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Most recently published research findings.....

MK1965
Posts: 194
Joined: Jun 2016

Prostate Cancer: Adverse Effects Favor Less Invasive Tx Over Surgery

VascodaGama's picture
VascodaGama
Posts: 3191
Joined: Nov 2010

https://www.medpagetoday.com/hematologyoncology/prostatecancer/84381

MK,

Thanks for posting this article. However, the study falls short in conclusions as it involves the data from 5 years cases alone. If the authors have continued collecting data, at ten years the results would be very different.

Best

VG

ASAdvocate
Posts: 129
Joined: Apr 2017

IMHO, any study comparing the effects of RT vs RP would have to include data from men who had SBRT and protons. Those are the two specific RT protocols with the most impressive 5 and 10 year results.

lighterwood67's picture
lighterwood67
Posts: 256
Joined: Feb 2018

Sometimes I think when we are comparing medical treatment strategies for prostate cancer, it feels like we are trying to compare apples to oranges.  Especially when it comes to RP vs less invasive treatments (RT).  When I made my decision to go with a RARP, I made it based on what I had read, what I could find out from others, and what did the doctors say.  I made my decision knowing full well that I may be incontinent the rest of my life; I may be impotent; Urethra shortening; hernias.  I knew going in that to me the RT strategy would probably have less adverse effects.  How couldn't it?  Removal of prostate gland; seminal vesicles; bladder neck reconstruction; lymph node removal; urethra shortening.  The side effects, to me, were more defined than the RT route.  I was told my cancer was contained.  So , I went with what the doctors (RP and RT) recommended.  Did I make the correct decision?  I am continent; I am intimate with my wife; experienced some urethra shortening; developed a hernia.  At this time my PSA is undetectable.  To me surgery will always have more adverse effects.  To me the adverse effects were secondary to a curative knockout blow to the cancer.  If your focus is on the adverse effects only, by all means go with RT.  MK1965, enjoyed the article, but to me trying to compare adverse effects of RP to RT is like comparing apples to oranges.  Two totally different stratgeies.

Clevelandguy
Posts: 552
Joined: Jun 2015

Hi all,

Each person has to look at the side effects, medical diagnostic tests and scans plus facilities at your disposal.  As I have always said great doctors+great facilities = great results. People come to this board with both good results from radiation and surgery also some have had bad results. Thats why in my opinion you need to look at all the medical/life style facts and make a choice. Both surgery or radiation are totally different courses of treatments and have specific side effects. But I don't feel can be judged better or worse based on studies. From what I have seen here rarely are there two cancer cases identical so it would seem logical to have different end results. In statistics if your sample population has a variety of attributes (3+3,3+4,4+3,4+4) your end conculsion could be clouded based on that variability of the sample. Some people say surgery is better, some say radiation. I say do your home work, look at the facts and make a decision. Could a, should a, usually doesn't do much in life except piss you off.

Dave 3+4

MK1965
Posts: 194
Joined: Jun 2016

Had radical prostatectomy 3 years ago. Had really bad experience in prostatectomy aftermath.

Wrote about it here and on other forums and was criticized for it here as no one else. 
God forbid, buti if I ever develop any other Ca in future, surgery will always be the last treatment modality. I won't even consider seeing surgeon at all. Lesson learned.

I am glad, this research came from very reputable institution and I hope it will help future prostate Ca patients choose lesser evil from two.

MK

Steve1961
Posts: 301
Joined: Dec 2017

I take you are NED cancer free. I hope you are and I hope you are over loss of length issue .i am telling you radition ruined me ..I would give anything to know I am cancer free .,not have bowel problems and have to take flowmax just to urinate ..I wouldn't care if my penis was only 3 inches and couldn't get an erection ..personally I think what you went through is a small price to pay fir beating cancer ...hopefully you will realize that soon if you haven't already .but then again we are all different ...god bless 

Clevelandguy
Posts: 552
Joined: Jun 2015

Yeah its kind of like saying both a Porsche Boxster Spider and a Semi truck will both get you to the same destination but are totally different forms of transportation that offer different good points and bad points. The choice is between you, your family and medical team. There is no right or wrong choice to deal with Pca, the correct choice is the one you make and live with the consequences good or bad. All forms of treatment have their good and bad points. Some people have had very bad results with radiation treatment also, some very good, the same goes for surgery. All that we Pca patients can hope for is that we chose the right one that will put our cancer in remission for many years to come even if it takes two or three attempts to subdue the beast.

DONT GIVE UP, KEEP FIGHTING................

Dave 3+4

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3427
Joined: May 2012

Anti-surgical treatment documents have been published for decades regarding PCa.  Yet, I read recently that around 70% of all new PCa patients in the US who need curative treatment choose surgery.   I have know about ten men personally with PCa, and every one of them chose surgery.  I have never met in person a man who chose curative Radiation for first-line response.  I believe that intuitively and instinctually men know surgical removal to be a better choice.  It is odd that in cancer therapy, high-dose radiation is regarded by some as more "nautral," when everywhere else in life, radiation is viewed as deadly.

I am NOT 'anti-radiation,' and never have been.  Just some thoughts on the unending drama over how 'bad' PCa surgery is. For me and the men I've known, it was  wonderful.  Bless every man who has, or will, choose radiation.

max

ASAdvocate
Posts: 129
Joined: Apr 2017

The latest results from the 400,000 man SEER prostate cancer database show that newly diagnosed men are choosing active surveillance, surgery, and radiation in equal percentages.

Your 70% statistic is VERY outdated.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/pros.23496

 

Clevelandguy
Posts: 552
Joined: Jun 2015

So data from the Seer study 2004-2013 is not old data?  Why does it matter what percentage of men choose what proceedure?  Is this a popularity contest or are we trying to find the best method based on our own individual case to eliminate the cancer?  We should be looking at data on stopping reoccurrence by method, when you decide on treatments you don't know at that point whether it will eventually get rid of the cancer.

Dave 3+4

ASAdvocate
Posts: 129
Joined: Apr 2017

There are statistics on recurrence by method, and by Gleason Grade. A big probem is that they are usually not neatly compared in the same publications. We know that surgery has about a 35 percent chance of recurrence at ten years. That varies greatly by risk level.

We also have reports showing less than 10 percent recurrence with either SBRT or protons at five years, maybe more now. They are stating results from 95 to 99 percent recurence free for low and intermediate risk men.

So, there is data out there, and, yes, people will argue with every result that doesn't fit their opinions, But, there certainly is plenty of data to sort through when making a decision.

https://medivizor.com/blog/SampleLibrary/prostate-cancer/examining-the-risk-of-disease-recurrence-more-than-10-years-after-prostate-surgery/

https://www.sciencedaily.com/releases/2016/04/160418145458.htm

https://pcnrv.blogspot.com/2016/08/proton-therapy-at-university-of-florida.html

 

 

Clevelandguy
Posts: 552
Joined: Jun 2015

Just be sure to look at who conducted the various treatment methods. Sometimes results are published by companies or facilities that either make or use one type of equipment that they are reporting on.  Todays treatments are rapidly evolving so make sure folks get the latest data available when they are making their decisions.

Dave 3+4

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3427
Joined: May 2012

Cleveland,

My point was not to argue for a given modality (I suspect you know this already); ASA is one of a small core here who does that routinely; his moniker states so directly.  

You are correct that "who paid for the study" is nearly always key.   Someone submitted a "Surgery for PCa is Horrible" report here about two years ago.   I looked into the group, and EVERY oncologist listed was a Radiation Oncologist.  Not one surgeon or medical oncologist, out of the 30 or so expert writers.  Many worked for radiation apparatus manufacturers also.

As the Dave Mason hit said in the 70s, "There's just you and me, and we just disagree."  And that is a fine, OK state of affairs.

 

Clevelandguy
Posts: 552
Joined: Jun 2015

Good point Max on checking on any data source.  Like ASA said there is a lot of data out there we just have to decipher what the data says and who reported it. Some of the data I have read you have to take with a grain of salt because of what source reported it.  That's why the data should be discussed with your doctors and other learned folks in the know you trust. Sometimes hospital systems or manufactures of equipment just love to report data that makes them look the best.

 Cheers,

Dave 3+4

ASAdvocate
Posts: 129
Joined: Apr 2017

Max, I would certainly be suspicious of any "Surgery for PCa is Horrible" report, and would likely not share it.

I participate in about a dozen online forums and FB groups, and also a local support meeting. Accordingly, I get a lot of input on men's feelings about their treatments. IMHO, surgery has the most impact on their quality of life. So, I advocate for AS when it is feasible, and for less damaging treatments when treatment is needed. So far, those appear to be RT protocols, but I am also very interested in TULSA-PRO, gold particles, TOOKAD, and other potential treatments.

If some new protocol gets rid of the PCa with few side effects, I would embrace it over SBRT, PBT, and even over AS, which would no longer have a rationale. But, we ain't there yet...so we ponder and debate what to do.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3427
Joined: May 2012

The classic "Prostate Snatchers" book was a total hit piece, and is still quoted here on occasion by partisans.   Not dispassionate science at all.   That is what I object to.

Dave Mason was lead singer for Fleetwood Mac for a few years decades ago.   Except for the romantic lines, it fits here.  The refrain was a common slogan in the 70s.  As the R&B stars say, "Peace Out !"  He had another hit around that time entitled Mystic Traveller, which was, well, mystical.

I have no control over the random political ads, run by billionaires, explaining why they are just plain, simple folk.

https://www.youtube.com/watch?v=p8_FOQ7-P30

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