Where in the world is best for a radical prostatectomy?
Ever wondered whether medical tourism makes sense for a radial prostatectomy? After all, most of us are well aware that a RP comes with significant expectations for erectile dysfunction and incontinence. A recent paper in JCO Global Oncology analyses surgical outcomes in 10 countries covering almost 22,000 men, although by far the most (72%) come from Germany. Notably none are Scandinavian where we already know Active Surveillance (AS) for men with Low/Intermediate risk prostate cancer (PCa) is highest.
If you’ve been paying attention to our AS Mods, in particular Howard Wolinsky, you will already know that the US lags far behind when it comes to treating suitable men with AS. This study confirms 84% of men treated in the US were Stage 1 and 26% were Grade Group 1. Only the Barbers of Seville performed more aggressively treating 88% of T1 and 27% in GG1. The Brits were way out ahead treating just 13% of men with T1, 9% in GG1. G-d Bless the National Health Service and its cost saving measures.
Sexual dysfunction reported a fairly tight band between 40-53%. The happiest campers were those singing Waltzing Matilda in Oz, while the Brits were the loudest complainers, although Canada was slightly higher when weighted. US was in the middle.
Those Spanish toreadors caused the most urinary bother at 54% (33% when weighted) albeit 29% reported issues going in. The Italians only reported 1% after surgery and 10% before… either those Italian surgeons are true maestros, or the Signore are not being honest. USA was right around average at 9%.
The main caveats in the study are the huge variance in respondent numbers between countries with a heavy bias to Germany. The researchers also recognize that men in different countries may answer the survey referencing different standards. All told, this is the fist ever comparative study… and for me personally, I’d stick to the beaches and the Prado when visiting Spain!
There are a lot of numbers to plough through here, and a Mike Wyn deserves a big shout out for helping us get through them. If you want to dig into them yourselves, you’ll find the link at https://ascopubs.org/doi/pdfdirect/10.1200/GO.23.00420
Join us for this ‘ripped from the headlines’ webinar featuring a hot topic in the Active Surveillance community.
When world famous physician-scientist, leader of The Human Genome Project and former NIH Chief, Dr. Francis Collins, suddenly needs treatment for his prostate cancer that has accelerated from indolent to aggressive faster than a Formula 1 racer, many patients and medical professionals ask – whats up?
The NIH/NCI is considered one of the best medical institutions in the world. Did their active surveillance (AS) protocol fail or was Dr. Collins an anomaly? Do patients need to worry? … and is ‘cure’ really a possibility for Dr. Collins?
At short notice, AnCan Foundation, ASPI and The Active Surveillor have gathered together two world-renown urologists who curate their own AS cohorts. Drs. Peter Carroll and Laurie Klotz will discuss their views on the safety of pre-treatment AS for prostate cancer. Howard Wolinsky will moderate the discussion. AnCan’s own AS Support Group Moderators will be speaking after the presentation sharing their own thoughts
Watch here: (closed captioning is provided for this webinar, click the CC button at the bottom next to the gear.)
Special thanks to Bayer, Novartis, Johnson & Johnson, Myriad Genetics, Telix, and Blue Earth Diagnostics for sponsoring this webinar.
For information on our peer-led video chat PROSTATE CANCER VIRTUAL SUPPORT GROUPS, click here.
To SIGN UP for any of our Virtual Support groups, visit our Contact Us page.
Hi-Risk/Recurrent/Advanced PCa Video Chat, Feb 19, 2024
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Myovant, Telix & Blue Earth Diagnostics.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about our 12 monthly prostate cancer meetings at https://ancan.org/prostate-cancer/ Sign up to receive a weekly Reminder/Newsletter for this Group or others at https://ancan.org/contact-us/
darolutamide achieves undetectable status after many years; should he radiate L4 – ask his QB!; PSMA scans at low PSA levels; intermittent hormone therapy requires active surveillance… and anxiety for some; Ac225 Tx in Austria followed by Ac225+Lu177 and a PARP with no HRR mutation; another Gent remains undetectable; no evidence of PCa from scans but inferior blood counts; Newbie at the back end – 20 year survivor finally requires 2nd line anti-androgen
Even though I have been on Treatment Holiday for 21 months I still get my PSA and testosterone blood test every month. I feel like I am then proactive. jim Marshall
Jerry Grimes, Brighton, MI
sent: 6:55 PM
Hey all, gotta run. All the best!
Peter Kafka – Maui
sent: 7:08 PM
With all this movement in the nuclear medicine field, are there specialized Nuclear Oncologists now working at Centers of Excellence or is much of this being managed by GU Med Oncs or Radiation Oncs?
Len Sierra
sent: 7:09 PM
Peter, in many instances, nuclear medicine specialists are used.
Len Sierra
sent: 7:19 PM
The European Medicines Agency (EMA) is the European Union’s (EU) equivalent to the FDA. The EMA is a decentralized agency located in Amsterdam, Netherlands, that evaluates, supervises, and monitors the safety of medicines for humans and animals in the EU and the European Economic Area (EEA). The FDA and the EMA work together to streamline efforts, share best practices, and promote human and animal health.
Len Sierra
sent: 7:40 PM
From Johns Hopkins: Blood cells are made in the bone marrow. The bone marrow is the soft, spongy material in the center of the bones. It produces about 95% of the body’s blood cells. Most of the adult body’s bone marrow is in the pelvic bones, breast bone, and the bones of the spine.
Webinar: Radionuclide Diagnostics & Theranostics – Theory and Clinical Practice Meet!
Nuclear payloads, guided missiles, directed assassinations…not in global conflict or wars, but prostate cancer and what happens inside bodies of men getting radionuclide theranostics (treatment) and diagnostics (scanning) today.
Radionuclide treatment for prostate cancer is at least 10 years old – does that surprise you? Bayer’s Xofigo was approved in 2013 but adoption has been slow until recent FDA approvals of theranostics (treatment) viz. Pluvicto, and diagnostics (scans) like Illucix and Posluma.
Radionuclides are theory-intense with nuclear medicine doctors less exposed to treatment of advanced prostate cancer. Conversely, GU medical oncologists are less familiar with radionuclides than hormone and chemo-therapy.
Two global experts, GU medical oncologist Dr. Oliver Sartor and nuclear medicine guru, Dr. Philip Kuo will introduce radionuclide theranostics and diagnostics and discuss how the clinic and the theory intersect.
Learn about radionuclide medicine – how it works and what it can do for you! This information will help patients learn how to make sure your Genitourinary Medical Oncologist and Nuclear Medicine Doctor work in harmony.
Watch here:
Special thanks to our sponsors who made this webinar possible….
Active Surveillance Prostate Cancer Virtual Support Group
Active Surveillance (AS) for low-risk prostate cancer presents its own challenges that are very different from other treatment protocols. This virtual group is for men and caregivers on or considering AS to treat their condition. New participants are given priority to discuss their situation.
1st, 2nd & 3rd Wednesdays & 4th Thursdays of each month at 8 pm EST/EDT (US)
Ever wondered whether medical tourism makes sense for a radial prostatectomy? After all, most of us are well aware that a RP comes with significant expectations for erectile dysfunction and incontinence. A recent paper in JCO Global Oncology analyses surgical outcomes in 10 countries covering almost 22,000 men, although by far the most (72%) come from Germany. Notably none are Scandinavian where we already know Active Surveillance (AS) for men with Low/Intermediate risk prostate cancer (PCa) is highest.
