Statins Benefit ADT-Treated Prostate Cancer Patients | Cancer Network

Prostate cancer patients starting treatment with androgen deprivation therapy (ADT) who were already taking cholesterol-lowering statins had a 10-month prolonged time to cancer progression compared with patients who were not on statins, according to the results of a new study published in JAMA Oncology. – See more at: Statins Benefit ADT-Treated Prostate Cancer Patients | Cancer Network.

This study reported men starting on hormonal therapy who already were taking statin therapy for high cholesterol had better results than men not taking statins.

There have been many studies that show that taking statins help reduce the risk of prostate cancer recurrence.

I encourage patients that have borderline high cholesterol to speak to their primary care doctors about starting on statin therapy.

Endoscopic simple prostatectomy – Abstract

Endoscopic simple prostatectomy – Abstract.

This review looked at minimally invasive treatments for patients that have urinary obstruction from very large patients.

Traditionally open surgery was done since procedures done through the natural urinary opening often did not have goo long term results.

Laparoscopic adenomectomy (LA) and robotic-assisted simple prostatectomy (RASP) have been performed for about 10 years.  I started performing these operations in 2005 and have one of the worlds largest experiences in removing the middle part of the prostate robotically.  I disagree that the learning curve is short.  It is important to be in the correct plane in the prostate which is often more difficult to find with robotic or laparoscopic surgery than traditional open surgery.

Most of my patients are able to go home the day after surgery when I perform this operation robotically.

 

Lower PSA Predicts Favorable Salvage Radiotherapy Outcomes – Renal and Urology News

The overall median follow-up was 63.5 months. The 5-year BCR-free survival rate was 58.2% for the cohort overall and 76.2% for the 118 patients 55.7% who had early salvage RT, defined as RT started when the PSA level was 0.5 ng/mL or less, the investigators reported online in PLoS One

via Lower PSA Predicts Favorable Salvage Radiotherapy Outcomes – Renal and Urology News.

When patients have a PSA that rises over 0.1 after robotic prostatectomy, they likely have recurrent prostate cancer somewhere. This study shows that patients treated with salvage XRT (external beam radiotherapy) had better results if the treatment was started below a PSA of 0.5.

Personally, in the patients who are good candidates for salvage XRT, I prefer to start the radiation after the PSA goes higher than 0.2 and sometimes lower.

Penile Shortening After Prostate Surgery Temporary – Renal and Urology News

At six months, men who took a daily PDE5i had no SFPL loss, whereas those who did not take a PDE5i consistently had a significant mean 4.4 mm SFPL loss compared with baseline.“The present study is among the first to show preservation of SFPL in patients using daily PDE5i as compared with those patients not using regular PDE5i,” the authors wrote.

via Penile Shortening After Prostate Surgery Temporary – Renal and Urology News.

There have been reports of men having shorter penises after prostate cancer surgery for many years. This study looked at stretched flaccid penile length (SFPL) in men who were given phosphodiesterase inhibitors, like viagra, levitra, or cialis.

I have been recommending PDE5i for men for many years since the data shows that men who have good preoperative sexual function are more likely to have return of erectile function in assorter time if they take these medications after surgery. The same medication is used to have a full erection, but this use is more for penile rehabilitation after surgery.

This study shows taking PDE5i also helps prevent the shortening of the penis by 4.4 mm. This is about 1/5 of an inch.

An interview with MD Advisor

I recently gave an interview to the MD Advisor. We discussed some of the recent safety concerns with robotic surgery and the daVinci robot.

Some of the important points that we discussed are:

Robotic surgery is performed by a surgeon and is not automated.
Experienced surgeons have less complications that inexperienced surgeons.
Robotic surgery magnification can lead to a more precise surgery, but the magnification will lead to instruments not being in the surgeons filed of view which is similar to laparoscopy.

You can view the article on page 11 of the Fall issue of MD Advisor.

Prostate cancer screening event at Overlook Medical Center on October 3, 2013.

ONC-1498-13ProstateCancerScreening

I am participating in a prostate cancer screening event for men over 50 years old that would like to be screened for prostate cancer. Men will have a PSA blood draw and a digital rectal examination. The target audience is for men not under the care of a physician currently.

The event will be held in the hospital from 6 to 9pm. Please call 1-800-247-9580 for pre-registration.

Dr. Krieger and Dr. Savatta discuss prostate cancer and PSA screening

In June of 2013 I joined my partner and president of UGNJ, Alan Krieger, MD to educate the public about prostate cancer.

Recently a governmental agency recommended against prostate cancer screening with PSA without recommending a replacement for PSA. We had a thorough discussion about the need to screen for prostate cancer and what men and their loved ones should know about the prostate.

Pivotal data on radium in PCa published in NEJM | Urology Times

“The publication of the ALSYMPCA data in the New England Journal of Medicine is important, as it will provide physicians with comprehensive data on this recently approved treatment that has demonstrated overall survival in men with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease,” explained North American principal investigator Oliver Sartor, MD, of the Tulane Cancer Center, New Orleans.

via Pivotal data on radium in PCa published in NEJM | Urology Times.

Prostate cancer frequently spreads to bones if it escapes the prostate. In the ALSYMPCA (ALpharadin in SYMptomatic Prostate CAncer) trial, Radium was shown that it can be safeyl injected into patients with pain from prostate cancer spreading to bones. It was shown to improve survival for these patients, as well as decrease the need for narcotics and radiation therapy for the bone metastases.

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