Prostate cancer ultrasound treatment as effective as surgery or radiotherapy – an article by Imperial College London.
This is a ground-breaking and game-changing study for males. For may years, the only curative treatment for males with prostate cancer that had not spread outside the prostate was surgery or radiation therapy.

What is particularly exciting about this study, is that many of these patients were “high-risk,” meaning they could have a PSA of at least 20, a Gleason Score of 8-10, and or presumed extraprostatic extension on digital rectal examination.
Now we have data indicating that a large percentage of patients diagnosed with prostate cancer can have treatment equal to the efficacy of surgery or radiation, with a significantly reduced incidence of urinary incontinence and/or erectile dysfunction. Keep in mind, however, that it has only recently been FDA-approved in the U.S., so success can be operator dependent.

 

July 23rd, 2019

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woman in a lab

“Circulating Tumor Cells Predictive of Adjuvant Radiotherapy Benefit in Early Breast Cancer” – an article from Cancer Therapy Advisor can be accessed here.

This article validates what I have been proposing for quite some time; we should be checking for circulating tumor cells (CTCs) in early stage cancer.

In the US, we have a test called CellSearch, to search for CTCs in breast, prostate, and colorectal cancer. This test is FDA approved to help physicians make clinical decisions in patients with metastatic breast, prostate, and colorectal cancer.

We know the greater the number of CTCs, in a patient with metastatic cancer, the worse the prognosis. This study found that approximately 20% of patients with early stage breast cancer had CTCs. This study also showed that more aggressive treatment, adding radiation therapy, in those with CTCs, improved survival.

One of my mantras has always been, “the practice of medicine lags far behind the science of medicine.” This scientific data can and should be applied to the practice immediately. On early stage cancers, we should be checking for CTCs. If we are dealing with breast, colorectal, or prostate cancer, we can use the CellSearch test for those in the U.S. If it is a different type of cancer, we will need to send the patients’ blood outside of the country (such as a lab in Germany), where they test 6 other genetic markers for CTCs. If the patient has early stage cancer and CTCs, in my opinion, the adjuvant or neoadjuvant treatment should be continued until the CTCs are zero.

February 7th, 2019

Posted In: cancer care

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