STEP 2

Browse The ACOR Prostate Archives

Now that I had a basic understanding of the treatment options I logged in to the ACOR web site. The first thing I did here was just read the recent discussions about treatment options.

After reading for awhile, it became clear to me that there is great debate as to what the best treatment is.  Specifically, in younger, healthier individuals, there is great debate about surgery versus radiotherapy (especially the seed implants).

It also became clear that a discussion of potential side effects is crucial since the side effects include the possibility of erectile dysfunction and urinary incontinence.  Obviously, these are major issues and men who have to decide on treatment need to know as much as they can.

After reading the most recent posts, I then searched the archives for specific terms such as seed implants, radiotherapy, watchful waiting, active surveillance, radical prostatectomy, laparoscopic radical prostatectomy, robotic-assisted laparoscopic prostatectomy, and brachytherapy.

Here is a summary of my general and personal impressions after I had spent some time reading the treatment reviews at www.cancer.gov and browsing the ACOR prostate archives:

§        There is controversy about the best method of treatment.

§        Watchful waiting seems best for older men and seems now to be less recommended for younger, healthier men who would be able to tolerate treatment.

§        The results of laparoscopic prostatectomy seem to be as good as, or possibly even better than the results from open radical prostatectomy, especially in relation to possible lower side effects.

§        The results of robotic-assisted prostatectomy appear to be as good as, or possibly even better than the results from open or even laparoscopic prostatectomy.

§        Both the laparoscopic procedure and the robotic-assisted procedure are relatively new and there is no long term data comparing the results of these procedures to traditional open prostatectomy.

§        Brachytherapy (surgical implantation of radioactive seeds) plus external radiation is another option. Cure rates seem similar although the initial side effect profile is better.

§        If one elects for radiation therapy there is a chance of a second cancer developing 15-20 years later.

§        There is a learning curve for both the laparoscopic and robotic- assisted surgery – anywhere from forty to a few hundred procedures. The results of these new procedures seem to depend very much on the surgeon’s experience.

§        There are a number of surgeons who are considered experts in their respective areas of expertise. From The ACOR mailing list I discovered who are considered the top laparoscopic, the top open, and the top robotic-assisted surgeons.

§        Studies have shown that each specialist will tend to recommend their therapy. In other words, surgeons tend to recommend surgery and radiation oncologists tend to recommend radiation therapy all things being equal. I concluded that getting opinions from different specialists is important.

                                               NEXT           PREVIOUS