High-risk patients get conflicting messages from radiation oncologists and urologists after first-line surgical treatment

In spite of data suggesting that brachy boost has better outcomes for high-risk patients, it is being utilized less often and surgery is being utilized more often. … READ MORE …

SBRT vs. standard IMRT as first-line radiation therapy for localized prostate cancer

Many readers may be interested in an article by Gina Kolata in today’s issue of The New York Times. It deals with the rising popularity of stereotactic body radiation therapy (SBRT) in the management of localized prostate cancer. … READ MORE …

Vessel-sparing IMRT spares erectile function

While either nerve-sparing surgery or radiation can cause erectile dysfunction, the probability for that for any given patient is always worse after surgery. The recent ProtecT randomized clinical trial removed any doubt of that, if there ever really was any. … READ MORE …

Less treatment regret with SBRT, and when patients are fully informed

There is growing recognition that the patient’s satisfaction or regret with his treatment decision is more than just a matter of whether he is happy with the oncological outcome. Satisfaction/regret is the product of many variables, including how well he understood his options, his interactions with his doctors, the side effects he suffered and when he suffered them, his expectations about the side effects of treatment, and cultural factors. … READ MORE …

Real care beyond medical treatment, and impact on quality of life

A small, recent pilot study in Geneva, Switzerland, has shown that radiation therapy (RT) + androgen deprivation therapy (ADT) can be given safely to frail patients with non-metastatic, locally advanced or aggressive, intermediate prostate cancer, if and when a multidisciplinary care program is implemented to help such frail patients to limit risk for and manage predictable side effects. … READ MORE …

Nadir PSA predicts survival after radiation and androgen deprivation for unfavorable risk patients

The following commentary addresses the article on risk for recurrent prostate cancer that we had mentioned briefly yesterday.

If a treatment isn’t working, we want to know as quickly as possible so we can try a salvage therapy while it can still make a difference. … READ MORE …

Letters to the Editor on interpretation of data from the ProtecT trial

In September last year, Hamdy et al. published the initial results of the ProtecT trial — a trial designed to compare overall outcomes at 10 years among > 1,600 men diagnosed with low- and intermediate-risk, localized prostate cancer and randomized to treatment by surgery, by external beam radiation therapy, or by active monitoring (a very basic form of active surveillance). … READ MORE …