Two interesting articles on Medscape recently


A couple of recent articles on the Medscape web site deal with aspects of the effectiveness and safety of robot-assisted laparoscopic prostatectomy (RALP) and various types of radiation therapy in the first-line treatment of prostate cancer. It would be difficult to summarize these articles in brief, so we suggest people simply read the articles themselves if they find the subject matter interesting.

In their article “Technique of traction-free nerve-sparing radical prostatectomy,” Tewari et al. discuss the use of increasingly sophisticated surgical techniques (monitored through information on penile oxygen saturation levels) to minimize vascular insults and therefore damage to the tissues surrounding the prostate. They argue that such techniques appear to be able to improve erectile function at 6 and at 52 weeks post-surgery.

Clearly, if such results can be replicated by other surgical teams, this would indicate a significant step forward in our ability to overcome one of the major undesirable complications of radical prostatectomy. The “New” Prostate Cancer InfoLink has long pointed out that any form of radical prostatectomy is a traumatic surgical procedure. The ability to be able to conduct the operation in ways that are less traumatic for surrounding tissues should, at least in theory, profoundly impact the likelihood of full and prompt recovery of erectile function (in men who have a bilateral nerve-sparing procedure, at least).

In the second article, Shen et al. go into detail about “Comparative effectiveness research for prostate cancer radiation therapy: current status and future directions.” This may be a particularly useful article for support group leaders and for those interested in the comparative clinical value of various types of radiation therapy when compared to each other and to other forms of treatment.

The bottom line to this article is that, while comparative effectiveness research (CER) is starting to tease out data that may be very helpful in assessing the relative merits of all the differing treatments currently available for the first-line treatment of prostate cancer, it can not yet tell us with any degree of accuracy what types of therapies may be “the best” or even just “better” for men with low-, intermediate-, or high-risk disease. Data from the ProtecT trial, currently ongoing in the UK, will help us with this question. However, for CER to really help us resolve this question, we will need ongoing data analysis from carefully designed registry trials conducted over many years.

For those not accustomed to use of the Medscape web site, access to content on this site is free to readers, but you do have to register to use the site. However, you can manage down to a minimum the number of messages you receive from Medscape.

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