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Metastasis after radical prostatectomy or external beam radiotherapy for

A study at Memorial Sloan-Kettering Cancer Center, New York, assessed the effect of radical prostatectomy and external beam radiotherapy on distant metastases rates in patients with localized prostate cancer treated with radical prostatectomy or external beam radiotherapy at a single specialized cancer center.

Researchrs concluded that metastatic progression is infrequent in men with low-risk prostate cancer treated with either radical prostatectomy or external beam radiotherapy. Radical prostatectomy patients with higher-risk disease treated had a lower risk of metastatic progression and prostate cancer-specific death than external beam radiotherapy patients. However, these results may be confounded by differences in the use and timing of salvage therapy.

Helping prostate cancer patients with localized disease reach treatment decisions

A recent sudy at Tom Baker Cancer Center, Psychosocial Resources, 2202 2nd St SW, Calgary, Canada, aimed to highlight two important aspects:

• role of psychosocial variables in treatment decision making for patients with localized prostate cancer, and
• how family physicians can be of most help to such patients in facilitating good treatment choices.

From the very beginning, researchers suggest that the optimal strategy for managing localized prostate cancer has not been established. Currently options for treatment include a number of potential ways: active surveillance, radical prostatectomy, external beam radiotherapy, brachytherapy, and cryoablation.

Study concluded family physicians can help minimize the decisional regret experienced by patients after treatment by encouraging patients to consider their values and social supports, as well as the accuracy and appropriateness of the information used in the decision-making process. However, an increased awareness of the psychosocial aspects of patient decision making, can teach family physicians for helping patients make better decisions.

Patient misperceptions about treatment choices for localized prostate cancer

Researchers at Eastern Virginia Medical School, USA, suggest that higher education, income and functional capacity of cancer patients are associated with poorer knowledge about their cancer, poorer understanding about treatment choices, and poorer judgement about survival with and without treatment among a group of 184 patients recently diagnosed with localized prostate cancer.

On the other hand, patients who were socioeconomically disadvantaged and those with physical ailments are better informed about the diagnosis, treatment options and prognosis of prostate cancer.

An interesting report has been publisheg in BJU International.

New way to treat castrate resistant cells in prostate cancer patients

Biomedical scientists Monash University, Australia, have identified a new way to treat castrate resistant cells in prostate cancer sufferers.

For more than 60 years the main way to treat the most common cancer in Australian men has involved removing the hormones that fuel growth of the cancer cells. Although initially effective, this treatment inevitably fails because the cancerous cells remain in a patient after they have undergone hormone treatment. The scientific team, has discovered a new way to treat these potentially fatal diseased cells.

The findings have been published in the prestigious medical journal PNAS.

Focal therapy may be the future for prostate cancer

A scientific team at University College London, UK, has now published an article outlining the need for an international research strategy which could be used to evaluate focal therapy over time. According to  which should be “pragmatic” in nature and include the use of focal therapies in a broad spectrum of patient types; and which should include a focus on landmark diagnostic studies incorporating imaging techniques and biomarkers in addition to studies directed at the biology of prostate cancer over time.

Experts agree that within the focal therapy framework there exists a unique opportunity to undertake landmark diagnostic studies incorporating imaging techniques and biomarkers in addition to studies directed at the biology of prostate cancer over time. [ more about focal therapy ]

Statins may benefit prostate cancer patients

Duke University Medical Center researchers found cholesterol-lowering statins significantly reduce prostate tumor inflammation. This new study suggests this finding may help lower the risk of disease progression

Researchers concluded that the use of statins before prostate cancer surgery was associated with a 69 percent reduced likelihood of inflammation inside prostate tumors. For the study, the researchers investigated tissue samples of prostate tumors from 236 men undergoing prostate cancer surgery, including 37 who took statins during the year prior to their surgery.

The study senior author Dr. Stephen Freedland said that doesn’t mean that all prostate cancer patients should take statins.

Surgeon skills more important than type of surgery

A recent analysis of the outcomes of different types of radical prostatectomy appears to reveal no difference between the patients’ clinical outcomes following laparoscopic (including non-robot-assisted and robot-assisted) categories of surgery (LRP/RALP) and traditional “open” radical retropubic prostatectomy (RRP) when used to treat Medicare patients of 66 years or older.

The report suggests that it is not the type of surgery that is most important, it is the skill and experience of the individual surgeon that is most likely to determine the quality of outcome for the individual patient — whether the surgeon uses a robot, a laparoscope, or  just his hands and eyes.

The full article is scheduled for publication in the April issue of the Journal of Urology.

Comparison study of open and laparoscopic surgery found few differences in outcome

A new study at Memorial Sloan-Kettering Cancer Center in New York City compared open radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP), outcames in nearly 6,000 men, age 66 or older, with localized prostate cancer.

Currently, open radical prostatectomy (ORP) is considered the standard treatment but the use of laparoscopic radical prostatectomy (LRP), with or without robotic assistance, is becoming more widespread.

After researchers adjusted for patient and tumor characteristics, the researchers found no differences in the rates of general medical/surgical complications, genital/urinary/bowel complications, or in use of postoperative radiation and/or androgen deprivation. However, the study authors noted.patients in the LRP group had a 35 percent shorter hospital stay and a lower rate of bladder neck/urethral obstruction.

Effect of extended vs standard pelvic lymphadenectomy

A recent study at The Royal Surrey County Hospital, Guildford, UK, investigated the effect of extended vs standard pelvic lymphadenectomy (sPLND) for patients with intermediate- and high-risk prostate cancer undergoing laparoscopic radical prostatectomy (LRP).

Study team has published data from their series of 1,269 patients treated with non-robot-assisted laparoscopic radical prostatectomy (LRP) over a period of just over 9 years (starting in 2000).

Based on their findings and the results of other studies which show a reduction of prostate cancer-specific mortality of 23% if lymph nodes are positive and 15% if they are negative after ePLND, and the correlation between surgical experience, lymph node yield and positivity, researchers offer three recommendations:

(a) all patients should undergo ePLND if they are being treated with curative intent for intermediate- and high-risk prostate cancer;

(b) ePLND should replace sPLND for all such patients; and

(c) surgeons performing < 35 cases of RP a year should stop performing RP.

Abiraterone drug shows promise for advanced prostate cancer

Recent results related to a phase II clinical trial of the prostate cancer drug abiraterone confirm that it may help men with advanced disease who have tried standard treatments.

According to research team, new drug shows promise for advanced prostate cancer patients. However, anUK clinician cautioned that there were still questions to be answered from ongoing studies about how best to use the drug.