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I did my Masters' thesis with the group that invented and developed this in Toronto. I know some of the co-authors on the paper personally since we worked together. AMA.
Earlier quoted context omitted.
The alternative is death right? So give me some pills, knock me out, and go to town.
Prostate cancer is rarely lethal since it develops so slowly, and is often left untreated. That said, many cases are life threatening.
https://www.reuters.com/article/us-prostate-cancer/untreated...
> Even without treatment, only a small minority of men diagnosed with early-stage prostate cancer die from the disease, Swedish researchers reported Friday. Drawing from a national cancer register, they estimated that after 10 years prostate cancer would have killed less than three percent of these men.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
> Prostate cancer often has an indolent natural history, and patients are more likely to die with than to die from the disease. There is reliable evidence that PSA testing results in considerable overdiagnosis and overtreatment of men with prostate cancer, while associated potential harms include pain, fever, bleeding, infection, and transient urinary difficulties resulting from prostate biopsy, as well as erectile dysfunction, urinary incontinence, and bowel dysfunction.
> On May 22, after reviewing the evidence on both benefits and harms of PSA testing, the US Preventive Services Task Force (USPSTF) concluded that the reduction in prostate cancer mortality after PSA testing was very small and that the benefits did not outweigh the harms. Their recommendations are against PSA-based screening for the general US population of men at any age.
Earlier quoted context omitted.
The alternative is death right? So give me some pills, knock me out, and go to town.
Prostate cancer is rarely lethal since it develops so slowly, and is often left untreated. That said, many cases are life threatening.
John Otvos DECEMBER 8, 2019 06:19 AM There’s no free lunch here by treating any disease, let alone pc with some form of invasive therapy. Nerves do get damaged. Cells are set on fire and left to die. In order to reach a man’s doughnut, the treatment regime must pass through many layers of cellular tissue to ‘hit’ the target area. Our healthcare system, whether here in Canada, or stateside, is really about disease management. Far better to stop it before it begins. How? Through a whole foods plant-based lifestyle and diet. None of these major killers of western societies was so prevalent in the early 1900s. Asia did not have them either, ’til they adopted our dietary regimen of highly processed foodstuffs, meat, dairy and junk food. andsoitgoes…
Yep, the medical industrial complex will keep on selling new snake oil. 80% of prostate cancers are indolent anyway so treating them is wasteful. Stratification was not used in this study.
I did my Masters' thesis with the group that invented and developed this in Toronto. I know some of the co-authors on the paper personally since we worked together. AMA.
Thanks.
I'm always wary of reading too much into articles about promising medical developments, because it seems like often the headlines look great but they are actually referring to some relatively early stage of trials, so results of later trials might not be so good or even if they are it might still be a long time before the treatment is used routinely.
However, in this case, the article reads as if this is literally a cure for (one sort of) cancer, with an 80% success rate, which can be done as an outpatient procedure with a relatively low risk of complications. That seems like about 80% of the holy grail, at least in terms of treating prostate cancer specifically.
Can you give an expert perspective on how excited we should or shouldn't be about this result?
This commenter said it best John Otvos DECEMBER 8, 2019 06:19 AM There’s no free lunch here by treating any disease, let alone pc with some form of invasive therapy. Nerves do get damaged. Cells are set on fire and left to die. In order to reach a man’s doughnut, the treatment regime must pass through many layers of cellular tissue to ‘hit’ the target area. Our healthcare system, whether here in Canada, or stateside,…
This is highly misleading.
https://www.ncdemography.org/2014/06/16/mortality-and-cause-...
> In 1900, the top 3 causes of death were infectious diseases—pneumonia and flu, tuberculosis, and gastrointestinal infections (a fourth infectious disease, diphtheria, was the 10th leading cause of death). Improvements in sanitation, public health (vaccination development and delivery), and medical treatments, such as antibiotics, led to dramatic declines in deaths from infectious diseases during the 20th century.
> Mortality from all causes declined 54% between 1900 and 2010.
In other words, we cured or learned to treat the formerly top killers. Now we've just got the harder to cure and less prevalent stuff left, but continue to make significant headway on those too.
I did my Masters' thesis with the group that invented and developed this in Toronto. I know some of the co-authors on the paper personally since we worked together. AMA.
And after a quick search it looks like there's some movement there: https://fusfoundation.org/diseases-and-conditions/urological...
@HorizonXP, any thoughts on this and it's potential to go mainstream? Asking for a friend...
>The minimally invasive technology involves a rod that enters the prostate gland via the urethra Ouch.
>The minimally invasive technology involves a rod that enters the prostate gland via the urethra Ouch.
>The minimally invasive technology involves a rod that enters the prostate gland via the urethra Ouch.
The alternative is death right? So give me some pills, knock me out, and go to town.
I haven't read this paper, and it's been years since my Masters when I last kept up with this, but the patients at this stage are usually getting their prostates removed. The aggressiveness of the cancer is enough to threaten their life and well-being, so they elect for this procedure. It's usually followed up with radiation and chemotherapy to kill any residual tumour cells left behind, usually at the periphery, or if metastasis has occurred.
So great, prostate and cancer's gone, everyone's happy right? Well, no. The surgery damages a lot of the surrounding tissues, so these men are left with sexual dysfunction (which sucks but you can somewhat handle since you are living) and incontinence. The urinary and bowel issues affect your quality of life immensely. If you're in your 60s, you might have another 10-20 years to live with this. But if you're in your 40s, which is a lot of the cases for aggressive cancer types, you're stuck this way for many decades.
Hence why this ultrasound technique is so appealing because you can perform a minimally-invasive procedure that destroys only what you target, and spares the urethra and other tissues. Better outcomes, and better quality of life.
Given that the gold standard is surgery, this new technique has to prove itself against that, by showing that it is actually successfully destroying the cancer. That's why these clinical trials are occurring.
As an addendum, one study in Thailand looked at a sample size of dead men, and found that 1 in 7 had prostate cancer, but died of other causes. What that means is that many men get prostate cancer and may be asymptomatic because it is not aggressive. It can manifest as localized tumours/nodules within the prostate that you wouldn't be able to detect without good palpation and/or sensitive imaging. And because you're asymptomatic, you might not even seek diagnosis, and you'll probably die of other causes.
It also means that many men get diagnosed with cancer and may seek premature treatment. Most good doctors will recommend a watchful waiting approach; regular checkups and PSA level checks to ensure that you're still in the asymptomatic area. There's other treatments that can occur before surgery. But if you end up down this path, your cancer could be very localized within the prostate.
However, surgery is an all-or-nothing approach, there's no saving the prostate. Ultrasound ablation could be a good alternative and allow targeting. We're still far off from proving that though, but it's definitely viable. It's also why ultrasound ablation is being used for things like uterine fibroids, and breast cancer. There's even use cases for brain cancers.
It's a very cool technology, and I'm very optimistic for it. But I left my Masters in 2012, and we're still conducting these clinical trials. This is exactly the pace it should be occurring at, since it needs to be ironclad. But I found it too slow for my liking, so I moved on in my career path.