Prostate cancer news reports: Wednesday, June 24, 2009

Today’s news reports include discussion of items on:

  • Prostate cancer risk awareness
  • Improving cryotherapy technique with 3D ultrasound
  • Interposition (“sural”) nerve grafting
  • Post-brachytherapy “PSA bounce”
  • The potential of targeted, peptide-linked, α-emitting radioisotopes

Shavers et al. have published data suggesting that, despite statistics to the contrary, few African-American men perceive themselves to have a higher-than-average risk of prostate cancer, while a higher percentage of Hispanic men perceive their risk to be higher than that of the average man of the same age. Based on these findings, they suggest that all men, but particularly African-American and Hispanic men, need more and better information regarding their specific risk of developing prostate cancer before making a decision about prostate cancer screening. The “New” Prostate Cancer InfoLink would note, however, that the data on which this study was based were collected 5 or more years ago, and that, at least in the African-American community, we suspect there is greater awareness today (although though more is very definitely needed).

Chalasani et al. have described the use of 3D-ultrasonography in association with cryotherapy at their institution in Canada, and how they believe that this has improved prostate cancer outcomes compared to older 2D techniques.

White and Kim have reviewed the available data on interposition (“sural”) nerve grafting in association with radical prostatectomy with the intent to preserve sexual functionality. Their basic statement is that this is still a controversial technique and that the numerous reports in the published literature “have demonstrated conflicting and contradictory outcomes.” Clearly we need a better and more detailed understanding of the techniques involved in this surgery if it is to be performed regularly with regularly effective outcomes.

Caloglu and Ciezki have reviewed the literature on the so-called “PSA bounce” that occurs in some 30-40 percent of men who are otherwise successfully treated with brachytherapy. We really do not understand what causes this phenomenon, and the authors note that patient age alone is  the most consistent predictor of the occurrence of the phenomenon. Post-brachytherapy PSA bounce is a worrisome issue for both clinicians and their patients because it may be many months before one can determine whether the PSA rise is “just” a bounce or a real signal of treatment failure.

A presentation on Tuesday at the Society of Nuclear Medicine’s annual meeting suggested that it may be possible to use α-emitting radioisotopes bound to rapidly clearing peptides that target prostate cancer cells as a form of treatment for prostate cancer. The presentation reported data from a very small study in mice, so we are unlikely to see this therapy being tested in men for a while yet. A more detailed report on this study is available on the Medscape web site.

3 Responses

  1. Relating to “Prostate cancer risk awareness” above, I thought this report (Cancer Incidence and Survival By Major Ethnic Group, England, 2002 – 2006) published today might be of interest, even though it’s UK/England based.

  2. When a man has his prostate removed, it may take months before he can get an erection again, or he may never get one again. Is there any kind of surgery that can be done so he can recover his erections again?

    This is a question more than a comment. Thank you

  3. Dear Mr. Sistrunk:

    I suggest you do two things:

    First, buy a copy of a book called, called Saving Your Sex Life: A Guide for Men with Prostate Cancer, by Dr. John Mulhall, which you can find on Some men and their wives swear by this! It deals with penile rehabilitation post-treatment as well as what else can be done if erectile function is permanently lost.

    Second, while you are waiting for the book to arrive, watch this video by Dr. Gerry Chodak that is available on YouTube.

    In addition, you can ask your doctors about “sural” nerve grafting, which is mentioned above. However, the results of this technique vary considerably and if you want to have this done you want to make sure it is being done by someone with a lot of experience AND a well-documented success rate in carrying out this procedure. This is a technique that is only offered to the patient at some centers, and only then if it has been decided prior to the radical prostatectomy, that at least one set of the cavernosal nerve bundles has to be removed.

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