Quality of Life After Radical Prostatectomy

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Quality of Life After Radical Prostatectomy"

Transcription

1 Quality of Life After Radical Prostatectomy Bernard H. Bochner, MD FACS Attending Surgeon, Urology Service Vice Chairman, Department of Surgery Memorial Sloan-Kettering Cancer Center

2 Quality of Life After Radical Prostatectomy Individual series data available HOWEVER: Poor characterization of patient groups (case mix) Variation in reporting method Different definitions for outcomes The lack of high quality evidence makes comparative evaluations between different treatments difficult No QOL data from randomized trials available

3 Health-Related Quality of Life Patient-centered variable taken from the field of health services research Can be measured reliably Questionnaires (instruments) are pilot-tested the validated Domains can be general or disease-specific Responses to items are scored and can be used to calculate a summary score for each domain

4 Patients; N=1201; Spouses, N=625 Treatment Modalities Radical Prostatectomy, N=603 Brachytherapy, N=306 External Beam Radiotherapy, N=292

5 Sexual function caused moderate or severe distress after 2 years: in 43% of men after RP, 37% after XRT and 30% after brachy; ED caused distress in 44%, 22% and 13% of partners. Urinary function lead to moderate or severe distress after 1 yr: in 7% of patients after RP, 18% after brachy, and 11% after XRT, and in 4-5% of partners. GI symptoms caused moderate or severe distress in 9% of patients (and 4-5% of partners) a year after radiation (brachy or XRT).

6 Figure 1. Changes in Quality of Life after Primary Treatment for Prostate Cancer.

7 Surgeon Factor: Outcomes after Radical Prostatectomy To what degree are the outcomes of radical prostatectomy perioperative complications, urinary incontinence, erectile dysfunction, surgical margins and long term cancer control related to surgical technique in addition to the characteristics of the patient and the cancer?

8 Variability in 5-yr progression-free probabilities among experienced surgeons (>40 cases) adjusted for case mix p<0.0005

9 Heterogeneity in outcome among surgeons at MSKCC: full continence (no pads) Bianco et al J Urol 2010

10 Heterogeneity in outcome among surgeons at MSKCC: full potency (+/- oral agents) Bianco et al J Urol 2010

11 Effect of Surgeon and Hospital Volumes For Radical Cystectomy Adjusted Mortality operative mortality is largely mediated by surgeon volume. Patients can often improve their chances of survival substantially by selecting surgeons who perform the operation frequently. Birkmeyer et al, NEJM, 2003

12 Surgeon and Impact On Outcome After RRP: High Volume Surgeons Outcomes (%) Low Medium High Very high Surgeon Volume 0 Postoperative complications Late urinary complications Long-term incontinence Begg CB, Reidel ER, Bach PB, Kattan MW, Schrag D, WarrenJL, Scardino PT. Variations in morbidity after radical prostatectomy. NEJM 2002; 346:1142.

13 Surgeon and Impact On Outcome After RRP: Urinary Complications, High Volume Surgeons Expected (n=159) > 50 % Late Urinary Complications after RP (Bianco F et al. J Urol 2005)

14 Surgeon and Impact On Outcome After RRP: Urinary Complications, High Volume Surgeons Expected Observed p <.0001 % Late Urinary Complications after RP > 50

15 Achieving Optimal Outcomes after Radical Prostatectomy: The Trifecta Optimal outcome after RP is cancer control with full recovery of continence and potency. Individual studies report rates of ED, incontinence or cancer recurrence (rising PSA) in isolation. These rates do not adequately reflect the quality of the surgery nor fully inform patients of the probability of being cured of cancer and recovering normal urinary and sexual function ( Trifecta ). Saranchuk J, J Clin Oncol 2005; 23:4146

16 Cummulative Incidence Probabilities of Event Probability of recovering complete continence, normal erectile function and freedom from biochemical recurrence ( Trifecta ) after RP alone Trifecta Outcomes (Potent, Continent, PSA undetectable) Failure of RP to control prostate cancer N=647 Markov model Time (Months) from Radical Prostatectomy Cumulative probability of continence, potency and freedom from biochemical recurrence Probability of PSA recurrence

17 Variation among surgeons in achieving optimal results (TRIFECTA) Probability of being both potent and continent at 12 months

18 Cumulative Incidence of Recovery of Continence (No Pads or Leakage): Open vs. Lap RP Touijer A et al. J Urol 2008; 197:1811 Open Lap HR 0.56, p<.0005

19 QOL After Radical Prostatectomy Conclusion All treatments for prostate cancer adversely effect QOL Poor quality comparative data makes direct comparisons very difficult Surgical skill strongly associated with oncologic and functional outcomes after RRP Technology has not proven to provide major breakthrough in improved QOL over good open surgery.

Robotic Radical Prostatectomy: What s s the Advantage? Matthew T. Gettman, M.D. Associate Professor Department of Urology

Robotic Radical Prostatectomy: What s s the Advantage? Matthew T. Gettman, M.D. Associate Professor Department of Urology Robotic Radical Prostatectomy: What s s the Advantage? Matthew T. Gettman, M.D. Associate Professor Department of Urology Prostate Cancer Epidemiology: 2009 Estimated new cases: 230,000 Estimated deaths:

More information

Management of Localized Prostate Cancer. Treatment Options

Management of Localized Prostate Cancer. Treatment Options Management of Localized Prostate Cancer Surgery James A. Eastham, MD Chief, Urology Service Memorial lsloan Kettering Cancer Center Treatment Options 1. Active surveillance/watchful waiting 2. Focal therapy

More information

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative.

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative. Adjuvante und Salvage Radiotherapie Ludwig Plasswilm Klinik für Radio-Onkologie, KSSG CANCER CONTROL WITH RADICAL PROSTATECTOMY ALONE IN 1,000 CONSECUTIVE PATIENTS 1983 1998 Clinical stage T1 and T2 Mean

More information

Beyond the PSA: Genomic Testing in Localized Prostate Cancer

Beyond the PSA: Genomic Testing in Localized Prostate Cancer Beyond the PSA: Genomic Testing in Localized Prostate Cancer Kelvin A. Moses, MD, PhD Vanderbilt University Medical Center Wednesday, December 2, 2015 5:00 p.m. ET/2:00 p.m. PT About ZERO ZERO s mission

More information

Thomas A. Kollmorgen, M.D. Oregon Urology Institute

Thomas A. Kollmorgen, M.D. Oregon Urology Institute Thomas A. Kollmorgen, M.D. Oregon Urology Institute None 240,000 new diagnosis per year, and an estimated 28,100 deaths (2012) 2 nd leading cause of death from cancer in U.S.A. Approximately 1 in 6 men

More information

7. Prostate cancer in PSA relapse

7. Prostate cancer in PSA relapse 7. Prostate cancer in PSA relapse A patient with prostate cancer in PSA relapse is one who, having received a primary treatment with intent to cure, has a raised PSA (prostate-specific antigen) level defined

More information

Prostate Cancer Treatment Comparison

Prostate Cancer Treatment Comparison Prostate Cancer Treatment Comparison Treatment Comparative Data Outcome Comparison: Surgery vs. Radiotherapy Outcome Radical Prostatectomy* Radiation** Survival duration compared to conservative disease

More information

SRO Tutorial: Prostate Cancer Treatment Options

SRO Tutorial: Prostate Cancer Treatment Options SRO Tutorial: Prostate Cancer Treatment Options May 7th, 2010 Daniel M. Aebersold Klinik und Poliklinik für Radio-Onkologie Universität Bern, Inselspital Is cure necessary in those in whom it may be possible,

More information

Individual Prediction

Individual Prediction Individual Prediction Michael W. Kattan, Ph.D. Professor of Medicine, Epidemiology and Biostatistics, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Chairman, Department

More information

Summary of Harms from Screening and Treatment for Prostate Cancer

Summary of Harms from Screening and Treatment for Prostate Cancer DRAFT: Advice from Dr John Childs MoH advisor Summary of Harms from Screening and Treatment for Prostate Cancer There are minimal risks directly attributable to PSA testing or transrectal ultrasound (TRUS)

More information

Radiation Therapy for Prostate Cancer: Treatment options and future directions

Radiation Therapy for Prostate Cancer: Treatment options and future directions Radiation Therapy for Prostate Cancer: Treatment options and future directions David Weksberg, M.D., Ph.D. PinnacleHealth Cancer Institute September 12, 2015 Radiation Therapy for Prostate Cancer: Treatment

More information

Prostate Cancer Treatment Comparison

Prostate Cancer Treatment Comparison Prostate Cancer Treatment Comparison Treatment Comparative Data Outcome Comparison: Surgery vs. Radiotherapy Outcome Radical Prostatectomy* Radiation** Survival duration compared to conservative disease

More information

Does my patient need more therapy after prostate cancer surgery?

Does my patient need more therapy after prostate cancer surgery? Does my patient need more therapy after prostate cancer surgery? Contact the GenomeDx Patient Care Team at: 1.888.792.1601 (toll-free) or e-mail: client.service@genomedx.com Prostate Cancer Classifier

More information

Cancer research in the Midland Region the prostate and bowel cancer projects

Cancer research in the Midland Region the prostate and bowel cancer projects Cancer research in the Midland Region the prostate and bowel cancer projects Ross Lawrenson Waikato Clinical School University of Auckland MoH/HRC Cancer Research agenda Lung cancer Palliative care Prostate

More information

4/8/13. Pre-test Audience Response. Prostate Cancer 2012. Screening and Treatment of Prostate Cancer: The 2013 Perspective

4/8/13. Pre-test Audience Response. Prostate Cancer 2012. Screening and Treatment of Prostate Cancer: The 2013 Perspective Pre-test Audience Response Screening and Treatment of Prostate Cancer: The 2013 Perspective 1. I do not offer routine PSA screening, and the USPSTF D recommendation will not change my practice. 2. In light

More information

East Lancashire Surgical Robot

East Lancashire Surgical Robot East Lancashire Surgical Robot For ALL patients in Lancashire Prostate cancer claims the life of one man every hour and by 2030 will be the most common cancer; it is already the most common male cancer.

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

Intermittent Androgen Deprivation Therapy (ADT): Benefits outweigh risks

Intermittent Androgen Deprivation Therapy (ADT): Benefits outweigh risks Intermittent Androgen Deprivation Therapy (ADT): Benefits outweigh risks Laurence Klotz Professor of Surgery Sunnybrook Health Sciences Centre University of Toronto Advantages of intermittent ADT Likely:

More information

NERVE GRAFT TO RESTORE ERECTILE FUNCTION DURING RADICAL PROSTATECTOMY

NERVE GRAFT TO RESTORE ERECTILE FUNCTION DURING RADICAL PROSTATECTOMY CLINICAL POLICY NERVE GRAFT TO RESTORE ERECTILE FUNCTION DURING RADICAL PROSTATECTOMY Policy Number: SURGERY 043.13 T Effective Date: October 1, 015 Table of Contents BENEFIT CONSIDERATIONS. APPLICABLE

More information

The Business of Prostate Cancer Care: A Clinician-Researcher s Perspective

The Business of Prostate Cancer Care: A Clinician-Researcher s Perspective The Business of Prostate Cancer Care: A Clinician-Researcher s Perspective David F. Penson, MD, MPH Departments of Urology and Preventive Medicine Keck School of Medicine University of Southern California

More information

Minimally Invasive Surgical Treatment of Prostate Cancer: Robots, Microwaves, and Freezers

Minimally Invasive Surgical Treatment of Prostate Cancer: Robots, Microwaves, and Freezers Minimally Invasive Surgical Treatment of Prostate Cancer: Robots, Microwaves, and Freezers Paul D. Maroni, MD Assistant Professor Department of Surgery/Urology Disclosures Relevant EDAP HIFU - investigator

More information

Questions to ask my doctor: About prostate cancer

Questions to ask my doctor: About prostate cancer Questions to ask my doctor: About prostate cancer Being diagnosed with prostate cancer can be scary and stressful. You probably have a lot of questions and concerns. Learning about the disease, how it

More information

Prostate cancer. Christopher Eden. The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing.

Prostate cancer. Christopher Eden. The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing. Prostate cancer Christopher Eden The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing. Screening Screening men for PCa (prostate cancer) using PSA (Prostate Specific Antigen blood

More information

Making sense of prostate cancer screening

Making sense of prostate cancer screening Making sense of prostate cancer screening Piotr Czaykowski MD MSc FRCPC Medical Oncology, CancerCare Manitoba University of Manitoba Disclosure of Potential for Conflict of Interest Name of presenter Name

More information

Focal therapy for prostate cancer: seriously or seriously? Disclosures

Focal therapy for prostate cancer: seriously or seriously? Disclosures Focal therapy for prostate cancer: seriously or seriously? Mitchell Kamrava, MD Assistant Clinical Professor Department of Radiation Oncology University of California Los Angeles Disclosures Speaking honorarium

More information

Questions to Ask My Doctor About Prostate Cancer

Questions to Ask My Doctor About Prostate Cancer Questions to Ask My Doctor Being told you have prostate cancer can be scary and stressful. You probably have a lot of questions and concerns. Learning about the disease, how it s treated, and how this

More information

Historical Basis for Concern

Historical Basis for Concern Androgens After : Are We Ready? Mohit Khera, MD, MBA Assistant Professor of Urology Division of Male Reproductive Medicine and Surgery Scott Department of Urology Baylor College of Medicine Historical

More information

NEW TREATMENTS FOR PROSTATE CANCER HOW DO I CHOOSE?

NEW TREATMENTS FOR PROSTATE CANCER HOW DO I CHOOSE? NEW TREATMENTS FOR PROSTATE CANCER HOW DO I CHOOSE? by Dr Phillip Stricker The following is a summary of a presentation to the St Vincent s Prostate Cancer Support Group on 4 th June 2002 The many new

More information

Proton Therapy for Prostate Cancer: Your Questions, Our Answers.

Proton Therapy for Prostate Cancer: Your Questions, Our Answers. Proton Therapy for Prostate Cancer: Your Questions, Our Answers. When you re looking for the right treatment for your prostate cancer, nothing s more important than accurate information. Read on, and learn

More information

LEARNING CURVE OF ROBOTIC RADICAL PROSTATECTOMY

LEARNING CURVE OF ROBOTIC RADICAL PROSTATECTOMY LEARNING CURVE OF ROBOTIC RADICAL PROSTATECTOMY Muhammed Ersagun Arslan, 1 *Abdullah Erdem Canda, 2 Ali Fuat Atmaca, 2 Mevlana Derya Balbay, 3 Ziya Akbulut, 2 Serkan Altinova, 1 Ahmet Tunc Ozdemir 4 1.

More information

Bladder cancer treatment decision, management, and psychosocial outcomes: Results of patients interviews

Bladder cancer treatment decision, management, and psychosocial outcomes: Results of patients interviews Bladder cancer treatment decision, management, and psychosocial outcomes: Results of patients interviews Nihal Mohamed & Michael Diefenbach Department of Urology Mount Sinai School of Medicine Study Questions

More information

Local Salvage Therapies After Failed Radiation for Prostate Cancer. Biochemical Failure after Radiation

Local Salvage Therapies After Failed Radiation for Prostate Cancer. Biochemical Failure after Radiation Local Salvage Therapies After Failed Radiation for Prostate Cancer James Eastham, MD Memorial Sloan-Kettering Cancer Center New York, New York Biochemical Failure after Radiation ASTRO criteria 3 consecutive

More information

New Technologies in Surgery

New Technologies in Surgery New Technologies in Surgery Jim C. Hu MD, MPH Center for Advanced Surgical and Interventional Technology (CASIT) Director of Robotic and Minimally Invasive Surgery Associate Professor Department of Urology

More information

Facing Prostate Cancer?

Facing Prostate Cancer? The Enabling Technology: The da Vinci Surgical System Your doctor is one of the growing number of surgeons worldwide offering da Vinci Surgery for a range of complex conditions. The da Vinci Surgical System

More information

da Vinci Prostatectomy (Robotically Assisted Radical Prostatectomy)

da Vinci Prostatectomy (Robotically Assisted Radical Prostatectomy) Peninsula Urology Center, Inc. Dieter Bruno, M.D, F.A.C.S Chris Threat, M.D. 3351 El Camino. Real, Suite 101 Atherton, CA 94027 (650) 306-1016 dbrunomd@pucenter.com http://www.pucenter.com/ da Vinci Prostatectomy

More information

Sexual Dysfunction Associated With Colorectal Cancer Treatment: An Ignored Condition

Sexual Dysfunction Associated With Colorectal Cancer Treatment: An Ignored Condition Sexual Dysfunction Associated With Colorectal Cancer Treatment: An Ignored Condition O. Lenaine Westney, MD Associate Professor Fellowship Director, Urinary Tract and Pelvic Reconstruction Department of

More information

Clinical Commissioning Policy: Proton Beam Therapy for Cancer of the Prostate. Reference: NHS England: 16020/P

Clinical Commissioning Policy: Proton Beam Therapy for Cancer of the Prostate. Reference: NHS England: 16020/P Clinical Commissioning Policy: Proton Beam Therapy for Cancer of the Prostate Reference: NHS England: 16020/P NHS England INFORMATION READER BOX Directorate Medical Operations and Information Specialised

More information

Facing Prostate Cancer Surgery? Learn about minimally invasive da Vinci Surgery

Facing Prostate Cancer Surgery? Learn about minimally invasive da Vinci Surgery Facing Prostate Cancer Surgery? Learn about minimally invasive da Vinci Surgery The Condition: Prostate Cancer Your prostate is a walnut-sized gland that is part of the male reproductive system. The prostate

More information

DEFINITELY NOT! SURGEON LOCAL RECURRENCE: >10% 5-YR SURVIVAL : 50-60% MANAGEMENT OF DISTAL RECTAL CANCER STILL CONTROVERSIAL

DEFINITELY NOT! SURGEON LOCAL RECURRENCE: >10% 5-YR SURVIVAL : 50-60% MANAGEMENT OF DISTAL RECTAL CANCER STILL CONTROVERSIAL A IV-a CONFERINŢĂ Ă INTERNAŢIONALĂ IONALĂ DE CHIRURGIE 19-22 octombrie 2006 Iaşi, România CENTENIAL CONFERENCE INTERSPHINCTERIC TOTAL PROCTECTOMY IN THE MANAGEMENT OF LOW RECTAL CANCER A. MONTORI M.D..

More information

Therapies for Prostate Cancer and Treatment Selection

Therapies for Prostate Cancer and Treatment Selection Prostatic Diseases Therapies for Prostate Cancer and Treatment Selection JMAJ 47(12): 555 560, 2004 Yoichi ARAI Professor and Chairman, Department of Urology, Tohoku University Graduate School of Medicine

More information

Precise, Minimally Invasive Prostate Cancer Removal

Precise, Minimally Invasive Prostate Cancer Removal Precise, Minimally Invasive Prostate Cancer Removal Learn why da Vinci Surgery may be your best treatment option 1 Beyond Minimally Invasive For Prostate Cancer 1 Facing Prostate Cancer Prostate cancer

More information

Screening for Prostate Cancer

Screening for Prostate Cancer Screening for Prostate Cancer It is now clear that screening for Prostate Cancer discovers the disease at an earlier and more curable stage. It is not yet clear whether this translates into reduced mortality

More information

Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine

Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine Case #1 A 55 yo white man with well-controlled hypertension presents for his annual

More information

Prostate Cancer Patients Report on Benefits of Proton Therapy

Prostate Cancer Patients Report on Benefits of Proton Therapy Prostate Cancer Patients Report on Benefits of Proton Therapy Dobson DaVanzo & Associates, LLC Vienna, VA 703.260.1760 www.dobsondavanzo.com Prostate Cancer Patients Report on Benefits of Proton Therapy

More information

Treatment of Incidental Prostate Cancer Diagnosed during BPH Surgery with Radical Prostatectomy: Appropriate or over Treatment?

Treatment of Incidental Prostate Cancer Diagnosed during BPH Surgery with Radical Prostatectomy: Appropriate or over Treatment? Journal of Cancer Therapy, 2012, 3, 256-262 http://dx.doi.org/10.4236/jct.2012.34036 Published Online August 2012 (http://www.scirp.org/journal/jct) Treatment of Incidental Prostate Cancer Diagnosed during

More information

Use Of Testosterone In Men With Prostate Cancer. Traditional view: T is dangerous for PCa

Use Of Testosterone In Men With Prostate Cancer. Traditional view: T is dangerous for PCa Use Of Testosterone In Men With Prostate Cancer Abraham Morgentaler, MD, FACS Director, Men s s Health Boston Associate Clinical Professor of Urology Harvard Medical School Boston, USA Traditional view:

More information

PROSTATE CANCER. Get the facts, know your options. Samay Jain, MD, Assistant Professor,The University of Toledo Chief, Division of Urologic Oncology

PROSTATE CANCER. Get the facts, know your options. Samay Jain, MD, Assistant Professor,The University of Toledo Chief, Division of Urologic Oncology PROSTATE CANCER Get the facts, know your options Samay Jain, MD, Assistant Professor,The University of Toledo Chief, Division of Urologic Oncology i What is the Prostate? Unfortunately, you have prostate

More information

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40. A.D.A.M. Medical Encyclopedia. Prostate cancer Cancer - prostate; Biopsy - prostate; Prostate biopsy; Gleason score Last reviewed: October 2, 2013. Prostate cancer is cancer that starts in the prostate

More information

TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER

TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER DILEMMA Thomas J Stormont MD January 2012 http://www.youtube.com/watch?v=8jd 7bAHVp0A&feature=related related INTRODUCTION A government health panel (the

More information

Role of Radiation after Radical Prostatectomy Review of Literature

Role of Radiation after Radical Prostatectomy Review of Literature Vol. 9, No: 1 Jan - Jun 2013. Page 1-44 Role of Radiation after Radical Prostatectomy Review of Literature S.K. Raghunath, N. Srivatsa Abstract Biochemical relapse after radical prostatectomy occurs in

More information

855-DRSAMADI or 212-241-8779

855-DRSAMADI or 212-241-8779 SMART SURGERY NEWS MARCH 2013 Dr. David Samadi 855-DRSAMADI or 212-241-8779 YOUR PROSTATE CANCER NEWS PREVENTION DIAGNOSIS TREATMENT LIFE AFTER PROSTATE CANCER PREVENTION Prostate Cancer Need-to-Knows

More information

TITLE: Robot-assisted Surgery for Prostatectomy and Hysterectomy: A Review of the Clinical and Cost-Effectiveness An Update

TITLE: Robot-assisted Surgery for Prostatectomy and Hysterectomy: A Review of the Clinical and Cost-Effectiveness An Update TITLE: Robot-assisted Surgery for Prostatectomy and Hysterectomy: A Review of the Clinical and Cost-Effectiveness An Update DATE: 07 November 2012 CONTEXT AND POLICY ISSUES Robotic surgery for prostatectomy,

More information

Welcome to the February Edition of the Robotic Oncology Newsletter! February 2012

Welcome to the February Edition of the Robotic Oncology Newsletter! February 2012 NEWSLETTER FROM DR. DAVID SAMADI TEL: 1-855-DRSAMADI or 1-212-241-8779 FAX: 1-212-308-6107 www.roboticoncology.com www.smart-surgery.com Welcome to the February Edition of the Robotic Oncology Newsletter!

More information

SIOG Guidelines Update 2014 Prostate Cancer. Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon

SIOG Guidelines Update 2014 Prostate Cancer. Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon SIOG Guidelines Update 2014 Prostate Cancer Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon Droz JP, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, Dickinson L, Efstathiou

More information

da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy)

da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy) da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy) Prostate Cancer Overview Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the

More information

These rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma.

These rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma. Prostate Cancer OVERVIEW Prostate cancer is the second most common cancer diagnosed among American men, accounting for nearly 200,000 new cancer cases in the United States each year. Greater than 65% of

More information

Radical Prostatectomy

Radical Prostatectomy Radical Prostatectomy Table of Contents Surgery Overview What To Expect After Surgery Why It Is Done How Well It Works Risks What To Think About References Credits Surgery Overview A radical prostatectomy

More information

The 4Kscore blood test for risk of aggressive prostate cancer

The 4Kscore blood test for risk of aggressive prostate cancer The 4Kscore blood test for risk of aggressive prostate cancer Prostate cancer tests When to use the 4Kscore Test? Screening Prior to 1 st biopsy Prior to negative previous biopsy Prognosis in Gleason 6

More information

The PLCO Trial Not a comparison of Screening vs no Screening

The PLCO Trial Not a comparison of Screening vs no Screening PSA Screening: Science, Politics and Uncertainty David F. Penson, MD, MPH Hamilton and Howd Chair of Urologic Oncology Professor and Chair, Department of Urologic Surgery Director, Center for Surgical

More information

CYBERKNIFE RADIOSURGERY FOR EARLY PROSTATE CANCER Rationale and Results. Alan Katz MD JD Flushing, NY USA

CYBERKNIFE RADIOSURGERY FOR EARLY PROSTATE CANCER Rationale and Results. Alan Katz MD JD Flushing, NY USA CYBERKNIFE RADIOSURGERY FOR EARLY PROSTATE CANCER Rationale and Results Alan Katz MD JD Flushing, NY USA Prostate Ablative Therapy Over the last 10 years our therapy has improved bned rates for LDR/HDR

More information

Issues Concerning Development of Products for Treatment of Non-Metastatic Castration- Resistant Prostate Cancer (NM-CRPC)

Issues Concerning Development of Products for Treatment of Non-Metastatic Castration- Resistant Prostate Cancer (NM-CRPC) Issues Concerning Development of Products for Treatment of Non-Metastatic Castration- Resistant Prostate Cancer (NM-CRPC) FDA Presentation ODAC Meeting September 14, 2011 1 Review Team Paul G. Kluetz,

More information

An Introduction to PROSTATE CANCER

An Introduction to PROSTATE CANCER An Introduction to PROSTATE CANCER Being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the

More information

Carcinoma of the Cervix. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology

Carcinoma of the Cervix. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Carcinoma of the Cervix Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Cervical Cancer Treatment Treatment Microinvasive (Stage IA1): Simple (extrafascial) hysterectomy/cone

More information

Prostate Cancer Patient- Reported Outcomes: What Do We Know and What is Still Unknown

Prostate Cancer Patient- Reported Outcomes: What Do We Know and What is Still Unknown Prostate Cancer Patient- Reported Outcomes: What Do We Know and What is Still Unknown Ronald Chen, MD MPH Associate Professor, Dept Radiation Oncology University of North Carolina at Chapel Hill Why Do

More information

Survivorship Care Plans Guides for Living After Cancer Treatment

Survivorship Care Plans Guides for Living After Cancer Treatment Survivorship Care Plans Guides for Living After Cancer Treatment Institute of Medicine Report 2005 Recommendations for meeting needs of cancer survivors Implement survivorship care plan Build bridges

More information

An Introduction to PROSTATE CANCER

An Introduction to PROSTATE CANCER An Introduction to PROSTATE CANCER Being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the

More information

Management of Urinary Complications

Management of Urinary Complications Management of Urinary Complications Prostate Cancer: Current Status & Future Directions March 27, 2010 Jaspreet S. Sandhu, MD Department of Surgery/Urology Memorial Sloan-Kettering Cancer Center Outline

More information

Milestones in Robotic Kidney Surgery at Henry Ford Hospital

Milestones in Robotic Kidney Surgery at Henry Ford Hospital Milestones in Robotic Kidney Surgery at Henry Ford Hospital Craig Rogers MD, FACS Director of Renal Surgery Director of Urologic Oncology Fellowship Director Vattikuti Urology Institute, Detroit, Michigan

More information

2/14/09. Long Term Risk of Radiation Therapy for Clinically Localized Prostate Cancer. Radiation Therapy: Various Forms of Radiation Treatment

2/14/09. Long Term Risk of Radiation Therapy for Clinically Localized Prostate Cancer. Radiation Therapy: Various Forms of Radiation Treatment Radical ctomy (surgery) Mack Roach III MD Professor & Chair Department of Radiation Oncology Long Term Risk of Radiation Therapy for Clinically Localized Cancer Radiation Therapy: Hormonal Therapy Cryotherapy

More information

Brian Louis Cohen, M.D., M.P.H.

Brian Louis Cohen, M.D., M.P.H. Brian Louis Cohen, M.D., M.P.H. MEDICAL TRAINING Fellowship in Female Urology, Voiding Dysfunction, and Reconstructive Urology Anticipated, July 2007 June 2008 Residency in Urology, July 2003 June 2007

More information

Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward

Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward 33 rd Annual Internal Medicine Update December 5, 2015 Ryan C. Hedgepeth, MD, MS Chief of

More information

Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer

Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer Jonathan A. Eandi,* Brian A. Link, Rebecca A. Nelson, David Y. Josephson, Clayton Lau, Mark H. Kawachi and Timothy

More information

Benjamin D. Sommers, M.D., Ph.D. a, *, Richard Zeckhauser, Ph.D. b

Benjamin D. Sommers, M.D., Ph.D. a, *, Richard Zeckhauser, Ph.D. b Urologic Oncology: Seminars and Original Investigations 26 (2008) 669 673 Seminar article Probabilities and preferences: What economics can teach doctors and patients making difficult treatment decisions

More information

This vision does not represent government policy but provides useful insight into how prostate cancer services might develop over the next 5 years

This vision does not represent government policy but provides useful insight into how prostate cancer services might develop over the next 5 years Prostate Cancer 2015 Annex H Summary - Improving Outcomes for Prostate Cancer Patients By 2015, there will be: Increased awareness about the prostate, the variability in risk with respect to the different

More information

Learning curve in robotic surgery: Review of the literature (RALP, RAPN and RARC)

Learning curve in robotic surgery: Review of the literature (RALP, RAPN and RARC) Learning curve in robotic surgery: Review of the literature (RALP, RAPN and RARC) G. De Naeyer, P. Schatteman, P. Carpentier, A. Mottrie Department of Urology, OLV Clinic, Aalst, Belgium Learning Learning

More information

Breast Cancer Pathway

Breast Cancer Pathway Breast Cancer Pathway Risk Stratified Follow Up Dr Dorothy Goddard, Associate Medical Director for Cancer Macmillan Consultant Medical Advisor Survivorship What is risk stratified follow up? Refers to

More information

Prostate Cancer Screening

Prostate Cancer Screening Prostate Cancer Screening Bruce L. Houghton, MD Associate Professor of Medicine Division of General Medicine Department of Internal Medicine Creighton University School of Medicine http://en.wikipedia.org/wiki/image:prostatelead.jpg

More information

Advice on the Development of Robotic Assisted Radical Prostatectomy in England

Advice on the Development of Robotic Assisted Radical Prostatectomy in England Advice on the Development of Robotic Assisted Radical Prostatectomy in England Prostate Cancer Advisory Group Summer 2011 - updated 2012 Contents Foreword 2 1. Introduction, purpose and scope 3 2. Executive

More information

DOCTOr. Doctor to HIGHLIGHTS. issue NO. 3 VOLuMe NO. 1

DOCTOr. Doctor to HIGHLIGHTS. issue NO. 3 VOLuMe NO. 1 Doctor to DOCTOr issue NO. 3 VOLuMe NO. 1 PROSTATE CANCER is the most common cancer in men, with 233,000 new cases diagnosed per year. Although prostate cancer remains the second leading cause of cancer

More information

Use of Androgen Deprivation Therapy (ADT) in Localized Prostate Cancer

Use of Androgen Deprivation Therapy (ADT) in Localized Prostate Cancer Use of Androgen Deprivation Therapy (ADT) in Localized Prostate Cancer Adam R. Kuykendal, MD; Laura H. Hendrix, MS; Ramzi G. Salloum, PhD; Paul A. Godley, MD, PhD; Ronald C. Chen, MD, MPH No conflicts

More information

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical Summary. 111 Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical recurrence (BCR) is the first sign of recurrent

More information

Advances in Diagnostic and Molecular Testing in Prostate Cancer

Advances in Diagnostic and Molecular Testing in Prostate Cancer Advances in Diagnostic and Molecular Testing in Prostate Cancer Ashley E. Ross MD PhD Assistant Professor Urology, Oncology, Pathology Johns Hopkins School of Medicine September 24, 2015 1 Disclosures

More information

Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases

Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases I Congresso de Oncologia D Or July 5-6, 2013 Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases Michael A. Choti, MD, MBA, FACS Department of Surgery Johns Hopkins University

More information

Prostate cancer is the second most

Prostate cancer is the second most Treatment Options for Localized Prostate Cancer RAVINDER MOHAN, MD, PhD, and PAUL F. SCHELLHAMMER, MD Eastern Virginia Medical School, Norfolk, Virginia In the United States, more than 90 percent of prostate

More information

ICHOM-INTERN L CONSORTIUM ON HEALTH OUTCOMES MEASUREMENT

ICHOM-INTERN L CONSORTIUM ON HEALTH OUTCOMES MEASUREMENT Poster Session HRT11420 Innovation Awards November 2014 Melbourne ICHOM-INTERN L CONSORTIUM ON HEALTH OUTCOMES MEASUREMENT Jeremy Millar AlfredHealth Monash University The Health Roundtable Key problem:

More information

Ryan C. Hedgepeth,* Jessica Labo, LingLing Zhang and David P. Wood, Jr.

Ryan C. Hedgepeth,* Jessica Labo, LingLing Zhang and David P. Wood, Jr. Expanded Prostate Cancer Index Composite Versus Incontinence Symptom Index and Sexual Health Inventory for Men to Measure Functional Outcomes After Prostatectomy Ryan C. Hedgepeth,* Jessica Labo, LingLing

More information

The PSA Controversy: Defining It, Discussing It, and Coping With It

The PSA Controversy: Defining It, Discussing It, and Coping With It The PSA Controversy: Defining It, Discussing It, and Coping With It 11 TH ANNUAL SYMPOSIUM ON MEN S HEALTH June 12, 2013 The PSA Controversy Defining It, Discussing It and Coping With It As of May 2012,

More information

Oncology Annual Report: Prostate Cancer 2005 Update By: John Konefal, MD, Radiation Oncology

Oncology Annual Report: Prostate Cancer 2005 Update By: John Konefal, MD, Radiation Oncology Oncology Annual Report: Prostate Cancer 25 Update By: John Konefal, MD, Radiation Oncology Prostate cancer is the most common cancer in men, with 232,9 new cases projected to be diagnosed in the U.S. in

More information

2010 SITE REPORT St. Joseph Hospital PROSTATE CANCER

2010 SITE REPORT St. Joseph Hospital PROSTATE CANCER 2010 SITE REPORT St. Joseph Hospital PROSTATE CANCER Humboldt County is located on the Redwood Coast of Northern California. U.S census data for 2010 reports county population at 134,623, an increase of

More information

Chapter 3. Treatment Options

Chapter 3. Treatment Options Chapter 3. Treatment Options With contributions from Nancy L. Brown, Ph.D., Palo Alto Medical Foundation Research Institute; Patrick Swift, M.D., Alta Bates Comprehensive Cancer Program; D. Jeffrey Demanes,

More information

Treating Prostate Cancer

Treating Prostate Cancer Treating Prostate Cancer A Guide for Men With Localized Prostate Cancer Most men have time to learn about all the options for treating their prostate cancer. You have time to talk with your family and

More information

CMScript. Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014

CMScript. Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014 Background CMScript Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014 Prostate cancer is second only to lung cancer as the leading cause of cancer-related deaths in men. It is

More information

A Gene Expression Test to Predict Prostate Cancer Aggressiveness. Use Prolaris as a guide in your medical and surgical management

A Gene Expression Test to Predict Prostate Cancer Aggressiveness. Use Prolaris as a guide in your medical and surgical management A Gene Expression Test to Predict Prostate Cancer Aggressiveness Use Prolaris as a guide in your medical and surgical management What is Prolaris? A direct molecular measure of prostate cancer tumor biology

More information

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj.

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj. PSA Testing 101 Stanley H. Weiss, MD Professor, UMDNJ-New Jersey Medical School Director & PI, Essex County Cancer Coalition weiss@umdnj.edu September 23, 2010 Screening: 3 tests for PCa A good screening

More information

Coding for Prostate Cancer

Coding for Prostate Cancer Coding for Prostate Cancer Tracy L. Burney, M.D. Health First Physicians Urology September 19, 2012 Prostate Cancer Basics What is the Prostate and What Does it do? Walnut sized organ found only in men.

More information

Evidence for the role of obesity in prostate cancer progression Elizabeth A. Platz, ScD, MPH

Evidence for the role of obesity in prostate cancer progression Elizabeth A. Platz, ScD, MPH Evidence for the role of obesity in prostate cancer progression Elizabeth A. Platz, ScD, MPH Professor and Martin D. Abeloff, MD Scholar in Cancer Prevention Johns Hopkins Bloomberg School of Public Health

More information

Clinical Practice Assessment Robotic surgery

Clinical Practice Assessment Robotic surgery Clinical Practice Assessment Robotic surgery Background: Surgery is by nature invasive. Efforts have been made over time to reduce complications and the trauma inherently associated with surgery through

More information

Bridging Techniques. What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS

Bridging Techniques. What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS Bridging Techniques What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS Associate Professor of Surgery Assistant Program Director, General Surgery Residency Disclosures

More information

Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent. Disclosure

Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent. Disclosure Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent Cervical lcancer Yasuo Yoshioka, MD Department of Radiation Oncology Osaka University Graduate School of Medicine Osaka, Japan

More information

Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto

Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto Clinical Trials and Radiation Treatment Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto What I will cover.. A little about radiation treatment The clinical trials

More information