To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Salvage Cryotherapy After Radiation Failure for Prostate Cancer Shows Benefits for Patients: Presented at CURy URL: http://www.pslgroup.com/dg/21C356.htm Doctor's Guide February 4, 2008
By Chris Berrie BARCELONA, SPAIN -- February 4, 2008 -- Salvage cryotherapy has high efficacy and a low complication rate as a minimally invasive treatment and should be a treatment option after radiation failure for patients with prostatic cancer and before radiotherapy for patients with localized prostatic cancer, according to research presented here at the World Congress on Controversies in Urology (CURy). This research was presented February 2 by Shmuel Cytron, MD, Principal Investigator and Chairman, Urology Department, Barzilai Medical Centre, Ashkelon, Israel. "The failure of radiation therapy [for prostate cancer] reaches 50% at 15 years... and the radiation patient remains with severe complications," Dr. Cytron said. Furthermore, recurrent prostatic cancer after radiation therapy is a significant disease that should be considered to be multifocal. As well as salvage cryotherapy, treatment options for these patients include high-intensity focused ultrasound (HIFU), salvage radical prostatectomy and, possibly, photodynamic therapy. However, from biochemical disease-free rates over the last 10 years, cryotherapy appears to show the most promise for patients, as Dr. Cytron indicated. Selection criteria for this cryotherapy study included positive biopsies and no evidence of extracapsular involvement or rectal injuries; there were no age or prostate size limitations. Of specific note, however, Dr. Cytron stressed the need for rectal wall protection, through rectal wall warming needles (mandatory when using Ice-Rod needles) and rectal cavity irrigation with warm water during the procedure. From 1999 to 2006, they treated 136 patients (median age, 74.6 years). These included radiation failures (n = 87), primary tumours (n = 41), salvage postradical prostatectomies (n = 5), and palliation for pain control (n = 3). At 5 years of follow-up (n = 87; median age, 78.4 years), Dr. Cytron considered specifically assessment of the 62 patients with prior radiation failure, although the results for 25 patients with primary tumours can also be considered. When prostate-specific antigen levels below 1 ng/mL and below 0.5 ng/mL were considered, these were seen for 82% and 71% of patients with radiation failure, respectively, and for 93% and 84% of those with primary tumours, respectively. One patient suffered a major complication (deep vein thrombosis), and the range of minor complications included 28 patients with peritoneal haematomas; seven scrotal haematomas; 31 patients with urine retention; four patients with transurethral resection of the prostate; and two patients with urinary tract infections. "Pain is not really an issue," Dr. Cytron added. No opiates were required, although hypoesthesia of the peritoneal region was reported by 54% of patients. After a consideration of the alternative treatments, Dr. Cytron said that salvage cryotherapy has high efficacy, a low complication rate, and minimal invasivity. He finally stressed that cryotherapy should be offered prior to radiotherapy for patients with localized prostatic cancer. Dr. Cytron declared connections with Galil Medical, which produces the cryomachines. [Presentation title: Prostate Cancer After Irradiation Failure.] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.