HIFU treatment results in perfect results in 90 % of patients:

http://www.telegraph.co.uk/health/healthnews/9206425/New-treatment-for-prostate-cancer-gives-perfect-results-for-nine-in-ten-men-research.html

HIFU: A New Cutting-edge Treatment Option for Prostate Cancer

HIFU is a treatment option that I have been offering to patients since 2007:

http://youtu.be/159LUD6wUxY

Nineteen percent of men who undergo prostate surgery later regret their decision, data indicates.

Nineteen percent of men who undergo prostate surgery later regret their decision, data indicates.

The New York Times (8/27, Parker-Pope) reported in its Well blog that a study published in the journal European Urology suggests that "one in five men who undergoes prostate surgery to treat cancer later regrets the decision." Notably, "regret is highest among men who opt for robotic prostatectomy." For the study, researchers "surveyed 400 men with early prostate cancer who had undergone either a traditional 'open' surgical procedure or newer robotic surgery to remove the prostate." While "the vast majority of men were satisfied,"19 percent reported regretting their choice of treatment. "Men who had undergone robotic surgery were four times more likely to regret their choice than men who had undergone the open procedure." The researchers said that "the higher level of regret among robotic patients suggests that they had higher expectations for their recovery, possibly because the robotic procedure is widely touted as a more innovative treatment." They concluded "that the study shows urologists need to communicate more carefully the risks and benefits of the treatment prior to surgery so that men have more realistic expectations of what to expect."

August 27, 2008,  9:26 am

Regrets After Prostate Surgery

One in five men who undergoes prostate surgery to treat cancer later regrets the decision, a new study shows. And surprisingly, regret is highest among men who opt for robotic prostatectomy, a minimally invasive surgery that is growing in popularity as a treatment.

The research, published in the medical journal European Urology, is the latest to suggest that technological advances in prostate surgery haven’t necessarily translated to better results for the men on which it is performed. It also adds to growing concerns that men are being misled about the real risks and benefits of robotic surgical procedures used to treat prostate cancer.

Of the 219,000 men in the United States who learn they have prostate cancer each year, nearly half undergo surgical removal of the gland, according to the National Cancer Institute.

Duke University researchers surveyed 400 men with early prostate cancer who had undergone either a traditional “open” surgical procedure or newer robotic surgery to remove the prostate. Overall, the vast majority of men were satisfied. However, 19 percent regretted their treatment choice. Notably, men who had undergone robotic surgery were four times more likely to regret their choice than men who had undergone the open procedure.

Researchers say the higher level of regret among robotic patients suggests that they had higher expectations for their recovery, possibly because the robotic procedure is widely touted as a more innovative surgery than traditional prostatectomy. Even among men who had the same scores on erectile function and other measures of post-surgery recovery, the robotic patients still reported a higher level of dissatisfaction and regret than other men.

Part of the problem may be that doctors who perform robotic prostatectomies commonly cite potency rates as high as 95 percent and above among their patients, giving patients an unrealistic view of life after surgery.

But the data are highly misleading. Researchers often define potency as simply being able to achieve an erection that is “adequate” for intercourse — but for many men, that definition doesn’t capture their ongoing struggle to return to a normal sex life. Earlier this year, researchers from George Washington University and New York University used a more realistic definition of potency, showing that after surgery, fewer than half of the men studied felt their sex lives had returned to normal within a year.

Another important finding of the new research showed that men were less likely to regret their choice shortly after surgery. The men who were long past surgery experienced more regret. That finding likely speaks to the fact that as time passes after surgery, men gain a more realistic view of lingering health and quality-of-life issues like erection problems and other changes in their sex lives.

The Duke researchers said that the study shows urologists need to communicate more carefully the risks and benefits of the treatment prior to surgery so that men have more realistic expectations of what to expect.

To learn more, read “Sex After Prostate Cancer,'’ a Well blog post that includes my column about the issue as well as numerous comments from men and women about the aftermath of prostate cancer treatment

Significant long-term impairment in prostate cancer patients

Significant long-term impairment in prostate cancer patients

By Liam Davenport

31 December 2008

Int J Radiation Oncology Biol Phys 2008; 73: 30–38

MedWire News: Long-term prostate cancer survivors experience significant bowel, urinary, and sexual problems, say Dutch scientists who call for a focus on such problems after treatment.

Due to treatment improvements and earlier detection of prostate cancer, the majority of patients survive for at least 5 years after diagnosis. Despite importance of information on disease-specific complaints of long-term prostate cancer survivors, there have been few relevant studies.

Floortje Mols, from Tilburg University, and colleagues sent a questionnaire to 964 prostate cancer patients diagnosed between 1994 and 1998 who were alive in 2004, of whom 81% responded. These were compared with a normative reference population of 3892 men without a history of prostate cancer screened for the disease.

The questionnaire included the Expanded Prostate Cancer Index, a Dutch sexual activities model and three in-depth questions. The patients were treated with radical prostatectomy (193 patients), external beam radiotherapy (263 patients), primary hormonal therapy only (60 patients), or watchful waiting (56 patients).

Radical prostatectomy patients were significantly younger than those treated with radiotherapy, hormonal therapy, or watchful waiting, at an average of 72 years at the time of the survey versus 76 years, 77 years, and 76 years, respectively.

Compared with patients treated otherwise, radical prostatectomy patients had significantly and clinically relevant worse urinary function, while radiotherapy patients had significantly and clinically relevant worse bowel function, bother, and summary scores than other patients.

Prostate cancer survivors had significantly worse urinary and bowel functioning compared with the reference group, with urinary incontinence reported by 23%–48% of survivors versus 4% of controls, bowel leakage recorded in 5%–14% versus 2%, respectively, and erection problems reported by 40%–74% versus 18%, respectively.

“In conclusion, we have demonstrated that differences in prostate-specific problems exist between treatment type and years after diagnosis,” the team writes in the International Journal of Radiation Oncology • Biology • Physics.

“Comparison with an age-matched normative population without prostate cancer showed us that these problems cannot be explained merely by age. Nevertheless, this study was cross-sectional, and our results need to be verified in longitudinal studies.”