Conquer Prostate Cancer Now

Prostate Cancer Treatment in the form of Robotic Surgery Isn't Foolproof

No prostate cancer treatment is foolproof. Errors can occur, at least some of the time. This was reflected in a recent edition of the Journal of the American Medical Association (October 16, 2009). 

When comparing prostate cancer treatments a national study concluded that robotic surgery can result in more complications than standard prostate cancer surgery. That's not a new conclusion, but I'd like to respond to these findings anyhow.

Prostate Cancer Treatment: Will a New Scientific Finding Make "Watchful Waiting" (aka, "Active Surveilance") More Viable?

Prostate Cancer treatment, following an early stage diagnosis, tends to be aggressive in American medical circles. After consulting with their doctors, half of nearly 200,000 patients each year opt for surgery (primarily robotics), and the remainder generally choose some form of radiotherapy. Relatively few select High Intensity Frequency Ultrasound (HIFU) or cryotherapy, which respectively use hot or freezing temperatures to eradicate a man’s tumor. 

Prostate Cancer Surgery after a Steep Gleason Score Jump

Q: My biopsy Gleason score recently jumped to a 9 (out of 10), so there's no question my prostate cancer is more aggressive than I thought it was. I've decided to have robotic surgery. How likely is it that I'll have a prostate cancer recurrence some time after my cancerous prostate is removed?

-D.

Most Prostate Cancer is Localized

This week a London Mail Online interviewer spoke with three of Britain's leading urologists, who did a masterful job of listing the "pros" and "cons" of each prostate cancer treatment option. After the review the reporter indicated that a Gleason score of 1-6 is least aggressive (mild), 7 is intermediate, and 8-10 is most aggressive.

In point of fact, other doctors divide these categories into 1-4, 5-7, and 8-10. Furthermore, it should be underscored that all three categories refer to cancers localized within the prostate. These prostate cancers have not metastasized to other parts of the body such as a man's bones or upper extremities.

Christmas Day News about Prostate Cancer Surgery

Christmas Day, with its multi-colored trees and pageantry, enjoyed by Christians and non-Christians alike, is coming to an end as I write these lines at 11:45 pm on December 25, 2008. Whether you observe Christmas or Hanukah or Kwanzaa, this is a time to focus on light and hope in the face of darkness and despair, both past and present.

 

It's with this in mind that I wrote a letter-to-the-editor of the New York Times after reading an extensive description of prostate cancer treatment in this morning's special news edition. For your interest I've reproduced my thoughts below, penned just an hour ago. I hope these words will serve as a reminder that whatever treatment option you or those you love end up choosing to treat prostate cancer, there's always room for hope.

Prostate Cancer Treatment - Cut or Wait?

Question: Why do you advocate robotic surgery when a patient and doctor feel that's the best way to go after a low-grade prostate cancer is first diagnosed? What's wrong with waiting until you see if things might get worse, before you choose surgery?  - Martin G.

Answer:

I'm an advocate of robotic surgery when appropriate, but would not dismiss active surveillance, as it is now called, when indicated.

My only question after a low-grade prostate cancer is diagnosed is whether an annual biopsy will actually detect if a man's tumor has advanced. As far as I know, biopsies are done randomly (that is, the needle probe tests random prostate locations for cancer). 

In my own case, a previous biopsy missed prostate cancer two years before a followup biopsy, in spite of an elevated PSA score. That first one was a "miss," but my biopsy two years later was unfortunately a "hit".

It is possible that a second biopsy might not catch the spread of a cancerous tumor, even if the original biopsy discovered it at another location an earlier stage. For that reason surgery (of the robotic sort, to make for a more pain-free recovery) was the route I took.

Rabbi Ed Weinsberg

I invite the comments of doctors or fellow survivors. Do you agree or not, and please tell us why?

Real Men, Lupron, and Prostate Cancer

New York Times editor, Dana Jennings, has written an ongoing series of insightful articles on experiencing prostate cancer and its side effects. His most recent column is “Real Men Get Prostate Cancer”, and it’s worth reading. (See http://well.blogs.nytimes.com/2008/11/18/real-men-get-prostate-cancer/#comment-112157.) My response to his thoughts follows.

-Rabbi Ed Weinsberg, Moderator, www.ConquerProstateCancer.

Hi, Dana,

Your openness is both astonishing and reassuring for prostate cancer patients and survivors like myself.

Prostate Cancer Treatment? What You Need to Know First

 

It's clear that physicians don't know everything, but many docs (not all) have a hard time admitting it, even if they are relatively knowledgeable, caring folks.  And why should they admit to ignorance about matters big or small, given their many years of education and experience in their speciality!  For all that, denying any shortcoming is a professional and personal character flaw that can come to haunt us.

I believe the fault lies as much with the patient as the doctor. For instance as a prostate cancer patient 1 1/2 years ago, I learned the hard way that a doctor must earn a patient’s trust.  At that time, my first urologist, whom I call "Dr. Jones" in my new book Conquer Prostate Cancer, administered Lupron  hormone, deliberately bringing me to castrate level to shrink my prostate  and prevent my malignant tumor from growing further.