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"Salvage"
Cryosurgery for Prostate Cancer - More Research Needed on Long-Term Survival
June 22, 1999. A new technology assessment by the U.S.
Agency for Health Care Policy and Research says research is needed to
determine the long-term outcomes of cryosurgery in men who undergo the
procedure because radiation therapy was not effective in treating their
prostate cancer. Cryosurgery destroys diseased tissue by freezing it.
An estimated 179,300 men will be diagnosed with prostate cancer in 1999,
and 37,000 will die from the disease.
"Some deaths from prostate cancer in patients
not helped by radiation therapy may be prevented or delayed by cryosurgery,"
said AHCPR's administrator, John M. Eisenberg, M.D. "However, morbidity
remains high and we just don't know enough about the long-term effects
of the procedure." Dr. Eisenberg said prospective clinical trials appear
warranted because they would help determine the long-term survival benefits
and make possible comparison of cryosurgery patient survival rates with
those of untreated biopsy-positive patients.
AHCPR's technology assessment (conducted
at the request of the U.S. Health Care Financing Administration -- the
federal agency responsible for the Medicare program) found that in the
short term, cryosurgery can result in negative prostate biopsies following
surgery, and low or undetectable serum PSA levels in some patients. Some
patients who have failed radiation therapy have benefited from the use
of cryosurgery as a second-line therapy.
After
effects are quite severe
According to the assessment, outcomes
of cryosurgery have tended to improve with better instrumentation, better surgical
technique and greater experience on the part of the urologists performing
the procedure.
But the assessment also found that while
the procedure itself is well tolerated, postoperative complications are
significant. Major complications of salvage cryosurgery include incontinence,
impotence and obstructive urinary symptoms. (These complications are added
to any caused by the first-line radiation).
Cryosurgery is increasingly being used as
a second-line therapy in men not helped by radiation treatments. Because
cryosurgery is better tolerated than traditional prostate cancer surgery
-- prostatectomy -- it can be offered to men who would not normally be
candidates for the surgery because of advanced age or the presence of
other health problems
For more information, request a free copy of Cryosurgery
for Recurrent Prostate Cancer Following Radiation Therapy. Health
Technology Assessment No. 13, AHCPR Publication No. 99-0004, from
the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, Md.
20907, U.S.A., or call 1(800) 358-9295 from within the United States,
or (410) 381-3150 from outside the country.
July 5, 1999
PSA
Rising
prostate cancer survivor news
http://www.psa-rising.com ©2000
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