Pros and Cons of All Possible Treatments of Prostate Cancer
May 30, 2005 - 9:17:38 PM
Prostate cancer continues to be a leading priority among medical researchers. For this reason, a special panel briefing dedicated to prostate cancer treatments and outcomes will be held during the 100th Annual Scientific Meeting of the American Urological Association (AUA) on May 25, 2005 in the Henry B. Gonzalez Convention Center in San Antonio. J. Brantley Thrasher, M.D., a spokesperson for the AUA and chair of urologic surgery at the University of Kansas Medical Center, will moderate the briefing, which will feature research on best treatments for high-grade prostate cancer.
Featured research includes:
Five-year Urinary and Sexual Outcomes After Radical Prostatectomy: Results from the Prostate Cancer Outcomes Study ( 672 ): Results have never been obtained of comprehensive, unbiased studies of outcomes following prostatectomy. Researchers followed prostatectomy patients for five years after their procedure to examine changes in urinary and sexual function. Problems with urinary control and sexual performance were found common up to five years after surgery, but functional outcomes were stable over the population.
A Cost and Revenue Analysis for Retropubic, Perineal and Robotic Prostatectomy at a Large Community Hospital ( 24 ): With the frequency of prostatectomies performed each year, it is important for hospital administrators to know which form of prostatectomy is most financially beneficial to their institution. Hospital records and financial data from 2003-2004 were analyzed to determine the cost and revenue for each type of prostate cancer treatment ( retropubic, perineal and laparoscopic-robotic assisted ). Cost was determined by factors such as length of stay, type of procedure and length of time to perform a procedure. Revenue was determined by cost and insurance type. Combining all those factors, retropubic prostatectomy was found to have the greatest cost advantage due to the lower hospital costs.
Variations Among High-Volume Surgeons in Rate of Complications After Radical Prostatectomy: Further Evidence that Technique Matters ( 188 ): Practice might make perfect for surgeons when it comes to performing prostatecomies. It has been shown that a strong correlation exists between surgeon, hospital volume and degree of success following prostatectomy, but the differences in outcomes among surgeons has not been measured. Surgical technique and post-op care among surgeons was evaluated to determine their importance in the outcomes following surgery. Surgeons that performed well in post-operative care, for example, tended to perform well in other areas confirming the theory that variations in technique and post-operative care play an important role in the outcome following the prostatectomy.
Technique of Radical Prostatectomy: A Head to Head Comparison of Retropubic, Perineal and Laparoscopic Access -Data on Perioperative Morbidity ( 684 ): Prostatectomies can be performed several ways, including perineal ( inserted through the perineum ), retropubic ( incision in the abdomen and reaching behind the pubic bone ) and laparscopic ( tube inserted in abdomen to perform minor surgeries ). Techniques were evaluated based on safety and efficacy, blood loss and operation time. Comparison found all three techniques effective in treating prostate cancer with very similar surgical margin rates.
Comparison of Radical Prostatectomy, Radiotherapy and Hormonal Therapy for Screen-Detected Prostate Cancer ( 1459 ): The purpose of screening for prostate cancer is to detect early warning signs so action can be taken against the disease when it reaches a certain level of seriousness. When detected early, patients have more flexibility in choosing treatment, weighing the effectiveness of a treatment against the detrements it brings to the quality of life. It is controversial as to what form of treatment is most preferred among patients, so researchers updated and evaluated results on prostate cancer patients who chose their own treatment and by doing so have stopped the progression of the disease. Radical prostatectomy was found to have the lowest progression rate following procedure with brachytherapy close behind.
Adjuvant Radiotherapy for Pathologic T3 Prostate Cancer: Results of a Randomized, Prospective Clinical Trial with Metastasis-Free Survival Endpoint ( 1665 ): Patients commonly use as an additional treatment following radical prostatectomy. The effect of radiotherapy combined with prostatectomy has never been measured to determine the rate of cancer-free survival. After close examination, radiotherapy was found to be effective in preventing relapses and normalizing PSA levels, but it did not have an effect on the growth of new cancers.
Radical Prostatectomy for Clinically Advanced Prostate Cancer in the PSA Era: 15-year Outcomes ( 826 ): Historically, patients with locally advanced prostate cancer have been told that they cannot undergo a prostatectomy for treatment. New research reports that this belief may be outdated. Eighty-percent of patients who underwent prostatectomies 15 years ago were reported as having remained cancer-free, proving that prostatectomies can be performed on patients with advanced prostate cancer. Not only did patients remain cancer-free for 15 years, but the prostatectomy did not cause adverse effects any worse than those experienced by prostatectomy patients with lesser grade cancer.
Quality of Life After Radical Prostatectomy or External Beam Radiotherapy for Localized Prostate Cancer ( 1017 ): External beam radiotherapy is the most common form of radiotherapy, where patients lie on their backs and X-rays are pointed at certain points of the body. This non-invasive treatment was compared to the surgical prostatectomy treatment to determine the quality of life following each. Both had similar results with prostatectomy patients experiencing lower quality of life only in the month immediately following surgery. Patients experienced declines in sexual function following both prcedures.
It is critically important to understand the pros and cons of all possible treatments of prostate cancer, said J. Brantley Thrasher, MD, who moderated the panel. This research presents a variety of findings for the many courses of action available.
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