THE "NEW" PROSTATE CANCER INFOLINK

A series of review articles and editorials on the first-line treatment of prostate cancer has started this month in the journal Oncology. Additional articles will appear in the October issue of the journal. The full text of all articles is available on line at no cost.

These articles have been coordinated under the general title “Controversies in the Treatment of Localized Prostate Cancer” under the guest editorship of Derek Raghavan of the Cleveland Clinic’s Taussig Cancer Institute. Each article is written from a specific point of view, and should not considered to be “right” or “wrong,” it merely reflects the opinions and perspectives of the individual authors or editorial commentators.

In the September issue of Oncology, you can find the following five articles:

• Controversies in the Treatment of Localized Prostate Cancer: After the Rhetoric, by Derek Raghavan, MD, PhD, which acts as an introduction to the series.
• Radical Radiotherapy for Prostate Cancer is the “Only Way to Go”, by Amin Mirhadi, MD, and Howard Sandler, MD, which argues that radiation therapy (including external beam therapy and/or brachytherapy) is the optimal form of treatment of localized disease for most patients today.
• Radical Prostatectomy Reigns Supreme, by Heidi Rayala, MD, PhD, and Jerome Ritchie, MD, which argues in a similar manner that radical prostatectomy is the optimal form of treatment of localized disease.
• Optimal Therapy in Localized Prostate Cancer: An Unfolding Story, by Stacy Loeb, MD, and Edward M. Schaeffer, MD, PhD, which is an editorial comment on the article by Mirhani and Sandler.
• Localized Prostate Cancer: The Battle of Treatment Options Enters the Larger Arena, by Deborah Kuban, MD, which is an editorial comment on the article by Rayala and Ritchie.

Additional articles and editorials will appear in the October issue of Oncology, and we will let you know about these articles when they are published.

What is perhaps unfortunate is that this series of articles does not appear to address some of the more recent innovations in the treatment of localized prostate cancer. Based on the available information, there appears to be no discussion of high-intensity focal ultrasound (HIFU) in treatment of the whole gland or as focal therapy or of cryotherapy as focal therapy. Having said that, we suspect that the newly diagnosed patient or any support group leader will have a sound and up-to-date overview of the relative merits and demerits of the use of the various forms of surgery, seed implantation, and external beam radiation if they print out an read all of the articles in the September and October issues of Oncology.

And again, as a last comment — there is no “right” or “wrong” here; we just don’t have that data. What we have here is “expert opinion” from recognized experts who do bring their personal biases and opinions to the discussion. At the end of the day, the well-informed patient has to come to his own conclusions about whether, for him, treatment is necessary at all — and if so, which form of treatment.