The weekend news reports: April 18, 2009

Today’s news reports deal with:

  • Active surveillance management strategies and outcomes to date
  • Life expectancy and the appropriateness of treatment
  • Penile rehabilitation post-surgery
  • Testosterone replacement therapy in prostate cancer patients

Dall’Era and Carroll have reviewed available data on outcomes and follow-up strategies for patients on active surveillance. They note the increased interest in managing men with prostate cancer and low risk features expectantly, with close observation for early signs of progression — an approach that allows the physician and the patient to focus prostate cancer treatment and any risk of related morbidity on men who will benefit the most from active intervention. They report that in the studies on active surveillance publisghed to date, even though follow-up has been relatively short, outcomes have been favorable, about 33 percent of patients receive treatment after 3-5 years of surveillance, and quality of life remains high.

Jeldres et al. have carried out an interesting  retrospective analysis of survival times after surgery and radiation therapy based on 17,000+ men treated in Canada between 1989 and 2000. They postulate that many men with a life expectancy of less than 10 years were getting treatment that was not appropriate based on their life expectancy. This hypothesis is supported by their data, particularly in the case of men receiving radiation therapy. However, there are many caveats that should be considered in interpreting these data, not least the fact that in the period 1989 to 2000, first-line radiation therapy was more common for men who were diagnosed with at least locally advanced disease rather than localized disease.

Shaiji et al. have reviewed available data in the controversial field of “penile rehabilitation” post-treatment. The authors say their article offers “a comprehensive literature review involving both the basic and clinical data surrounding rehabilitative approaches.”

An article by Rinnab et al. (in German) reviews data on the use of testosterone replacement therapy (TRT) in men with low testosterone levels who have been treated for prostate cancer. This group of authors states that, in their opinion, “physicians cannot really justify withholding TRT from symptomatic patients after they have been successful[ly] treated for prostate cancer.

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