to listen to people like viper, with first hand knowledge.
Kongo, you stated that we don’t know the state of urinary function prior to surgery, really? I don’t know of anyone with incontinence except those of us who had surgery. I don’t disagree with all the stats, just wanted to post the stats that I found, it’s the personal attacks on posters who went a different route that annoys me.
I do look forward to reading what you tell … your story…..I feel certain it will be great, glad you followed your own drummer..0 -
Marge I am sorry but you way misunderstood my postsmarge said:Randy, you completely
Randy, you completely misread what I wrote. It’s the new people who have stories, not “you attacking them with your stories.”
My use of the word “story or stories” is referring to the person who writes what happened to him recalling his particular cancer story. Thus ‘Randy’s story‘, and ‘Vipers story‘, ‘new people’s cancer story‘, and in calling these new posters Trolls or sales people, “peddling an unapproved treatment”, that sort of talk, where you slam the poster instead of the treatment, when you know nothing about these new treatments.
The stats I posted above are from a PubMed article which you can look up. They even state “CONCLUSION: Assessment of the comparative effectiveness and harms of localized prostate cancer treatments is difficult because of limitations in the evidence.” Which we all know. However, I find the stats in that study accurate. In my life, my experiences are that surgery is not the easy route that Randy eludes it is, and he should take his own advice and beware recommending it so highly with his “rock star” surgeon and let people with other info from other treatments say what they know, we all have to sift through what it written, let us, don’t condemn what you don’t know, and run off good people. Let’s advance.
Can surgery actually advance? Nothing changes inside the body, the gland is wrapped up in nerves very tightly, I believe the nurse who said the men who have function after surgery just got lucky.
Now, I’m finished with cancer forums, I didn’t come to fight or “joust”, I came to tell my story but find my info won’t be appreciated, much too combative for me here. You are right dbhilton, I am not happy with surgery, wish I’d listened to other ideas. The stats aren’t in for cyber knife, so it seems a good thing to listen to people like viper, with first hand knowledge.
Kongo, you stated that we don’t know the state of urinary function prior to surgery, really? I don’t know of anyone with incontinence except those of us who had surgery. I don’t disagree with all the stats, just wanted to post the stats that I found, it’s the personal attacks on posters who went a different route that annoys me.
I do look forward to reading what you tell … your story…..I feel certain it will be great, glad you followed your own drummer..
More than I misunderstood yours. What I object to is the web site statistics that Viper represents on his web site...I would challenge anyone to refute what I say about his typical risk pointing everyone away from surgery when in FACT there are many thousands that have benefited from surgery with exceptional results....based on the fact everyone needs to do their own research and find the person that is best for the surgery. People who do not and just take the next bloke that happens to be the doctor they go to and end up in a mess...then shame on them...I did not go with two urologists that examined me...and did a biopsy on me...because I was bound and determined to find the best for Randy...because that is what I always do and always will. Viper's statistics stink... and that is a obvious FACT. Again...I have said not one word agains Cyberknife as a treatment and never will but when someone trys to mislead away from other treatments the way the "WEBSITE" he proclaims as his...I will fight for the truth to the end. You are really funny about the comment you state about incontinence...prior to surgery....you must be in your 30's....I have a brother and mother that both have issues and are exceptionally healthy people of the age of 55 and 78. You need to get out more and talk frankly with other people....it's an everyday very pervasive occurance in our aging population.0 -
Wowrandy_in_indy said:Marge I am sorry but you way misunderstood my posts
More than I misunderstood yours. What I object to is the web site statistics that Viper represents on his web site...I would challenge anyone to refute what I say about his typical risk pointing everyone away from surgery when in FACT there are many thousands that have benefited from surgery with exceptional results....based on the fact everyone needs to do their own research and find the person that is best for the surgery. People who do not and just take the next bloke that happens to be the doctor they go to and end up in a mess...then shame on them...I did not go with two urologists that examined me...and did a biopsy on me...because I was bound and determined to find the best for Randy...because that is what I always do and always will. Viper's statistics stink... and that is a obvious FACT. Again...I have said not one word agains Cyberknife as a treatment and never will but when someone trys to mislead away from other treatments the way the "WEBSITE" he proclaims as his...I will fight for the truth to the end. You are really funny about the comment you state about incontinence...prior to surgery....you must be in your 30's....I have a brother and mother that both have issues and are exceptionally healthy people of the age of 55 and 78. You need to get out more and talk frankly with other people....it's an everyday very pervasive occurance in our aging population.
I read this thread and have to say just let it it go already. If not there may be a cure for cancer before this thread ends. I am dying a little more each day and working at my job and in the garden and playing golf and spending time with my wife and friends is what keeps me going. Much of my long survival is due to getting the stress out of my life and it pains me to read all the stressfull posts in this thread. You should all be so happy you got treated in time to save your lives and stop trying to one up each other. You would understand this if you knew your life was to be cut off in a few weeks. I will let his be my very last post and wih you all the best. Be kind to others and perform a random act of kindness every day. Peace, Mark0
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