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Archive for the ‘Radical prostatectomy’ Category

PROSTABLOG NZ: My last PSA test recently showed it continues to be undetectable, some 20 months after my surgery in March, 2009.

But I’m not getting cocky just yet (forgive the pun).

From what I’ve read about prostate cancer treatment, if the cancer bug has got out of the organ during/after a prostatectomy, there’s a good chance the first signs will come two years after the operation.

My two-year anniversary comes up in a couple of months – so wish me luck.

It’s interesting how long it takes to fully recover from the surgery’s effects.

My scar is virtually gone and I’ve felt fit for ages.

There’s no incontinence. I haven’t done the pelvic floor exercises for more than a year, but there’s never any problem with not being able to hold it in, even when I’m busting.

Not that I put myself in the busting mode if I can avoid it.

So, hey, no regrets and no real worries. I’m bloody lucky.

Well, there is one worry – the number of friends and people I know who have been diagnosed. Talk about an epidemic.

And I wonder if the NZ Parliamentary Health Select Committee will ever get round to reporting back on its prostate cancer inquiry…

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URO TODAY: Men undergoing prostate surgery have a higher risk of later developing a penis-deforming condition called Peyronie’s disease. READ MORE>

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URO TODAY: Having erectile dysfunction prior to prostate cancer surgery does not affect you chances of surviving the treatment, a study shows. READ MORE>

Pre-operative erectile dysfunction is associated with decreased overall survival and survival from causes other than prostate cancer following radical prostatectomy.

However, pre-operative ED was not an independent predictor of overall survival after adjusting for other predictors of survival.

Urologists should carefully assess pre-treatment ED status to enhance appropriate treatment recommendation for men with prostate cancer.

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URO TODAY: Use of a carbon dioxide laser to assist in robot-assisted radical prostatectomy improves nerve sparing and reduces damage that can cause impotency. READ MORE>

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URO TODAY: Robot-assisted surgery for prostate cancer is now the preferred method in the US, where a study says its benefits outweigh other methods. READ MORE>

While cost remains a valid criticism to the robotic technique, some of the additional expenditure is offset by improved convalescence, fewer medical complications, and decreased morbidity.

Data with follow up approaching 10 years demonstrates equal if not superior outcomes with respect to continence, sexual and oncological factors.

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URO TODAY: Only 38% of men treated with radical prostatectomy, if able to choose, would unconditionally accept radical prostatectomy again for treatment. READ MORE>

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URO TODAY: Prostate cancer patients with localised disease but positive margins do derive a survival benefit from adjuvant radiation therapy, a new study has found. READ MORE>

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URO TODAY:  The five main prostate cancer treatments can all have bad side effects, so a panel of 15 specialists have compared them and come up with some recommended improvements.

Prostate cancer (PC) is one of the tumours with the highest incidence in recent years. PC therapies have several adverse effects.

A panel consensus recommendation has been made to prevent or ameliorate complications in PC treatment to improve quality of life.

Fifteen specialists have met to analyse the different toxicities associated with PC treatment.

Each medical specialist searched National Library of Medicine PubMed citations about these secondary effects and his specialty from 1999 to 2009 to propose measures for their prevention/amelioration.

  • Surgery is associated with incontinence and impotence.
  • Radiotherapy can produce acute, late urological and gastrointestinal toxicity.
  • Brachytherapy can produce acute urinary retention.
  • Chemotherapy is associated with haematotoxicity. peripheral neuropathy and diarrhoea.
  • And hormone therapy can produce osteoporosis, metabolic syndrome, cognitive and muscular alterations, cardiotoxicity, etc.

Improvement in surgical techniques and technology (IMRT/IGRT) can prevent surgical and radiotherapeutic toxicity, respectively.

Brachytherapy toxicity can be prevented with precise techniques to preserve the urethra.

Chemotherapy toxicity can be prevented with personalized schedules of treatment and close follow-up of iatrogenia

And hormone therapy toxicity can be prevented with close follow-up of possible secondary effects.

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PROSTABLOG NZ: Sooo…another nil PSA test, 60 weeks after the prostatectomy.

So far, so good.

I guess the next hurdle is two years out (from the surgery on March 25, 2009), when – according to the reading I’ve done – if the prostate cancer is going to flare up again, that’s when the first sign is likely to show in rising PSA.

Here’s my PSA readings over the past couple of years:

  • August 30, 2007: 0.9
  • November 28, 2008: 0.7 – this was when a digital exam first discovered cancer.

MARCH 25, 2009: Radical prostatectomy

  • August 6, 2009: <0.05
  • January 29, 2010: <0.05
  • May 21, 2010: <0.05

Note the PSA was never very high, which reinforces the message I give to anyone who’ll listen – get both the PSA and the digital exam, because some of us don’t show on PSA.

I’m hoping that no longer applies, of course. If I have recurrence, I want something to show up.

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SCIENCE DAILY: A combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival. READ MORE>

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