Archive for the ‘prostate cancer and radiation’ Category

Percutaneous Tibial Nerve Stimulation Is an out patient office based procedure for overactive bladder and is offered at Northeast Ga. Urological Associates.

It is also effective for men who have urinary frequency and urgency after radiation or prostatectomy for prostate cancer.

For more details go to ptnsinfo.com or call Christy Woodruff N.P.,NP-C. at 770-535-0001 ext 126.

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when you say your are sorry...stop right there....no need to say "but.....

What makes my book special ( I think ) is the attention that only a urologist who has been through the prostate cancer process and treatment could make of the voiding issues. That’s what urologists do…we are human plumbers. We understand how men void, the difference between obstructive (slow stream) and irritative (frequency, urgency, getting up at night) and the medicines and surgeries used for each. It is confusing. In my book there is a very large chart showing the differences in each and how all the treatments affect each.

I once wrote on a prescription pad the symptoms and the meds for each for another doctor. A year later, he pulled it out of his wallet to use to treat a patient in my presence and said, ” John, you just would not believe how many times I have used your little cheat sheet!”

Back to the question. Obstructive…i.e. an  enlarged prostate, slow stream, secondary frequency and nocturia, stop start stream, no pressure, small caliber…….”You can’t piss and run under it.”

If you have obstructive symptoms and want to do radiation you had better beware!

If you want radiation and you have obstructive voiding symptoms…you can fix the symptoms before but not after. Things don’t heal well after radiation.

So….you have big prostate and obstructive symptoms and you want radiation, particularly seeds….

  • Microwave therapy
  • Laser prostatectomy
  • TURP
  • Maximum medical therapy if with very good response

After the above…then seeds…in most cases of prostate cancer with favorable pathology, the delay of a month or so is not a medical issue.

When  it comes to obstructive voiding symptoms and a male that want to do radiation…..

“It is better to cure at the beginning, than at the end.”

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the pepster at sunset in "her vest"

 From “The Decision”

around the tube through which you "pee" are 100 radioactive seeds...any wonder there will be voiding symptoms?

if you don't understand this fully... you cannot make an informed decision specific to you

Study this… and I’ll explain tomorrow.

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pretty in pink

Removing the prostate is a simpler concept for me to get. If the cancer is only in the prostate and you remove it, all the cancer in the gland will be gone. This study suggests to me that if the cancer is only in the prostate then ,depending on the amount of radiation that is used or concentrated on the prostate, the cancer is not killed in a certain percentage of the time. The newly diagnosed prostate cancer patient should consider this information particularly if he is young or his health is such that his longevity exceeds ten years. The above is a big reason I chose to pursue removal over radiation. The decision would be different for the 70-year-old male with marginal health, in him radiation or surveillance makes more sense.
High doses required for optimal local control after prostate brachytherapy
By James Taylor
05 March 2010
Int J Radiat Oncol Biol Phys 2010; 76: 355–360

MedWire News: Prostate cancer patients treated with permanent prostate brachytherapy (PPB) who receive a biologically effective dose (BED) of more than 200 Gy achieve significantly better local control than patients who receive lower doses of radiation, researchers report.

Improved local control in turn increases biochemical freedom from failure (bFFF) and survival rates, say Nelson Stone (Mount Sinai School of Medicine, New York, USA) and colleagues in the International Journal of Radiation Oncology Biology Physics.

Stone et al analyzed data from 584 patients receiving PPB alone or PPB with external beam radiation therapy (EBRT) who agreed to undergo prostate biopsy 2 years after implantation and thereafter yearly if results were positive or if their prostate-specific antigen (PSA) level increased. Short-term hormone therapy was used by 280 patients.

Over a median follow-up of 7.1 years, prostate biopsy results were positive for 48 (8.2%) patients. In all, 3.1% of patients who received a BED of more than 200 Gy had positive biopsy results versus 6.1% of patients receiving >150–200 Gy and 18.2% of patients receiving no more than 150 Gy, giving significant differences among the groups.

Furthermore, bFFF rate by prostate biopsy result was 84.7% for patients with negative results versus 59.2% for those with positive results , and cause-specific survival was 99.2% for patients with negative prostate biopsy results versus 87.6% for those with positive findings. Again, both differences were significant.

Stone et al comment: “One of the advantages of using the BED to investigate the radiation effects on local control is that it allows other investigators to compare their outcomes regardless of the type of radiation used.”

For example, they explain that “a BED of more than 200 Gy can be achieved with postimplant D90s of I-125 of 188 Gy, Pd-103 of 167 Gy, and combination therapy with ERBT (25 fractions of 1.8 Gy) for I-125 of 110 Gy and for Pd-103 of 102 Gy.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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