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Research, Trials and Treatments

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User
Posted 22 May 2016 at 00:52

It may be surprising to many how much research is underway, how many trials there are and various treatments for PCa.  This link is a useful reference I think. http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/research/research-into-treatments-for-prostate-cancer#hifu

Barry
User
Posted 22 May 2016 at 00:52

It may be surprising to many how much research is underway, how many trials there are and various treatments for PCa.  This link is a useful reference I think. http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/research/research-into-treatments-for-prostate-cancer#hifu

Barry
User
Posted 15 Sep 2016 at 19:27

Hi Howard,

Interesting but only really confirms essentially what previous surveys have said. The timescale given is 10 years and it would be helpful to know whether similar results would apply if 15-20 year period was considered. We will have to wait for future analysis but 10 years is not long for men diagnosed in their forties to say seventy, so need to know potential risks well beyond the 10 year period. Then the survey only relates to men diagnosed at an early stage. I believe men diagnosed when their cancer is more advanced will benefit more by having treatment than not doing so. Also, surveys like this are in retrospect often covering many years during which time treatment has been improved but not been fully taken into account.

It is well known that more men with PCa - many unknowingly having the disease - eventually die from a different cause. It follows that many men diagnosed early with PCa and treated, would not have needed it. That is why many of us here feel AS for as long as it is judged appropriate is something that should be carefully considered rather than rush into immediate radical treatment. But AS has to be very carefully monitored and if consultants consider changes call for treatment, a man should give serious consideration to this. Some men can accept AS whereas others cannot. Efforts are being made to establish how likely so called 'pussy cats' may become 'tigers' but this is proving a difficult task, particularly with the way cancer can mutate, sometimes fairly quickly

 

Edited by member 15 Sep 2016 at 19:31  | Reason: Not specified

Barry
User
Posted 15 Sep 2016 at 21:28

Radio 2 this afternoon on Jeremy Vine who can not seem to stop himself making jokes about serious topics, and making inaccurate misleading and somewhat hysterical statements about treatment and options.

There was a discussion about treatment options and outcomes in a trial of 1600 men aged 50 to 65, and it was suggested that doing nothing had been shown to be as successful as doing something.

And among his many outbursts was his statement that surgery gives such awful side effects.

Also that there should be more use of MRI scans rather than biopsies, although we know that MRIs can miss cancer spread.

Worth a listen to on I player or whatever so that you can judge how seriously and dangerously misinformative the item was.

The so called expert Professor did herself no favours.

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

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User
Posted 15 Sep 2016 at 12:26

Hi BarryIn case some chaps are having a hard time deciding on which treatment to choose, like me for example, these 2 articles, both saying the same thing, are worth a read.

http://www.telegraph.co.uk/news/2016/09/14/prostate-cancer-survival-rates-equally-high-if-you-monitor-disea/

https://www.theguardian.com/society/2016/sep/14/monitoring-prostate-cancer-effective-treatment

Curiously enough just had another PSA test and mine has gone down to 3.8. I had a previous one too soon after TRUS biopsy which gave 6.8 and before that 5.5. Not sure why it's now 3.8. My consultant recently recommended surgery. I am T2A, (Gleason 3+4). But I managed to get hold of a copy of my Pathology report which is interesting.

Thanks for your helpful posts.

Kind regards

Howard

User
Posted 15 Sep 2016 at 19:27

Hi Howard,

Interesting but only really confirms essentially what previous surveys have said. The timescale given is 10 years and it would be helpful to know whether similar results would apply if 15-20 year period was considered. We will have to wait for future analysis but 10 years is not long for men diagnosed in their forties to say seventy, so need to know potential risks well beyond the 10 year period. Then the survey only relates to men diagnosed at an early stage. I believe men diagnosed when their cancer is more advanced will benefit more by having treatment than not doing so. Also, surveys like this are in retrospect often covering many years during which time treatment has been improved but not been fully taken into account.

It is well known that more men with PCa - many unknowingly having the disease - eventually die from a different cause. It follows that many men diagnosed early with PCa and treated, would not have needed it. That is why many of us here feel AS for as long as it is judged appropriate is something that should be carefully considered rather than rush into immediate radical treatment. But AS has to be very carefully monitored and if consultants consider changes call for treatment, a man should give serious consideration to this. Some men can accept AS whereas others cannot. Efforts are being made to establish how likely so called 'pussy cats' may become 'tigers' but this is proving a difficult task, particularly with the way cancer can mutate, sometimes fairly quickly

 

Edited by member 15 Sep 2016 at 19:31  | Reason: Not specified

Barry
User
Posted 15 Sep 2016 at 20:52

Thanks Barry.

A good post. It really is hard to make a treatment decision on this. I'm not the first and won't be the last, but some of the side effects are life changing and permanent in some cases.

I was looking yesterday at the clinical trials in London using HIFU and MRI. They sure sound tempting for me, but there are risks too with that obviously. I mean, I'm 67 now so maybe 10 - 15 years of AS if I'm lucky, ain't so bad, but then that's the trick isn't it - knowing.

Thanks for your reply and hope you are well.

Kind regards

Howard

User
Posted 15 Sep 2016 at 21:28

Radio 2 this afternoon on Jeremy Vine who can not seem to stop himself making jokes about serious topics, and making inaccurate misleading and somewhat hysterical statements about treatment and options.

There was a discussion about treatment options and outcomes in a trial of 1600 men aged 50 to 65, and it was suggested that doing nothing had been shown to be as successful as doing something.

And among his many outbursts was his statement that surgery gives such awful side effects.

Also that there should be more use of MRI scans rather than biopsies, although we know that MRIs can miss cancer spread.

Worth a listen to on I player or whatever so that you can judge how seriously and dangerously misinformative the item was.

The so called expert Professor did herself no favours.

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 15 Sep 2016 at 21:37

I didn't hear that Dave, but thank you.

I have always thought Jeremy Vine is just dreadful, his depressing and pointless show and that awful spin he puts on things.

User
Posted 16 Sep 2016 at 03:44

At present, if there is a suspicion that a man might have PCa (possibly symptoms, high PSA, hard or irregular Prostate as felt at DRE), it is most likely he will have a TRUS biopsy. This is rather like shooting in the dark and it is not surprising that in quite a number of cases any PCa is missed. It has become more widely accepted that a better way is to have an MRI first, which can in many cases show suspicious areas to insert the biopsy needles and some hospitals are doing this. However, MRI scans are expensive and take up more resources and many hospitals will not give an MRI first. As Dave has said, it is not always possible to see cancer from MRI's anyway. The chances are improved of finding any cancer if a better type of scan is used but the cost of very high quality scans is great and few hospitals have the necessary equipment/expertise to provide the current 'state of art' ones and even these do not always show definitively some cancerous cells that may be present. So although scans are likely to become more significant, biopsies will still need to be done but perhaps not so many.

Not all consultants take the same overall view concerning various aspects of PCa. For example, some are in favour of men from the age of 50 having a PSA test as a matter of course (and all that that might lead to) whereas others oppose this because many more men would be found with early cancer and quite a proportion would have treatment that they didn't really need, so called 'overtreatment' and what that might entail. This would also stretch resources of the NHS which is already in dire straights. It does mean that some men whose PCa had advanced and who would benefit from treatment could be found earlier if tested routinely.

 

Edited by member 16 Sep 2016 at 03:46  | Reason: Not specified

Barry
 
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