New Books Stir Debate on Prostate Cancer Therapies



April 27 2005 Two new books about prostate cancer Dr Peter Scardinos Prostate Book The Complete Guide to Overcoming Prostate Cancer Prostatitis and BPH and Surviving Prostate Cancer Without Surgery The New Gold Standard Treatment That Can Save Your Life and Lifestyle are drawing attention to the ongoing medical controversy over what doctors believe to be the best type of treatment for this disease With the PSA blood test widely used for screening since the 1990s more men are being diagnosed and treated early with physicians now recommending a variety of curative treatments depending on their particular specialties The choice most often comes down to surgery versus radiation with or without some form of hormonal therapy In the past most patients had their prostates surgically removed with the procedure known as radical prostatectomy But with recent changes in insurance coverage and Medicare reimbursements there is a growing trend among mainstream patients who are turning to high tech radiation therapies in order to avoid the risk of surgical side effects such as sexual dysfunction and incontinence Reflecting these changes in the field the two most recent books were written by doctors from different specialties and they present often opposing viewpoints on treating prostate cancer Dr Peter Scardino a urologist at Manhattans Memorial SloanKettering Medical Center provides a surgical perspective in Dr Peter Scardinos Prostate Book In a recent interview with Michael Milkens National Prostate Foundation Dr Scardino compared the cure rates for the most common types of treatment With surgery three out of four men are totally cured With radiation the cure rate is two out of three Dr Scardino also suggests in his book that surgery has a favorable complication rate profile compared even with the more popular noninvasive therapies such as radioactive seed implants also known as brachytherapy The other prostate cancer book Surviving Prostate Cancer Without Surgery was cowritten by a radiation oncology team at the Dattoli Cancer Center Brachytherapy Research Institute in Sarasota Florida The group is under the direction of Dr Michael Dattoli who specializes in brachytherapy and Intensity Modulated Radiation Therapy IMRT Dr Dattoli stated in a recent press release The greater than 10year diseasefree survival rate for patients who have completed our brachytherapy protocol is superior to surgical removal of the prostate with far less risk of complications such as erectile dysfunction and incontinence Even higher risk patients those with high PSA values and high Gleason scores have enjoyed a greater than 80 survival rate Relying on their own studies and published research data the two specialisits come to different conclusions when evaluating the pros and cons of the currently available treatment options Traditionally urologists were reluctant to refer prostate cancer patients to radiation oncologists because of the technical complexity of radiation procedures and lucrative payments made for radical surgery But the most recent CMS Medicare statistics indicate that more patients in the over65 age bracket are choosing brachytherapy rather than surgery That age group accounts for more than 70 of all prostate cancer patients In 2001 49985 Medicare patients underwent brachytherapy compared to 30783 patients who had radical prostatectomies Both types of treatment continue to be recommended to early stage patients and are proliferating however many urologists now offer patients a choice of either radical surgery or brachytherapy The books have stirred debate among patients in prostate cancer support groups and on Internet forums Because there are as yet no randomized studies that definitively compare the competing treatments that debate is likely to continue with physicians presenting their own results to try to sway patients toward one treatment or the other Peerreviewed studies by Dr Scardino and Dr Dattoli can be obtained on the PubMed Web site httpwwwncbinlmnihgoventrezqueryfcgidb=PubMeditool=toolbar Dr Peter Scardinos Prostate Book The Complete Guide to Overcoming Prostate Cancer Prostatitis and BPH by Peter Scardino Judith Kelman Hardcover 496 pages Pub Avery 4705 List Price $2795nbspnbspnbsp ISBN 1583332200 Surviving Prostate Cancer Without Surgery The New Gold Standard Treatment That Can Save Your Life and Lifestyle by Michael Dattoli Jennifer Cash Don Kaltenbach Paperback 284 pages Pub Seneca House Pathway Books 32805 List Price $1895 ISBN 0964008882



New Books Stir Debate on Prostate Cancer Therapies