BEST TREATMENT FOR LOCALIZED PROSTATE CANCER.
Report #7287
All men who live long enough will develop prostate cancer. Of all definitive treatments for localized prostate cancer, the one least likely to cause impotence and incontinence is based on radioactive implants.
Most cases of prostate cancer in men over 70 do not need treatment as it is usually a slow-growing disease that takes many years to spread through the body. Once prostate cancer has spread, there is no cure and the treatment is with hormone manipulation to slow it down. However, when men under 70 develop localized prostate cancer that has not spread to other parts of their bodies, treatment is to destroy the cancer by beaming radiation at the prostate, cutting out the prostate or implanting radio-active needles into the prostate. Shining a radioactive beam on the prostate destroys tissue randomly, causing terrible discomfort, impotence and incontinence. In spite of earlier reports, surgery also has a high incidence of impotence and incontinence. The safest treatment is to first shrink the prostate with injections of medications, such as Leupron, and then planting many radio-active needles into the prostate. This is less likely to cause impotence and incontinence.
By Gabe Mirkin, M.D., for CBS Radio News
1) VE Arterbery, A Frazier, P Dalmia, J Siefer, M Lutz, A Porter. Quality of life after
permanent prostate implant. Seminars in Surgical Oncology 13: 6 (NOV-DEC 1997):461-464.
Address VE Arterbery, Crittenton Hosp Radiat Oncol, Karmanos Canc Inst, 1101 W Univ Dr,
Rochester, MI 48307 USA. Urinary symptoms such as nocturia, hesitancy, frequency, and
dysuria were the most pronounced in the first few months after the implant and then
decreased in most of patients; 40% noticed that they urinated more frequently and 17% had
mild dysuria. All patients denied hematuria and none reported incontinence. Few patients
reported any psychological distress or disruption in social or family life; none reported
disruption in economic status or viability. All fifty-one patients said that they would
have an implant again as definitive treatment. Seventy-nine percent reported an excellent
quality of life post-implant. While survival is clearly a central goal of treatment for
prostate cancer, the nature of this malignancy compels clinical attention to the quality
of the patient's life after treatment. Sexual quality and function are maintained in the
majority of patients and there is minimal interruption of their social and economic
function. Semin. Surg. Oncol. 13:461-464, 1997. (C) 1997 Wiley-Liss, Inc.
Checked 8/9/05; see report #1434.