Radical cystectomy as first-line treatment for clinical stage T4NxM0 prostate cancer

Clinical stage T4 prostate cancer is characterized by prostate tumors that have grown through the prostate capsule and into or even through the bladder wall. There is no agreed or “standard” form of first-line treatment for this form of localized prostate cancer.

Survival after a diagnosis of AJCC Stage IV prostate cancer

For many men, a diagnosis of prostate cancer of any stage or grade — even of the lowest level of risk — is hard to deal with. If they have progressive disease after first-line therapy, it may appear to be an overwhelming issue.

Small, Phase I combo trial suggests 3-year overall survival in men with mCRPC

A media release issued earlier today by Barvarian Nordic (the developer of Prostvac®) gives us an inkling of where we may be headed in the development of combination therapies for the management of late stage (and maybe even earlier stage) forms of prostate cancer.

Active surveillance or immediate surgery for low-risk prostate cancer: let’s look at the math

A new study has attempted to calculate the impact of age, health status, and patient preference on the relative outcomes (and merits) of immediate surgery as compared to active surveillance for the management of low-risk prostate cancer.

Relative 10-year survival after surgery, EBRT, or brachytherapy in the PSA era

A new study on relative rates of survival at 10 years, just published on line, is probably going to get differing reactions from patients and from physicians depending on their individual points of view.

Is low-dose brachytherapy really “better” than other treatment options (redux)?

An article just published by Grimm et al. in a supplement to BJU International argues (quite persuasively) that low-dose brachytherapy is the best form of treatment for men with low-risk prostate cancer.

Korean study says that HIFU “does not provide effective oncologic outcomes”

A new paper by clinical researchers in Korea has concluded that treatment with high-intensity focused ultrasound (HIFU) “does not provide effective oncologic outcomes even in low risk patients with prostate cancer as well as in the intermediate or high risk groups,” but does have a low associated incidence of treatment complications.

First directly comparative data question safety of PBRT vs. IMRT

For the first time, some 15 years after proton beam radiation therapy (PBRT) was initially popularized as a potential treatment for prostate cancer by the group at Loma Linda, we have an independent assessment of the risk for side effects associated with this form of radiation therapy … and the comparative data are not good.

RALP not associated with better continence, sexual function after prostate cancer surgery

The “New” Prostate Cancer InfoLink has long been pointing out the lack of any evidence that men who are treated with robot-assisted laparoscopic prostatectomy (RALP) will have better outcomes with respect to continence and sexual function than men who elect to have the older, ”open” form of radical prostatectomy.

The value of MRI prior to surgery as a treatment for localized prostate cancer

A recent media release from the Radiological Society of North America (RSNA) is headed, “Preoperative MRU may reduce risk of nerve damage in prostate cancer surgeries” … and this is absolutely true.

The future of focal therapy

Two “pro” and “con” commentaries appeared on line this week in the Journal of Urology under the heading “Focal therapy will become standard treatment for localized prostate cancer.”

A small, multi-center cohort study of SBRT in treatment of low-risk prostate cancer

Published reports on the safety and efficacy of extreme hypofactionated radiation therapy (stereotactic body radiation therapy or SBRT, a.k.a. CyberKnife radiation therapy) have, to date, come from just a couple of key centers.

Robot-assisted surgery is not necessarily better than open surgery

As we regularly point out, outcomes after surgery for prostate cancer are massively impacted by the skill, the experience, and the focus of the surgeon. The tools he or she uses to carry out the surgery may or may not be a factor. We simply do not really know.

ASTRO claims “Proton therapy effective prostate cancer treatment”

A media release issued yesterday by ASTRO reads as follows:

Patient satisfaction after first-line treatment for localized prostate cancer (in Germany)

A new article in the journal Anticancer Research suggests that patients had greater satisfaction after modern forms of external beam radiation therapy (EBRT) than after some other standard forms of first-line treatment. Of course the absolute truth of this conclusion may be affected by the details of the study.

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