7 replies to this topic

[Lazarus Long]

I would like to try and enlist help from all who read this. My best friend was diagnosed last week with Prostate Cancer. All six biopsies of the gland came back positive but he is still in the "Stage Analysis" phase. I will know more by next week.

The purpose of this post is to address this forum for an evaluation of this issue as the procedures that are available are vast and getting larger. The quality of the healthcare practitioners also varies widely and I would like informed opinions and experiences to share with him.

I would also ask that analysis of the newest techniques be encouraged. In particular this example caught my attention. I have been researching the options of a new treatment being developed in Japan ( http://aolsvc.health...0000_0000_f1_04 ) that uses focused Ultrasonic beams to lyse the malignant cells has caught my attention.

The idea of using non-nuclear wave radiation and diffraction to selectively attack cells that they are specifically tuned to makes a lot of sense. It also offers hope in many other areas of cancer and disease treatment. It is an offshoot of lithotripsy and I see potential from this fall out in other ways as we are able to focus field effects from Magnetic Resonance, holographic microwave diffraction and a combination of these and other field generating methods. The key seems to be being able to select exactly where the highest energy emanations are as well as to fine tune the character of the non nuclear radiation to kill one type of tissue and not adjacent organ tissues necessary for life support.

Here is the article from the above link for those that can't retrieve it from AOL:

Ultrasound Zaps Prostate Cancer

By Jennifer Warner
WebMD Medical News Reviewed By Dr. Gary Vogin
March 26, 2002 -- Men with prostate cancer may soon have a new, less invasive treatment option that promises fewer side effects. Japanese researchers are reporting 100% success in early tests of a high-intensity focused ultrasound treatment that zaps localized tumors.


Prostate cancer is the second leading cause of cancer-related deaths in the U.S. and the most common cancer among men. Although surgical treatment for prostate cancer (radical prostatectomy) can be successful, the surgery can be risky for some. Another conventional cancer treatment option, radiation therapy, can also cause significant side effects such as erectile dysfunction and incontinence.


Those problems have prompted a recent surge in the development of alternative treatments to treat early-stage prostate cancers. But many of these less-invasive procedures don't always completely eliminate the cancer, and some treatments can't be repeated if the cancer comes back.


In a study published in the journal Urology, Japanese researchers tested a new method that uses high-intensity focused ultrasound (HIFU) to deliver intense sound energy to destroy the tumor without damaging the surrounding tissue. Twenty patients with prostate cancer that had not spread beyond the prostate gland received the HIFU treatment either once or twice.


After six months, all 20 patients were cancer-free and had no elevations of PSA (prostate-specific antigen, a substance in the blood that doctors use to monitor prostate cancer). Side effects included difficulty urinating in the first two months after treatment, but the symptoms were easily treatable with medications.


In addition, three of the 10 patients developed erectile dysfunction after HIFU treatment.


In an editorial accompanying the study, John M. Fitzpatrick, MCh, FRCSI, FEBU, of Mater Misericordiae Hospital and University College in Dublin, Ireland, says much more research is needed before HIFU can be used as a safe alternative to traditional therapies. He says the study has only shown that HIFU was effective in eliminating the cancer in the short term, and the frequency of side effects was still relatively high.


© 2002 WebMD Inc. All rights reserved.


Lazarus Long

[Bruce Klein]

I'm very sorry to hear about your friend... I hope he comes through this ordeal safely. I would also hope that he has a cryonics membership as a backup, but would guess not.

I'm going to just post this info as I come across it... as I learn about it...

Four methods are often used in the United States to treat prostate cancer today.

• The first is surgery to remove the cancer.
• The second is radiation therapy, which uses different types of high energy radiation to kill the cancer cells.
• The third is cryotherapy or cryoablation, which is a way of freezing the prostate to destroy the organ. (Cryotherapy is widely considered to be an experimental procedure at this time.)
• The fourth is hormonal therapy, in which different types of hormone are used on their own or in combination with other methods to stop the cancer cells from growing.

All these methods have benefits and risks. There is no one "right" way to treat prostate cancer.

What are the promising experimental treatments for prostate cancer? The most widespread form of experimental treatment for prostate cancer in the US today is probably cryotherapy (also known as cryosurgery and cryoablation). Many physicians and patients consider this form of therapy to be a major advance in the management of prostate cancer that is definitely confined to the prostate, offering benefits superior to those of radical surgery or radiotherapy. Other physicians argue that there is no data yet available to demonstrate the benefits claimed by the proponents of this new technique. Basically, cryotherapy involves controlled freezing of the prostate gland with liquid nitrogen to temperatures so low that the tissue is actually killed. Thus it is proposed to have effects comparable to radiation therapy. Until the completion of at least one well constructed clinical trial that carefully compares the results of cryotherapy to other forms of therapy in a randomized, controlled manner, we will not know whether cryotherapy actually offers superior or inferior results to any other possible form of therapy. Link

[Bruce Klein]

Cryotherapy or freeze therapy is a newer modality that is being used in some centers to treat initial or recurrent prostate cancer. Long term results are not yet available, but this new treatment may prove promising. It one of the few potentially curative treatments that can be given for local prostate cancer recurrence after radiation therapy or seeds. I may be offered as an alternative to Brachytherapy, (seeds), in patients who have urinary obstructive symptoms, as it helps to open the urinary channel over time.

Cryotherapy is frequently done as an outpatient procedure either at a surgicenter or a hospital. (Medicare at this time requires a hospital admission). Under regional or general anesthesia multiple small probes are placed under sonographic guidance, through the perineum, (area between rectum and scrotum), into the prostate. By circulating argon gas through the probes, the prostate and some surrounding tissues are converted into an ice ball. As the ice ball is repeatedly formed and thawed , the cells are killed, and the area shrinks and is eventually replaced by scar tissue. A catheter is left in place for a period of time, and the patient goes home the same day. Pain is minimal, but it takes a period of time for the killed tissue to pass and allow for normal voiding. Some patients require catheterization for several weeks to months or occasionally trans urethral surgery to remove the killed tissue.

Impotence occurs in virtually 100% of patients treated with cryotherapy as the nerves for erection lie on the surface of the prostate and are frozen as well. However as the technique develops, "nerve sparing" cryotherapy may become a reality. Incontinence, (loss of urinary control), may occur, but is not common.
Link

[Bruce Klein]

You may try asking the "experts":

At the Cancer Information Network, we understand that the diagnosis of cancer brings with them many questions and a need for clear, understandable answers.  That is why we have assembled a top team of board-certified oncologists to assist patients and caregivers understand the disease and treatment options

The Cancer Information Network

[Lazarus Long]

Thank you Bob and Bruce for the kind words. I have broached the topic of Life Style changes with him because he owns and runs his own auto shop and is constently exhosed to potential carcinogens. But there are two clearly divided decisions he must address, the first is what to do right now (by the way he has been diagnosed in Stage Two) and what to do in the Post Intervention period.

Some parts of the choices he has available for the second phase are determined by the choices he makes in the first, but general Lifestyle questions are best answered a few at a time to insure the best integration of change into daily life.

The big question is: Surgery versus treatment? and it all revolves around the fundamental question of leaving malignant tissue present within the body. The prostate is NOT a critical organ for life support. It does pose a serious risk to quality of life if the procedure fails, or if the cancer spreads to the nerve bundles or urethra. There is a very good reason to elect for removal once the problem is identified if there exists a reasonable probability of extraction without corrollary damage.

We were joking last night in our conference about how "Wouldn't it be nice if you wanted it treated if it could then be removed from the body and treated in a tank so as to minimize the risks of metastization. This way once the organ was working properly and with no malignancy present it could be returned to the body.

His response was to say: " You ain't putting that thing back inside me once it's out, no way, no how!"

The point of the debate is the delicate question of "How much risk of quality of life change to elect to face in order to protect your life. Clearly as long as the cancer is viable and encapsulated in the prostate it poses a serious threat of metastisizing and spreading throughout the body.

*On some levels his prostate may be considered a "filter" that has been removing toxic substances and getting fouled in the process. Not because it is blocked but because it has collected substances that have mutated the cell division process.

*(This is a personal viewpoint not substantiated fact. But there is room in our understanding of the process for constructive conjecture. Frankly we still don't understand what triggers the "program override commonly called cancer. )

He is relatively young, not overweight, non-smoker, athletic, in very good general health with a wonderful and supportive family. He is a prime candidate for surgery and the effectiveness of surgery is best when it is done as quickly and effeciently as possible. Viewing surgery as a fall back position often mitigates the final results of the procedure.

He is looking at alternatives and is still learning about them. He isn't too interested in cryo because it lacks any serious long term data and he wants to feel more assured as to the outcome of enduring the procedure. He is examing some of the treatment strategies that involve multiple approaches but again there is the nagging fear that the longer he leaves the prostate in his body the more chance he is giving it to spread the malignacy to other parts and the CAT & Bone scans have come back negative. So he would like to not put his lymphatic system or his nerve bundle and urethra in jeapardy (and only surgery can conclusively show they aren't involved and minimize the threat).

Anyway, I would love any links the readers have of this and in particular I invite any physicians with experience in these matters to also please weigh in. This isn't a symbolic debate for me it is the "Frontline" in a battlefield against death. The war for acheiving immortality is a total one and the battlefields are numerous but once the enemy is engaged it must be faught with a total committment to success for anything less offers victory to the enemy. Every battle counts and each is an opportunity to learn the weaknesses of the foe (death). We are not expendable.

[Bruce Klein]

We are not expendable

So very true, as Max More put it, something along the lines, "Humans are not disposable". If this is a war, then we've only just now defined the enemy, and I believe, we're still trying to rally the troops, we're still trying to alert our fellow members that there is impending danger.

Ahh, but we are moving in the right direction.

[Lazarus Long]

After I posted the previous articles my friend and I have been discussing these issues extensively to say the least. I should add that he has decided for the surgical option and is scheduled to undertake it on the 11th of Oct. After all this while reviewing a separate issue on which I will post I found this article which summarizes new finding that solidly supported both our logic and his decision.

The article is worth reading so I have included it in its entirety.

Men's Health & Prostate Cancer
Personal Time/Your Health
Prostate Cancer: Cut or Wait?
New evidence tips the balance toward surgical intervention. But you still may not live longer
BY CHRISTINE GORMAN


Tuesday, Sep. 17, 2002
Imagine an experiment in which a few hundred women with breast cancer are divided into two groups. Patients in one group have their tumors surgically removed, while those in the other wait patiently, keeping a close eye on the progress of their disease, and are treated only if their cancer starts to spread. Sound barbaric? Substitute prostate cancer for breast cancer, and that is pretty much what 700 Scandinavian men in the early stages of prostate cancer agreed to. The results, published in the New England Journal of Medicine last week, showed that the men who underwent surgery were half as likely to die of prostate cancer as those in the "watchful waiting" group.

Predictable as that conclusion might seem, doctors consider the study a landmark. Physicians have debated for years how aggressively they should treat cancer of the prostate. Because the disease tends to be very slow growing, many more men will die with prostate cancer than from it. Nobody wants to undergo surgery or radiation treatment if that can be avoided, especially because in the case of prostate cancer the side effects typically include impotence and incontinence. On the other hand, you don't want to die of prostate cancer if you can help it. If the cancer spreads to the bones, it can be excruciatingly painful, and once it spreads, death is often unavoidable.

What does this mean for you? The New England Journal study probably tilts the equation toward treatment — especially if you have early-stage prostate cancer and expect to live 10 more years. (On average, it may take such a tumor, if it recurs, a decade or more after treatment to cause death.) Watchful waiting probably makes more sense for older men, particularly if they are frail.

As with any other complex medical study, however, there are some tricky caveats. First off, prostate cancer is treated differently in Scandinavia, where watchful waiting is the norm, than it is in the U.S. Moreover, because Scandinavian men are not screened for prostate cancer as aggressively as American men, they tend to be older when they get their first diagnosis. And though the men in the surgery group were less likely to die of prostate cancer than the watchful waiters, it turned out there was no statistically significant difference in how long they lived.

Such a result is not as contradictory as it sounds. Given that follow-up averaged just over six years, it's quite possible that the study didn't last long enough to show an appreciable difference in the two groups' death rates. Even if it turns out that the men in the surgery group didn't live any longer and were merely spared death from prostate cancer, that's quite an accomplishment, says Dr. Patrick Walsh at the Johns Hopkins Medical Institutions in Baltimore, Md., who invented a widely used nerve-sparing prostate surgery. "If you had a choice of dying of prostate cancer vs. dying of a heart attack," he says, "you'd pick dying of a heart attack."

Still unknown is whether screening someone for prostate cancer with blood tests that look for prostate-specific antigen (psa) reduces the risk of death from prostate cancer. Studies designed to answer that question are under way. Until then, you will have to gather and weigh all the information you can when deciding how, or even whether, to treat prostate cancer.

For more information, search for "prostate" at
cancer.gov