Per the NCCN guidelines, the treatment options for High-Risk prostate cancer are surgery, beam radiation, or a combination of beam radiation plus radioactive seeds. Hormonal therapy (with Lupron for example) is usually given along with the radiation for two to three years. But patients certainly wonder if one of these three treatment options is better than the other two. A study published recently in the October 2016 issue New England Journal of Medicine compared surgery and beam radiation prospectively in men with mostly Low-Risk prostate cancer. It showed equivalent survival rates. A prospective study for High-Risk prostate cancer, however, is unavailable. Only retrospective studies are available.

PCRI's free Helpline connects patients and caregivers with educational advocates and helps them understand their personal case. This article is a top ten frequently asked questions list that our Helpline receives. 

AUA is an annual meeting of urologists where data from new studies are presented. This data is presented in abstracts, or summaries of the entire peer reviewed articles. In this article, Mark Scholz, MD, analyzes the data and explains the practical implications of these new studies.

In this blog PCRI presents an interview from our contributing partner, Prostatepedia. 

Prostatepedia spoke at length with Dr. Laurence Klotz about why testosterone levels are significant in prostate cancer. Dr. Laurence Klotz is an esteemed Urological Oncologist from the University of Toronto. He is one of the driving forces behind the development of active surveillance as a viable approach for men with slow-growing, non-aggressive prostate cancer. Here is the interview:

LDR (low dose rate) brachytherapy for prostate cancer is more commonly known as seed implants. You may be familiar with this treatment option but for those of you who may be new to the confusing world of prostate cancer treatment, seed implants involve the insertion of small radioactive pellets or seeds into the prostate by transrectal ultrasound guidance, in order to deliver a focused dose of radiation to the prostate.

New prostate cancer drugs come to market quite rarely because the studies mandated by the FDA cost hundreds of millions of dollars. The FDA requires these studies to randomly allocate men into two comparison groups. One group receives the new medicine being tested. The other group gets an ineffective fake, called a placebo. Assuming the study is performed in an acceptable manner, the FDA will approve a new drug for commercial use, only if the men who are receiving the new medicine outlive those treated with the placebo by a specified margin without excessive toxicity.

Selecting a treatment for prostate cancer is increasingly complex. In an effort to help my prostate cancer patients navigate the complexities of this process, I routinely frame the discussion around these three rules:

Rule #1: If you listen to enough people you will hear just about anything.

Radium-223 (or Alpharadin) is a new targeted alpha-emitting agent which has shown a prolongation of survival in castrate-resistant prostate cancer patients with bone-metastatic disease (5). 

Despite the significant advances in treatment options, there is still considerable uncertainty—even among doctors—about how or even whether to treat prostate cancer. The treatment controversy is the prostate cancer equivalent of a Dempsey-Firpo fight: the proponents of surgery slugging it out with those who favor some form of radiation.

In reality, there is no “good” treatment for prostate cancer. Sure, some men can luck out and are happy to talk about it. But more frequently, when men are asked how they are doing after surgery, they say they are fine, even when they are not. No man likes going public about his lost sexuality.  And there is little value in bemoaning what can’t be changed.