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 …

SpaceOAR hydrogel — is the difference worthwhile?

SpaceOAR hydrogel is spacer injected between the rectum and the prostate that increases their separation (in men being treated with external beam radiation therapy). This allows less radiation targeted at the prostate to hit the rectum. The research group published an interim 15-month report in 2015, and now Hamstra et al. have published their final report based on 3 years of follow-up. … READ MORE …

SBRT vs. moderate hypofractionation: same or better quality of life?

In several randomized clinical trials of external beam treatment of primary prostate cancer, we have seen that moderately hypofractionated intensity-modulated radiation therapy (HypoIMRT), accomplished in 12 to 26 treatments or fractions, is no worse than conventionally fractionated IMRT treatment (in 40 to 44 fractions). … READ MORE …

Dose escalation for salvage radiation therapy

In the late 1990s and early 2000s, the advent of more accurate linear accelerators (LINACs) and image-guidance technology for delivering therapeutic X-rays to the prostate in the treatment of prostate cancer changed the dose that could be safely given. … READ MORE …