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Apr 24, 2012
Prostate cancer: Many patients, many treatments, many choices
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Radiation treatments, like this man is receiving, are just one type of prostate cancer therapy being continuously evaluated. Prostate cancer is the most common non-skin cancer in men, but the slow-growing cancer also has a high survival rate, as it is usually caught at a treatable stage. Just this past week, both billionaire investor Warren Buffett and actor Ryan O’Neal announced that they had early stages of the disease. Like men all over the world, Buffett and O'Neal will likely have several treatment options. With these options comes choice, and researchers, physicians and patients are continually weighing not only effectiveness, but also potential side effects, of prostate cancer therapies.

A new study published this month compared intensity-modulated radiation therapy (IMRT) with two other types of radiation treatments for prostate cancer: conformal radiation therapy (CRT) and proton beam radiation therapy (PBRT). The use of IMRT as a prostate cancer treatment has grown rapidly in the last decade or so. In 2008, it was used 95.9 percent of the time versus CRT, while in 2000 it was used just 0.15 percent of the time. The findings of the study confirm what these numbers would suggest: Overall, IMRT is a better option for most patients than CRT.

Specifically, patients who received IMRT had a significantly reduced incidence of gastrointestinal problems as a side effect of treatment that those who received CRT. IMRT was also associated with less need for additional treatments. However, there is some give-and-take, as patients who received CRT did have less instances of one important side effect -- erectile dysfunction.

Both CRT and IMRT are types of high-precision radiation. IMRT is a more advanced form that distributes precise radiation better suited for tumors wrapped around vulnerable structures. However, it does require more time from highly-experienced medical professionals.

Another aspect of the study compared IMRT with the newer PBRT. In the past few years, many proton therapy centers have opened and this novel treatment has been advertised directly to patients. However, the study found that while the proton therapy costs about twice as much as IMRT, there are no significant differences in effectiveness between the two. Additionally, IMRT was shown to have fewer gastrointestinal side effects than PBRT.

In the quest to provide patients with treatments that come with fewer side effects, some researchers have turned to natural compounds. Earlier this month, a study on a new formula that is non-toxic and botanical-based was released. The compound is a made up of botanical extracts, phytonutrients, botanically-enhanced medicinal mushrooms and antioxidants. So far, the formula has proven to be very promising, effectively reducing and suppressing tumors in mice and human prostate cancer cell samples. 

Professor Mark Emberton of UCL, who is leading a study on treating prostate cancer with ultrasound, with patient Alan JohnsonYet another new treatment, high-intensity ultrasound, was examined in a recent study and promises few negative side effects. A trial led by University College London found that this treatment, with the ability to target areas as small as a grain of rice, caused no urinary incontinence and few cases of sexual dysfunction in a group of 41 men, while keeping 95 percent of them cancer-free a year later.

The three radiation therapies and these new emerging forms of treatment are just a few of the options, and potential future options, for men with prostate cancer. The ‘perfect treatment’ may not be available any time soon, but, thanks to ongoing research, prostate cancer patients can consult with their doctors and pick the treatment that best fits their lives in terms of frequency, recovery time and possible side effects.

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