Thursday, March 4, 2010

POSTED BY DR. GEORGE M. SUAREZ, M.D. 3-4-10

The following is a perfect example of the lack of precision with Radiation --- (Brachytherapy seeds and/or Eternal Beam) commonly seen in the treatment of prostate cancer. It also explains the high incidence of associated complications and co-lateral damage when the ionizing effect of the scatter of radiation is inadvertently emitted to surroundings organs; such as the bladder, bowel and the nerves responsible for the preservation of potency.
Also, radiation therapist and medical oncologist often fail to inform patients that exposure to radiation places them at risk of developing a secondary cancer elsewhere. High Intensity Focused Ultrasound (HIFU), is an excellent alternatives for patients considering an ablative therapy with less risks of such complications.

George M. Suarez, M.D.

Contact information:

George M. Suarez, M.D. F.A.C.S. F.A.C.P.Founder, Medical Director EmiratesUSHIFU, International HIFUWebsite: WWW.HIFUMEDICALEXPERT.COMTELEPHONE: 305-5950199FAX: 305-59501969195 SUNSET DRIVE, SUITE 110MIAMI, FLA. 33173

LET MEN DECIDE ON PROSTATE SCREENING, CANCER SOCIETY SAYS

Let men decide on prostate screening, cancer society says
By Miriam Falco, CNN
March 3, 2010 12:47 p.m. EST
The American Cancer Society recommends that men weigh the risks of treatment before agreeing to prostate screening.
STORY HIGHLIGHTS
Patients should weigh risks of treatment before undergoing screening, group says
PSA tests sometimes give false positive results, leading to unnecessary therapies
Revised guidelines place greater emphasis on individual counseling by doctors
American Urological Association says all men should have baseline PSA test at 40
RELATED TOPICS
American Cancer Society
Prostate Cancer
Medical Treatments and Procedures
(CNN) -- Most men 50 and older should seriously consider the potential risks of treatment before deciding whether to be screened for prostate cancer, the American Cancer Society said Wednesday in revised guidelines.
"What we are trying to say to men is the harms (of prostate screening) are better proven than the benefits," said Dr. Otis Brawley, chief medical officer of the American Cancer Society.
Prostate cancer screening consists of the prostate specific antigen, or PSA, blood test or a digital rectal examination.
While these tests can detect cancer, they also can produce false positive results that lead to unnecessary and uncomfortable biopsies and treatments that carry undesirable side effects such as impotence and urinary incontinence.
On the other hand, tests that appear normal can overlook existing cancers.
The American Cancer Society estimates 192,000 men were diagnosed with cancer last year. Prostate cancer is the second leading cancer in men, killing about 27,000 in 2009.
The cancer society now recommends that beginning at age 50, men with no special risk of prostate cancer discuss the pros and cons of screening with their doctors and decide together whether it's worth doing.
The new guidelines are pretty much like the old guidelines issued in 1997 and 2001, but put more emphasis on individual counseling.
Cancer society official on what's behind the guideline change
Stephen, 63, a testicular cancer survivor from Hamilton, New Jersey, has undergone routine screening since he was in his late 40s. In 2007, his test results showed the PSA levels were climbing.
Even though his PSA levels were still below the 4.0 nanograms per milliliter threshold considered to be a positive PSA score, Stephen, who asked that we only use his first name, said he just wanted to eliminate the cancer risk.
"I did tons of research and was offered a lot of options," he said. "I decided to get a radical prostatectomy. I had no really long-term side effects, thankfully."
Cancer specialists know that because prostate cancer is usually a slow growing disease, many men are likely to die from other causes before they would die from prostate cancer.
The cancer society's Brawley says better cancer screening tools are needed.
"In prostate cancer we desperately need to tell the difference between cancers that kill and cancers we need to watch," he said.
Until new screening tools are available, the updated guidelines are meant to help men decide what to do.
Two studies published in the New England Journal of Medicine almost a year ago failed to clearly answer whether men should be screened using a PSA test.
One study conducted in the United States found no significant difference in the incidence of death among men who were screened for prostate cancer and those who weren't. In the other study, conducted at multiple sites in Europe, researchers found PSA testing lowered prostate cancer-related deaths by 20 percent.
According to data from the National Cancer Institute, three out of 100 men will die of prostate cancer. A 20 percent reduction in deaths as seen in the European study translates to only 2.4 men out of 100 dying.
Consequently the guidelines have essentially stayed the same. The American Cancer Society believes before a man gets screened for prostate cancer, he should be educated about the pros and cons.
"We want men who want to get screened to get screened, and men who don't want to get screened don't have to," Brawley said. "It should be left up to the man."
"I think the ACS folks got it right," said Dr. Michael Barry, who reviewed the two major studies for the New England Journal of Medicine last March. Barry is the chief of the general medicine unit at Massachusetts General Hospital in Boston and president of the Foundation for Informed Medical Decision Making. He said men really need to learn about the risks and benefits of prostate screening and make a decision for themselves.
"Before we had the trials, we had to say we don't know if there's a benefit to screening. Now we can begin to quantify those benefits," he said.
The American Society of Clinical Oncology, which represents cancer specialists, including those treating prostate cancer patients, supports the Cancer Society guidelines.
"All men considering testing for prostate cancer should be fully informed by their clinicians about their risk factors and other uncertainties before being screened," a statement from ASCO President Dr. Douglas Blaney said.
But not everyone agrees with the new/old cancer society recommendations. The American Urological Association, which revised its guidelines last April based on the same two studies, agrees that making an informed decision for screening is important. But it says all men with a life expectancy of 10 years or more should have a baseline PSA test at the age of 40.
Dr. Herbert Lepor, chairman of urology at NYU Langone Medical Center in New York, takes care of prostate cancer patients, including Stephen. Lepor believes every man should be screened once for prostate cancer at 40, and annually after 50.
He says then, when you find the 10 percent to 15 percent of men whose screenings suggest a risk of cancer, you talk to them about the risks and benefits of treatment.
Lepor thinks it is impractical to suggest that a primary care physician who has 15 to 20 minutes to spend with a patient fully explain all the pros and cons of screening in the course of an annual physical.
"How do you present this to a patient? You can't possibly spend an hour discussing this," Lepor said.
During the same 15- or 20-minute physical, the physician also has to discuss issues like blood pressure, diabetes, exercise and diet.
The new guidelines say that men can "be referred to reliable and culturally appropriate sources," so the information doesn't have to come from a doctor, Brawley noted.
For Stephen, getting screened is important.
"I would do it again," he said. "I have a son in his early 40s, and i'm telling him, 'Please get screened.' "


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diamondback1
diamondback1
i had prostate cancer and had the operation 9years ago and doing fine. it's up to you what you want to live or die...good luck..
1 hour ago Like (1) Report abuse
notjustpsa
notjustpsa
There is a lot of information that is missing in the original article. The insurance companies do recommend and do pay for the psa test. Especially for high risk patients like me: my father had prostate cancer. I just now am recovering from prostate surgery myself. My primary care physician was moni ...more
There is a lot of information that is missing in the original article. The insurance companies do recommend and do pay for the psa test. Especially for high risk patients like me: my father had prostate cancer. I just now am recovering from prostate surgery myself. My primary care physician was monitoring my psa. It went up almost 1 point per year the last two years. This is called psa veloctiy: how much the psa increases per year. One or more per year is considered high velocity. My physician referred me to a urologist. He did an ultrasound that showed a moderately enlarged prostate, but no indication of cancer. The urologist recommended that I have a urine test. This is the newest diagnostic tool for prostate cancer detection. The urine test (called pca3) was above normal. The urologist did a biopsy and cancer was detected. The main issue for all of us, men and women, is to monitor our own health and do all the research necessary to be prepared when we go for our annual physical. I decided on surgery because I am young, 58. Yes, prostate cancer is slow growing, but if detected at age 58 agressive treatment is recommended. less
1 hour ago Like (1) Report abuse
bluemaitai
bluemaitai
As a woman, this AMA recommendation for men to "make their own screening decision" is a bit grating.For years, cervical cancer screening has yielded similar results - high volume testing resulting in few aggressive cancers being diagnosed, with a measurably high degree of harmful over-treatment as a ...more
As a woman, this AMA recommendation for men to "make their own screening decision" is a bit grating.For years, cervical cancer screening has yielded similar results - high volume testing resulting in few aggressive cancers being diagnosed, with a measurably high degree of harmful over-treatment as a result. In fact, cervical cancer is also typically slow-growing, and rarer than prostate cancer - yet you don't see the AMA telling women to make their own decisions.I don't have the US figures on-hand, but in the UK (where rates of cervical cancer per capital are similar), 1000 women have to be screened 35 years to prevent 1 death. For each death prevented (and 1000 women screened), 150 women have an abnormal cervical screen, 80 or so are referred for further investigation, and only 50 or so actually require treatment.How typical that the AMA should encourage men to make their own decisions regarding prostate cancer screening - because their tests and potential treatments are "potentially damaging and uncomfortable" - while women are discouraged from making screening decisions, often being strongly “told” by their doctors to continue high frequency screening, despite the tests being just as uncomfortable and treatments equally damaging.In this age of health care reform, perhaps the male-centric health care profession should open its eyes and suggest women start making their own well-informed decisions as well. less
1 hour ago Like (4) Report abuse
bluemaitai
bluemaitai
That's interesting, CatherGirl, as I've never been asked for my consent. It's more or less been my experience that it's assumed you'll be having a pap if you come in for a physical. I've refused the hpv/pap as I'm not at risk, and have always gotten an earful. I've heard similar things from friends, ...more
That's interesting, CatherGirl, as I've never been asked for my consent. It's more or less been my experience that it's assumed you'll be having a pap if you come in for a physical. I've refused the hpv/pap as I'm not at risk, and have always gotten an earful. I've heard similar things from friends, as well. Either you've gotten lucky with a wonderful physician, or most everyone I know has a lousy doctor. less
1 hour ago Like (1) Report abuse
bluemaitai
bluemaitai
Sorry.. meant to quote my source on the UK figures: British Medical Journal Volume 326 April 26 2003. "Outcomes of screening to prevent cancer: analysis of cumulative incidence of cervical abnormality and modelling of cases and deaths prevented". A E Raffle, B Alden, M Quinn, P J Babb, M T Brett.
1 hour ago Like Report abuse
CatherGirl
CatherGirl
Women do make their own decisions regarding Pap smears. I only get one if I consent to it. It's also valuable not for it's detection of transformed cells, but for its detection of HPV. That is a part of every Pap test. That lets women know if they are infected and then (if they are responsible), the ...more
Women do make their own decisions regarding Pap smears. I only get one if I consent to it. It's also valuable not for it's detection of transformed cells, but for its detection of HPV. That is a part of every Pap test. That lets women know if they are infected and then (if they are responsible), they will tell their partner that they are infected as well. People who aren't tested don't know when they get infected and then they blithely pass it on to the next partner. Besides, the test isn't so bad. If you don't want a test, don't get one. You decide. less
1 hour ago Like (2) Report abuse
DSF
DSF
what your all missing is where this comes from, the insurance companies dont have to pay for it..if its not ABSOLUTLY NEEDED, this is their version of "healthcare reform". Buy a few MD's and get them to read a script, and BINGO we just increased our profit share for the next year....
2 hours ago Like (1) Report abuse
tpe
tpe
I seriously doubt the insurance industry cares about how many tests we demand. Ultimately we will collectively pay for the procedures we collectively receive and the insurance industry will still turn a profit. If their costs go up our premiums will go up accordingly.
1 hour ago Like Report abuse
nessuno
nessuno
If you are diagnosed with prostate cancer there is no way to know if its the aggressive type or the slow growing or if you might die of something else before it kills you. Yeah tell someone he has three months to live due to some ailment and then he dies in a car accident one month later - gee I gue ...more
If you are diagnosed with prostate cancer there is no way to know if its the aggressive type or the slow growing or if you might die of something else before it kills you. Yeah tell someone he has three months to live due to some ailment and then he dies in a car accident one month later - gee I guess the doctors where wrong he didn't die from that disease after all. Why put yourself in a situation where you know that prostate cancer will kill you should you live long enough. Why not eliminate one possible cause of your death if you can.I found a comment above about socialized medicine rather disturbing. I live in Italy where we have socialized medicine. All I had to do was ask my doctor to prescribe the psa test and on her own she included the free psa test. When we get blood tests here in the morning, the results are available over the internet that evening or in person the next day. All of my procedures where free including the robotic aided laproscopic surgery. Don't be fooled by the fear of socialized medicine. When doctors are free of health insurance restrictions and profit incentives they are free to practice medicine as best they can with no motive other than giving the patient the best care possible. less
2 hours ago Like (1) Report abuse
Guest
Guest
This is what bothers me when I hear people talk about socialized medicine. You say, "all my procedures were free". No, they are NOT free. The money is coming from SOMEWHERE (the doctor isn't working for free). And the money is coming in the form of your taxes, income taxes or otherwise. Compare your ...more
This is what bothers me when I hear people talk about socialized medicine. You say, "all my procedures were free". No, they are NOT free. The money is coming from SOMEWHERE (the doctor isn't working for free). And the money is coming in the form of your taxes, income taxes or otherwise. Compare your tax liability with the cost of health care in the US system and then decide if its less expensive or not. I actually don't know if the EU system is "cheaper" than the US - but I do know one thing - it is NOT free. less
46 minutes ago Like Report abuse
tpe
tpe
It sounds like everyone who's been treated for prostate cancer had a doctor that told them pretty much the same thing. The doctor tells them that they were very wise to have had the procedure. Imagine that. What exactly would you expect the doctor to say?
2 hours ago Like (2) Report abuse
Guest
Guest
not to be rude, but there seems to be a lot of reactionary statements here (much like the breast cancer guidelines).the ACS guidelines do not appear to be advocating that you do not get screening. they are only advocating that you should sit down with your doctor, have a talk about it, examine the r ...more
not to be rude, but there seems to be a lot of reactionary statements here (much like the breast cancer guidelines).the ACS guidelines do not appear to be advocating that you do not get screening. they are only advocating that you should sit down with your doctor, have a talk about it, examine the risk/benefit ratio, and then decide whether or not to get the test.excuse me, but that sounds like a very reasonable approach to medicine, period, whether that's a test, a drug, a surgery, or whatever. whether you like it or not, many primary care physicians send the PSA WITHOUT ASKING the patient whether or not they want it. the ACS definitely seems to advocate against that, and that's their right. after all, why don't we all drink some golytely, poop up a storm, and have a camera up your colon at 40 instead of 50? because right now, what evidence we have suggests that wouldn't help us, though there are definitely people who get colon cancer before 50! would you want your doctor to write a pill and tell you to take it, and you have no say? can i take out your gallbladder, no questions asked?of course not. less
2 hours ago Like Report abuse
Terry1
Terry1
99.99% of the folks sounding off and making comments on this issue have health care and can get the tests. Reform is for the folks who don't have health care and need the reform. It sounds like some on this subject are only concerned with dollars and cents and not sense. American should focus on pre ...more
99.99% of the folks sounding off and making comments on this issue have health care and can get the tests. Reform is for the folks who don't have health care and need the reform. It sounds like some on this subject are only concerned with dollars and cents and not sense. American should focus on prevention and healthy life styles such as fruits and veggies; less red meat, exercise, elimination of smoking and drinking alcohol. These steps would move the country in the right direction of health and wellness. less
2 hours ago Like Report abuse
Albus
Albus
I agree 100%. What if health insurers (or even the government, God forbid) incentivised or disincentivised folks with dollars for healthy or unhealthy lifestyle choices? I guess there is a chance the health nazis might get involved but think of how that would lower the cost of health assets that go ...more
I agree 100%. What if health insurers (or even the government, God forbid) incentivised or disincentivised folks with dollars for healthy or unhealthy lifestyle choices? I guess there is a chance the health nazis might get involved but think of how that would lower the cost of health assets that go to such things as diabetes, coronary health, blood pressure problems and the like. less
2 hours ago Like Report abuse
Albus
Albus
This drives me nuts. One of the reasons our medical costs are what they are is that so many people do not believe in preventative care and healthy lifestyle choices. Rather, they like to think if they get sick, a doctor will take care of it. Medical guidelines will prevail. Right. If I had followed ...more
This drives me nuts. One of the reasons our medical costs are what they are is that so many people do not believe in preventative care and healthy lifestyle choices. Rather, they like to think if they get sick, a doctor will take care of it. Medical guidelines will prevail. Right. If I had followed them, I would be dead. Keep in mind that most any doctor sees hundreds or thousands of patients and as dedicated as they may be, only you are responsible for the best care you can get. And no one has the vested interest in your health that you do. Eat smart. Get lots of exercise. Drink a little red wine. Cut down on stress. Love your loved ones and screen for every damned thing you reasonably (!) can. Life may be longer but it will surely be better. And medical costs in this country will go down to boot. less
2 hours ago Like Report abuse
DSF
DSF
while i agree with you on the learning to live better, americans are "engineered" to eat poorly, tried to buy anything "organic" lately ?
2 hours ago Like Report abuse
SeattleGuest
SeattleGuest
And another thing. Yes, I have the 5-year colonoscopy, and yes, I got my daughter the cervical cancer vaccine. And no, I'll not be taking my medical advice from Dr. Otis Brawley, chief medical officer of the American Cancer Society.
3 hours ago Like (3) Report abuse
SeattleGuest
SeattleGuest
"Cancer specialists know that because prostate cancer is usually a slow growing disease, many men are likely to die from other causes before ... prostate cancer." Really bad info CNN. 20% of prostate cancers are "high grade" or "aggressive" and they kill pretty quickly. My symptomless "high grade" w ...more
"Cancer specialists know that because prostate cancer is usually a slow growing disease, many men are likely to die from other causes before ... prostate cancer." Really bad info CNN. 20% of prostate cancers are "high grade" or "aggressive" and they kill pretty quickly. My symptomless "high grade" was found through PSA testing. My thanks to the Seattle Cancer Care Alliance for the 5 more years so far. And I sure told my two sons to get tested regularly. less
3 hours ago Like (4) Report abuse
Eric6397
Eric6397
Go ahead, don’t bother getting a prostate screening. Those could be your most ignorant last words, and you can start shopping for a headstone. Last year, my PSA was 3.8, which is under the 4.0 threshhold, but up from 1.3 of the previous year. My family physician referred me to a urologist. I was 62 ...more
Go ahead, don’t bother getting a prostate screening. Those could be your most ignorant last words, and you can start shopping for a headstone. Last year, my PSA was 3.8, which is under the 4.0 threshhold, but up from 1.3 of the previous year. My family physician referred me to a urologist. I was 62 with no family history of any cancer. There were no symptoms, no swelling, no problems whatsoever, and the rectal exams indicated nothing abnormal aside from typical age-related prostate enlargement which was well within the norms. The urologist recommended a biopsy just to be on the safe side of things. Of the 12 snippets taken, only one came back cancerous, and the Gleason Score was 7, on a scale of 10, which means it was moderately aggressive. The urologist, unfortunately, did not impart to me all of the treatment options available, and lobbied for what he does best: robotic surgery. He cautioned that I would be impotent and incontinent for the rest of my life. These were not options for me. My wife and I needed to do some serious research because this decision would affect me for the rest of my life, and would indeed determine if I would even have a life. I read five books on prostate cancer and networked with lots of friends who turned out to either have had treatment for prostate cancer or who were about to have treatment. I read everything about the different types of radiation therapy and surgeries available, and the pros and cons of each. Five days after diagnosis, I had made my treatment option of open surgery for a radical nerve-sparing prostatectomy with a surgeon who is considered to be the best in the world. Ten weeks after diagnosis, I underwent the surgery which was 100% successful and with no side effects. The point of all of this: the cancer had spread to over 75% of the prostate in those 10 weeks, and the surgeon said that if I had left it alone, I most likely would have been dead within a year. It turned out to be very aggressive. So you will never know, until you get screened. Prostate cancer is not to be messed with. It is a cancer, and it will kill you, and any doctor who says otherwise needs to find another line of work. I am alive because my doctors were proactive, and my wife and I confronted this disease head-on and beat it with the therapy that suited us best. less
3 hours ago Like (9) Report abuse
CatherGirl
CatherGirl
Eric, I'm glad you found a good treatment. You will have to follow up every 6 months with PSA and other tests to detect growth. One thing I will impart to you: do NOT take any folic acid supplements for any reason. Prostate cancer cells love this even more than other cancers because of one of their ...more
Eric, I'm glad you found a good treatment. You will have to follow up every 6 months with PSA and other tests to detect growth. One thing I will impart to you: do NOT take any folic acid supplements for any reason. Prostate cancer cells love this even more than other cancers because of one of their proteins. Vitamin C is a good one but no folic acid. You will be encouraging dormant seeds to grow. Ditch the multivitamin. Think about celecoxib. All cancers use the immune cells to grow and celecoxib will knock that back. Ask your doctor. less
1 hour ago Like Report abuse
kitkat76
kitkat76
Again, all this focus on the level of 4.0 is too simplistic. Its well known within the medical field that the slop of the PSA (i.e., rate of rise) is as important as the actual absolute value... so while you are all focusing on the miracle, its actually a well described phenomena known to most MDs.
3 hours ago Like Report abuse
Ruddy
Ruddy
Let me rephrase what these educated physicians should understand already. There is NO RISK to prostate screening. The risk lies solely in the treatment options. And that is individual. Are these medical people or gossip mongers?
3 hours ago Like (4) Report abuse
kitkat76
kitkat76
Not true. First, why check a test if you don't have any intention to act on it? Just to waste money? Second, once you do a test you know that a certain portion of men are going to get a biopsy (which is unfortunately, not always accurate, although its the best we have for now). The inaccurate biopsy ...more
Not true. First, why check a test if you don't have any intention to act on it? Just to waste money? Second, once you do a test you know that a certain portion of men are going to get a biopsy (which is unfortunately, not always accurate, although its the best we have for now). The inaccurate biopsy results might convince people to undertake surgical procedures that cause impotence and incontinence and pain with urination... and derive no benefit... as the tumor turns out to be a very slow growing, essentially harmless prostate cancer. Thats why they do these large studies... to figure out what exactly are the risks and benefits of screening. Effective screening is good, ineffective screening is not. The PSA is stuck in the muddy middle. less
2 hours ago Like Report abuse
Ruddy
Ruddy
Sounds like the dark ages! Of course we need information. Screening provides information! That's all, no more, no less. What we need to focus on is what to DO with that information. That requires patient 'education' and more time face to face with the doctor. I will always request prostate screening ...more
Sounds like the dark ages! Of course we need information. Screening provides information! That's all, no more, no less. What we need to focus on is what to DO with that information. That requires patient 'education' and more time face to face with the doctor. I will always request prostate screening because my grandfather died from prostate cancer. However, what I will question is how to deal with positive results of the screening. That is up to me and my doctor. I should not lose the right to obtain that information, but with this article, I feel that the powers that be are going to out right refuse the screening before long.... less
3 hours ago Like (1) Report abuse
kitkat76
kitkat76
Everyone seems to focus on the cancers prevented and the people who die. While those are understandably moving, just read the article and ponder this. 3 men out of 100 will die of prostate cancer. Screening only reduces this to 2.4 out of 100. That means that you have to screen ~167 men to save one ...more
Everyone seems to focus on the cancers prevented and the people who die. While those are understandably moving, just read the article and ponder this. 3 men out of 100 will die of prostate cancer. Screening only reduces this to 2.4 out of 100. That means that you have to screen ~167 men to save one man's life from prostate cancer. Now while you are screening those 167 men, how many of those men will have impotence following an invasive procedure due to a false positive screening? How many will have incontinence? How many will need to undergo a transrectal biopsy of the prostate (never had one... but probably not pleasant). The complications of prostate cancer can be tragic. However, most people die with prostate cancer, not from prostate cancer. And for most of those people it never progress to the point of having bone metastases or other serious complications.Thats why ultimately, you should discuss it with your doctor. Doctors are often torn about whether its worthwhile themselves. less
3 hours ago Like Report abuse
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Wednesday, March 3, 2010

DR. SUAREZ WISHES TO SHARE IMPORTANT INFORMATION ON PSA

FOR IMMEDIATE RELEASE: March 03, 2010
Contact: Wendy Isett, AUA410-689-3789, wisett@auanet.org
AUA RESPONDS TO AMERICAN CANCER SOCIETY GUIDELINES FOR THE EARLY DETECTION OF PROSTATE CANCER
LINTHICUM, MD, March 3, 2010-Today, the American Cancer Society issued its new Guideline for the Early Detection of Prostate Cancer. The American Urological Association (AUA), which represents more than 16.000 urologists and urologic health professionals worldwide, issued the following statement in response to the new ACS document. The statement is attribute to AUA President Anton J. Buescher, MD. "The American Urological Association (AUA) today applauds the American Cancer Society (ACS) for its new guidance statement on prostate cancer detection. We concur that informed consent - including a discussion between physician and patient about the risks and benefits of testing - is a key part of one's decision to be tested for prostate cancer. Equally it is necessary that patients receive culturally appropriate information from reliable sources. However, the new ACS statement may not fully Characterize the potential benefits of an individualized approach to assessing risk in men considering the risk and benefits of early detection strategies and may cause significant confusion for patients. The AUA feels PSA there is no single standard that applies to all men, nor should there be. Part of informed consent is giving patients as much information about their personal risk as is available. Applying population-based cut points while ignoring other individual risk factors (such as age, ethnicity, family history, previous biopsy characteristics, etc..) May not give a patient the most optimal assessment of his risk, including the risk of high grade disease. Prostate cancer testing is an individual decision that patients should make together with their doctor. The AUA believes that all men, with a life expectancy of 10 years or more, should have a baseline PSA test at the age of 40. Physicians should determine rescreening intervals for each patient based on PSA (and, on occasion on its change over time). Likewise, the decision to proceed to prostate biopsy should be based not only on elevated PSA and / or abnormal DRE results, but should take into account multiple factors including free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity , prior biopsy history and comorbidities. Although prostate cancer risk correlates with serum PSA, there is no PSA value below Which a man may be reassured that he does not have biopsy detectable prostate cancer.
The AUA is in full agreement with the current ACS early detection strategies that need to be refined and better validated. It is hoped that new biomarkers will be identified Which better distinguishes between indolent and aggressive prostate cancer, sparing the former from unnecessary testing and giving the latter a better chance of survival.
In April 2009, the AAU issued its new Best Practice Statement on Prostate-Specific Antigen, Which can be viewed at www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf. "

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 16.000 members throughout the world. An educational nonprofit organization, the AUA pursued its mission of Fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their patients.
# # #

Monday, March 1, 2010

FOCAL THERAPY PRESS RELEASE

24 HEALTHY UTAH MARCH 2010 25 UTHealth.com
wellness [ men’s health ]
One in 6 men in the U.S. will be diagnosed
with prostate cancer in their lifetime, and
most will have no symptoms at the time of
diagnosis. PSA (prostate specific antigen)
blood testing (available since the early 1990s)
combined with examination of the prostate
have improved early diagnosis rates. When
discovered early enough prostate cancer can
be cured. The problem men face as they make
a treatment decision is that the side-effects
of the most common treatments (radical
surgery and radiation) are significant and life
altering. Many men feel as though they are
between a rock and a hard place in making
that decision, and that the treatment seems
worse than the disease.
The development of a less invasive treatment
option called HIFU (High-Intensity Focused Ultrasound)
offers men with early prostate cancer
an exciting and potentially safer alternative.
Specifically this cancer treatment looks comparable
to traditional therapies, but with significantly
limited impact on sexual function
and causing almost no urinary incontinence.
HIFU is a therapy that destroys tissue with
rapid heating; this heating is achieved by
focusing sound waves to a very specific location
or “target”, and repeating the process
throughout the organ to attempt to completely
eradicate the tumor. Focused ultrasound
waves raise the temperature at the
tiny target area to over 90 degrees Celsius in
a matter of a few seconds, while the tissue
O outside the target area is virtually unaffected.
When performed for prostate cancer, a probe is
inserted in the rectum under anesthesia, which
both allows for precise focusing of energy to
the target and simultaneous avoidance of areas
of normal tissue, without making an incision
of any kind in the body and without the use of
ionizing radiation. A typical prostate treatment
lasts several hours and is performed on an outpatient
procedure. Patients experience little if
any post-operative pain, but may have trouble
urinating for up to a few weeks, so a small tube
is placed in the lower abdomen to drain the
urine for that time period.
HIFU was developed in the 1950s here in the
U.S., and has been used for treatment of various
tumors. It has already been FDA-approved
for use in uterine fibroids, and studies are
underway that will be presented for FDA
approval for treatment of prostate cancer soon.
Meanwhile, HIFU for prostate cancer has been
performed on nearly 10,000 men worldwide
and has been extensively studied in Japan and
Europe; studies from other countries suggest
this treatment is comparably as effective as
other treatment options but with reports of
fewer urinary and sexual side effects, making
this treatment option appealing to physicians
and patients alike.
Currently for a man from the US to receive HIFU
he must either enrolled in a clinical trial or travel
outside the US. International HIFU uses the
Sonablate® 500 overseas, and specially trained
American Urologists and a team of nurses
and engineers travel with patients for these
treatments. Most patients travel to Canada, the
Bahamas, or Mexico for their treatment, typically
arriving the day before the outpatient treatment,
and returning home the day after.
Regionally, only the doctors at Western Urological
Clinic have begun using HIFU for prostate
cancer (see www.westernhifu.com for details).
More information, including the opportunity
to speak with someone who has had HIFU
therapy, is also available at 1-888-874-4384.
About the doctor:
Dr Gange is a UCLA medical school
graduate and has practiced with
Western Urological Clinic since
1996, with particular expertise in
all stages of prostate cancer management,
emphasizing minimally
invasive procedures (including
HIFU since April 2009) and compassionate
care. He is also President of
the Utah Healthy Living Foundation,
founded in 2001 and dedicated
to improving quality of life through health
education and screenings. He is on the board
of IVUmed, an organization that trains third
world doctors to provide skilled urology care.
He has held numerous other leadership positions
including President of the Utah Urological
Society and Chief of Surgery at
St. Mark’s Hospital. He regularly
lectures to physicians and lay
groups on all aspects of urology
and was instrumental in the
creation of the Urology section
of WebMD. Dr. Gange is also
the medical director of Healthy
Utah magazine
“Heart disease is
at least six times
more likely to kill a woman
than breast cancer...”
HIFU for Prostate Cancer
w r i t t e n b y S t e v e n N . G a n g e , M D , F A C S
In spite of advances in early diagnosis, an American man dies of prostate cancer
every 15 minutes. If detected early enough it can be cured but often at a high cost of
debilitating side effects. Emerging treatments like HIFU may help change all that.

UT GANGE

24 HEALTHY UTAH MARCH 2010 25 UTHealth.com
wellness [ men’s health ]
One in 6 men in the U.S. will be diagnosed
with prostate cancer in their lifetime, and
most will have no symptoms at the time of
diagnosis. PSA (prostate specific antigen)
blood testing (available since the early 1990s)
combined with examination of the prostate
have improved early diagnosis rates. When
discovered early enough prostate cancer can
be cured. The problem men face as they make
a treatment decision is that the side-effects
of the most common treatments (radical
surgery and radiation) are significant and life
altering. Many men feel as though they are
between a rock and a hard place in making
that decision, and that the treatment seems
worse than the disease.
The development of a less invasive treatment
option called HIFU (High-Intensity Focused Ultrasound)
offers men with early prostate cancer
an exciting and potentially safer alternative.
Specifically this cancer treatment looks comparable
to traditional therapies, but with significantly
limited impact on sexual function
and causing almost no urinary incontinence.
HIFU is a therapy that destroys tissue with
rapid heating; this heating is achieved by
focusing sound waves to a very specific location
or “target”, and repeating the process
throughout the organ to attempt to completely
eradicate the tumor. Focused ultrasound
waves raise the temperature at the
tiny target area to over 90 degrees Celsius in
a matter of a few seconds, while the tissue
O outside the target area is virtually unaffected.
When performed for prostate cancer, a probe is
inserted in the rectum under anesthesia, which
both allows for precise focusing of energy to
the target and simultaneous avoidance of areas
of normal tissue, without making an incision
of any kind in the body and without the use of
ionizing radiation. A typical prostate treatment
lasts several hours and is performed on an outpatient
procedure. Patients experience little if
any post-operative pain, but may have trouble
urinating for up to a few weeks, so a small tube
is placed in the lower abdomen to drain the
urine for that time period.
HIFU was developed in the 1950s here in the
U.S., and has been used for treatment of various
tumors. It has already been FDA-approved
for use in uterine fibroids, and studies are
underway that will be presented for FDA
approval for treatment of prostate cancer soon.
Meanwhile, HIFU for prostate cancer has been
performed on nearly 10,000 men worldwide
and has been extensively studied in Japan and
Europe; studies from other countries suggest
this treatment is comparably as effective as
other treatment options but with reports of
fewer urinary and sexual side effects, making
this treatment option appealing to physicians
and patients alike.
Currently for a man from the US to receive HIFU
he must either enrolled in a clinical trial or travel
outside the US. International HIFU uses the
Sonablate® 500 overseas, and specially trained
American Urologists and a team of nurses
and engineers travel with patients for these
treatments. Most patients travel to Canada, the
Bahamas, or Mexico for their treatment, typically
arriving the day before the outpatient treatment,
and returning home the day after.
Regionally, only the doctors at Western Urological
Clinic have begun using HIFU for prostate
cancer (see www.westernhifu.com for details).
More information, including the opportunity
to speak with someone who has had HIFU
therapy, is also available at 1-888-874-4384.
About the doctor:
Dr Gange is a UCLA medical school
graduate and has practiced with
Western Urological Clinic since
1996, with particular expertise in
all stages of prostate cancer management,
emphasizing minimally
invasive procedures (including
HIFU since April 2009) and compassionate
care. He is also President of
the Utah Healthy Living Foundation,
founded in 2001 and dedicated
to improving quality of life through health
education and screenings. He is on the board
of IVUmed, an organization that trains third
world doctors to provide skilled urology care.
He has held numerous other leadership positions
including President of the Utah Urological
Society and Chief of Surgery at
St. Mark’s Hospital. He regularly
lectures to physicians and lay
groups on all aspects of urology
and was instrumental in the
creation of the Urology section
of WebMD. Dr. Gange is also
the medical director of Healthy
Utah magazine
“Heart disease is
at least six times
more likely to kill a woman
than breast cancer...”
HIFU for Prostate Cancer
w r i t t e n b y S t e v e n N . G a n g e , M D , F A C S
In spite of advances in early diagnosis, an American man dies of prostate cancer
every 15 minutes. If detected early enough it can be cured but often at a high cost of
debilitating side effects. Emerging treatments like HIFU may help change all that.

HIFU NEWS

24 HEALTHY UTAH MARCH 2010 25 UTHealth.com
wellness [ men’s health ]
One in 6 men in the U.S. will be diagnosed
with prostate cancer in their lifetime, and
most will have no symptoms at the time of
diagnosis. PSA (prostate specific antigen)
blood testing (available since the early 1990s)
combined with examination of the prostate
have improved early diagnosis rates. When
discovered early enough prostate cancer can
be cured. The problem men face as they make
a treatment decision is that the side-effects
of the most common treatments (radical
surgery and radiation) are significant and life
altering. Many men feel as though they are
between a rock and a hard place in making
that decision, and that the treatment seems
worse than the disease.
The development of a less invasive treatment
option called HIFU (High-Intensity Focused Ultrasound)
offers men with early prostate cancer
an exciting and potentially safer alternative.
Specifically this cancer treatment looks comparable
to traditional therapies, but with significantly
limited impact on sexual function
and causing almost no urinary incontinence.
HIFU is a therapy that destroys tissue with
rapid heating; this heating is achieved by
focusing sound waves to a very specific location
or “target”, and repeating the process
throughout the organ to attempt to completely
eradicate the tumor. Focused ultrasound
waves raise the temperature at the
tiny target area to over 90 degrees Celsius in
a matter of a few seconds, while the tissue
O outside the target area is virtually unaffected.
When performed for prostate cancer, a probe is
inserted in the rectum under anesthesia, which
both allows for precise focusing of energy to
the target and simultaneous avoidance of areas
of normal tissue, without making an incision
of any kind in the body and without the use of
ionizing radiation. A typical prostate treatment
lasts several hours and is performed on an outpatient
procedure. Patients experience little if
any post-operative pain, but may have trouble
urinating for up to a few weeks, so a small tube
is placed in the lower abdomen to drain the
urine for that time period.
HIFU was developed in the 1950s here in the
U.S., and has been used for treatment of various
tumors. It has already been FDA-approved
for use in uterine fibroids, and studies are
underway that will be presented for FDA
approval for treatment of prostate cancer soon.
Meanwhile, HIFU for prostate cancer has been
performed on nearly 10,000 men worldwide
and has been extensively studied in Japan and
Europe; studies from other countries suggest
this treatment is comparably as effective as
other treatment options but with reports of
fewer urinary and sexual side effects, making
this treatment option appealing to physicians
and patients alike.
Currently for a man from the US to receive HIFU
he must either enrolled in a clinical trial or travel
outside the US. International HIFU uses the
Sonablate® 500 overseas, and specially trained
American Urologists and a team of nurses
and engineers travel with patients for these
treatments. Most patients travel to Canada, the
Bahamas, or Mexico for their treatment, typically
arriving the day before the outpatient treatment,
and returning home the day after.
Regionally, only the doctors at Western Urological
Clinic have begun using HIFU for prostate
cancer (see www.westernhifu.com for details).
More information, including the opportunity
to speak with someone who has had HIFU
therapy, is also available at 1-888-874-4384.
About the doctor:
Dr Gange is a UCLA medical school
graduate and has practiced with
Western Urological Clinic since
1996, with particular expertise in
all stages of prostate cancer management,
emphasizing minimally
invasive procedures (including
HIFU since April 2009) and compassionate
care. He is also President of
the Utah Healthy Living Foundation,
founded in 2001 and dedicated
to improving quality of life through health
education and screenings. He is on the board
of IVUmed, an organization that trains third
world doctors to provide skilled urology care.
He has held numerous other leadership positions
including President of the Utah Urological
Society and Chief of Surgery at
St. Mark’s Hospital. He regularly
lectures to physicians and lay
groups on all aspects of urology
and was instrumental in the
creation of the Urology section
of WebMD. Dr. Gange is also
the medical director of Healthy
Utah magazine
“Heart disease is
at least six times
more likely to kill a woman
than breast cancer...”
HIFU for Prostate Cancer
w r i t t e n b y S t e v e n N . G a n g e , M D , F A C S
In spite of advances in early diagnosis, an American man dies of prostate cancer
every 15 minutes. If detected early enough it can be cured but often at a high cost of
debilitating side effects. Emerging treatments like HIFU may help change all that.