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Beyond The Abstract - Is It Necessary To Cure Prostate Cancer When It Is Possible?

UroToday.com - Treating Prostate Cancer as a Chronic Disease is becoming increasingly popular among physicians who recognize that up to a third of all prostate cancer treatments are unnecessary. The late, William Fair, M.D. (former Chairman of the Departments of Urology and Surgery at Memorial Sloan-Kettering) popularized the concept when he stated in 2000, "Based on everything we know about prostate cancer, I am not certain that it should not be treated as a chronic disease." What seemed like a condemnation of radical prostatectomy was based on his frustration or inability to predictably cure men with prostate cancer. His commentary energized a segment of the academic medical world that believed radical prostatectomy was over utilized. He also validated my research, which was in its infancy. To be sure, I have shown men can live with prostate in the majority of cases without the need for definitive therapy. I am motivated to do for the disease what is required and nothing more. My research shows that it is not necessary to cure prostate cancer when it is possible. Since 1999, men with favorable prostate cancer characteristics have been able to participate in a prospective chronic disease management (CDM) study, employing an academic strategy versus the cancer. While diet, nutrition, exercise, stress reduction and education are the pillars of this protocol, what sets this study apart from others is the attention to prostatitis resolution using a patented all natural formula.

To date, 28 men with a mean age of 63 years (median 64 years) have been followed for an average of 48.5 months (median - 46 months). A review of the updated data confirms the stability and integrity of a protocol that allows men to excel clinically with prostate cancer. All men in the study were believed to have had organ confined disease, while 71% had a clinical stage T1c and 29% of men noted clinical stages of T2a-T2c. 86% of the men had a Gleason score (GS) of 5 or 6 while the most aggressive cancer monitored was a GS of 7 (4+3). 93% of men had reduced their PSA by 55% noting a mean PSA entry of 6.6 ng/ml (range: 2.1-14.4), while overall a 48% reduction in PSA was seen. The International Prostate Symptom Score Index (IPSS-Index) noted a 63% reduction in voiding symptoms while the Expressed Prostatic Secretion (EPS) noted a 77.2% reduction in the white blood cell count (a standardized measure of prostate inflammation).

Based upon a preponderance of data, the American Association of Cancer Research (AACR) and independent experts like David Bostwick, M.D., pathologists have expressed a major role for inflammation to the evolution of prostate cancer. The reduction in prostate inflammation noted in this study as measured by the EPS may be the most sentinel finding that supports their belief. While further studies are encouraged, it is my belief that the resolution of prostatitis may be the key piece of information to allow us to formulate a prevention trial for prostate cancer. Minimally, an improvement in voiding symptoms, a reduction in prostate inflammation and a lower PSA value have validated a conservative approach for the majority of patients with prostate cancer.

References Barry MJ, PSA screening for prostate cancer: The current controversy a viewpoint. Annals of Oncology, 9: 1279-1282, 1998

Albertson PC, Hanley JA, Gleason DF, Barry MJ. A competing risk analysis of men age 55-74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA, 280: 975-980, 1998

Ornish D, Weidner G, Fair WR, Marlin R. Intensive lifestyle changes may affect the progression of prostate cancer. Journal of Urology, Vol. 174, 1065-1070, 2005

Soloway MS, Soloway CT, Williams S, etal.: Active surveillance; a reasonable management alternative for patients with prostate cancer; the Miami experience

Written by

Ronald E. Wheeler, MD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Link to Full Abstract

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

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Dincolo de abstracte - este cã este necesar de a vindeca cancerul de prostatã, atunci când este posibil? - Beyond The Abstract - Is It Necessary To Cure Prostate Cancer When It Is Possible? - articole medicale engleza - startsanatate