RE: UroToday - Complications of Open Radical Retropubic Prostatectomy in Potential Candidates for Active Monitoring - Abstract

[Guest guest]

For any newly diagnosed men reading

this posting, it should be emphasized that the percentages mentioned i.e. <snip>

After 18 months of follow-up, potency was

preserved in 70% to

74%. At least 93% of patients were continent, and the rate of surgical complications

ranged from 5% to 7%. <snip> will be related to the definitions of

potency, continence and complications.

The definitions of the first two of these

morbidities may not be quite what you think and to understand this study and

make use of it you should try to access the full study, not merely this Press

Release.

As I have said before, I do believe that

anyone posting studies, press releases etc should annotate their posts so

that there is a context for the newly diagnosed to better understand

them.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Kathy Meade

Sent: Friday, 28 March 2008 4:44

AM

To: Kathy Meade

Subject:

UroToday - Complications of Open Radical Retropubic Prostatectomy in Potential

Candidates for Active Monitoring - Abstract

Wednesday, 26 March 2008

Department of Urology, s Hopkins School

of Medicine, Baltimore,

land.

With the widespread use of prostate-specific antigen (PSA)-based screening,

there is now concern about the overdiagnosis and overtreatment of men with

low-risk prostate cancer (PCa). One of the most difficult aspects of PCa

management is a balance of the often-competing goals of cancer control with

functional outcomes and quality of life. To address this issue, we examined

the potency, continence and overall complication rates associated with

radical prostatectomy (RP), specifically in potential candidates for active

monitoring.

From a large RP database, we compared potency, continence, and complication

rates among men meeting one of the following active monitoring criteria from

the literature: clinically localized, Gleason score of 7 or less, and no

significant comorbidities; T1b-T2b NOMO, Gleason score of 7 or less, and PSA

of 15 ng/mL or less; and T1c PCa.

There were 3458, 3533, and 2338 men who met the above criteria,

respectively. After 18 months of follow-up, potency was preserved in 70% to

74%. At least 93% of patients were continent, and the rate of surgical

complications ranged from 5% to 7%. Increasing age was significantly

associated with a greater risk of all complications.

Men with newly diagnosed low-risk PCa must carefully weigh the risks and

benefits of treatment. In young men with low-risk PCa, RP was associated

with a relatively low complication rate and good long-term functional

outcomes. However, with increasing age, RP was associated with significantly

higher complication rates. These results can be used to help guide

management decisions for men with low-risk disease.

Written by

Loeb S, Roehl KA, Helfand BT, Catalona WJ.

Reference

Urology. 2008 Mar 6. Epub ahead of print.

doi:10.1016/j.urology.2007.12.016

PubMed Abstract

PMID:18329080

[Guest guest]

Terry,

As I have said before I post these studies

because they may be helpful to some. My time is very limited because I am

working full time. I have had to pull back my involvement. What I am sending

from UROTODAY is the abstract not a press release. These are journal summaries

for physicians. They are at time technical but men should be aware they are

what their physicians may be reading. At the bottom of each post is information

that will help anyone get more information.

Written by

Loeb S, Roehl KA, Helfand BT, Catalona WJ.

These are the authors of the article. The first and the last are

the one who have been most involved.

Reference

Urology. 2008 Mar 6. Epub ahead of print.

doi:10.1016/j.urology.2007.12.016

This is information about the Journal where the article is published.

Most articles will cost money to read but if anyone is interested they can go

to a medical library and read it for free. If not you have to pay for the cost

of the article.

PubMed Abstract

PMID:18329080

This is the PubMed number that will help you find a link to the article

online through the National Library of Medicine,

I would appreciate it if others can explain the abstracts if they need

explaining. My time is very limited.

If they are not helpful, I will discontinue sending them to the list.

Kathy

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of Terry Herbert

Sent: Friday, March 28, 2008 1:50

AM

To:

ProstateCancerSupport

Subject: RE:

UroToday - Complications of Open Radical Retropubic

Prostatectomy in Potential Candidates for Active Monitoring - Abstract

For any newly diagnosed men reading this posting, it should

be emphasized that the percentages mentioned i.e. <snip> After 18 months of follow-up, potency was preserved in 70% to

74%. At least 93% of patients were continent, and the rate of surgical

complications ranged from 5% to 7%. <snip> will be related to the

definitions of potency, continence and complications.

The definitions of the first two of these morbidities may not be

quite what you think and to understand this study and make use of it you should

try to access the full study, not merely this Press Release.

As I have said before, I do believe that anyone posting studies,

press releases etc should annotate their posts so that there is a context

for the newly diagnosed to better understand them.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr “Snuffy” Myers : " As a physician, I am painfully aware that

most of the decisions we make with regard to prostate cancer are made with

inadequate data "

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Kathy Meade

Sent: Friday, 28 March 2008 4:44

AM

To: Kathy Meade

Subject:

UroToday - Complications of Open Radical Retropubic Prostatectomy in Potential

Candidates for Active Monitoring - Abstract

Wednesday,

26 March 2008

Department of Urology, s

Hopkins School of Medicine, Baltimore,

land.

With the widespread use of prostate-specific antigen (PSA)-based screening,

there is now concern about the overdiagnosis and overtreatment of men with

low-risk prostate cancer (PCa). One of the most difficult aspects of PCa

management is a balance of the often-competing goals of cancer control with

functional outcomes and quality of life. To address this issue, we examined

the potency, continence and overall complication rates associated with

radical prostatectomy (RP), specifically in potential candidates for active

monitoring.

From a large RP database, we compared potency, continence, and complication

rates among men meeting one of the following active monitoring criteria from

the literature: clinically localized, Gleason score of 7 or less, and no

significant comorbidities; T1b-T2b NOMO, Gleason score of 7 or less, and PSA

of 15 ng/mL or less; and T1c PCa.

There were 3458, 3533, and 2338 men who met the above criteria,

respectively. After 18 months of follow-up, potency was preserved in 70% to

74%. At least 93% of patients were continent, and the rate of surgical

complications ranged from 5% to 7%. Increasing age was significantly

associated with a greater risk of all complications.

Men with newly diagnosed low-risk PCa must carefully weigh the risks and

benefits of treatment. In young men with low-risk PCa, RP was associated

with a relatively low complication rate and good long-term functional

outcomes. However, with increasing age, RP was associated with significantly

higher complication rates. These results can be used to help guide

management decisions for men with low-risk disease.

Written by

Loeb S, Roehl KA, Helfand BT, Catalona WJ.

Reference

Urology. 2008 Mar 6. Epub ahead of print.

doi:10.1016/j.urology.2007.12.016

PubMed Abstract

PMID:18329080

[Guest guest]

Kathy

I think we just have to accept that these posts are just indicative of present research results.

From my reading they have not all had peer reviews and therefore must be taken with a pinch of salt.

I find them useful however to see what is being looked at and what may come through later with further work.

What does eveyone else think??

UroToday - Complications of Open Radical Retropubic Prostatectomy in Potential Candidates for Active Monitoring - Abstract

Wednesday, 26 March 2008 Department of Urology, s Hopkins School of Medicine, Baltimore,land.With the widespread use of prostate-specific antigen (PSA)-based screening,there is now concern about the overdiagnosis and overtreatment of men withlow-risk prostate cancer (PCa). One of the most difficult aspects of PCamanagement is a balance of the often-competing goals of cancer control withfunctional outcomes and quality of life. To address this issue, we examinedthe potency, continence and overall complication rates associated withradical prostatectomy (RP), specifically in potential candidates for activemonitoring.From a large RP database, we compared potency, continence, and complicationrates among men meeting one of the following active monitoring criteria fromthe literature: clinically localized, Gleason score of 7 or less, and nosignificant comorbidities; T1b-T2b NOMO, Gleason score of 7 or less, and PSAof 15 ng/mL or less; and T1c PCa.There were 3458, 3533, and 2338 men who met the above criteria,respectively. After 18 months of follow-up, potency was preserved in 70% to74%. At least 93% of patients were continent, and the rate of surgicalcomplications ranged from 5% to 7%. Increasing age was significantlyassociated with a greater risk of all complications.Men with newly diagnosed low-risk PCa must carefully weigh the risks andbenefits of treatment. In young men with low-risk PCa, RP was associatedwith a relatively low complication rate and good long-term functionaloutcomes. However, with increasing age, RP was associated with significantlyhigher complication rates. These results can be used to help guidemanagement decisions for men with low-risk disease.Written by Loeb S, Roehl KA, Helfand BT, Catalona WJ.Reference Urology. 2008 Mar 6. Epub ahead of print. doi:10.1016/j.urology.2007.12.016PubMed Abstract PMID:18329080

[Guest guest]

This one was in a peer reviewed journal,

Urology.

Some are comments or opinion pieces but

this should be easy to distinguish. IMO these should also be read because they

will be read by urologists.

Terry is correct, we do not know from the

abstract what the definition is for comorbidities.

That said the statement below is probably

factual and should be considered by men making decisions:

Increasing age was significantly

associated with a greater risk of all complications.

Men with newly diagnosed low-risk PCa must carefully weigh the risks and

benefits of treatment. In young men with low-risk PCa, RP was associated

with a relatively low complication rate and good long-term functional

outcomes. However, with increasing age, RP was associated with significantly

higher complication rates. These results can be used to help guide

management decisions for men with low-risk disease.

Older men with low risk disease should be much more cautious about

rushing to treatment and should be strongly encouraged to consider AS. This

study supports a program of AS for them and they can use this as part of their

discussion with their physicians. I believe that many of them are over treated.

The decision making process is not as simple for a younger man but that

does not mean they should not chose AS but they should have information like

this to discuss with their doctors.

Kathy

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Metcalf

Sent: Friday, March 28, 2008 11:38

AM

To:

ProstateCancerSupport

Subject: Re:

UroToday - Complications of Open Radical Retropubic

Prostatectomy in Potential Candidates for Active Monitoring - Abstract

Kathy

I think we just have to accept that these posts are just indicative

of present research results.

From my reading they have not all had peer reviews and

therefore must be taken with a pinch of salt.

I find them useful however to see what is being looked at

and what may come through later with further work.

What does eveyone else think??

UroToday - Complications of Open Radical Retropubic Prostatectomy in Potential

Candidates for Active Monitoring - Abstract

Wednesday,

26 March 2008

Department of Urology, s

Hopkins School of Medicine, Baltimore,

land.

With the widespread use of prostate-specific antigen (PSA)-based screening,

there is now concern about the overdiagnosis and overtreatment of men with

low-risk prostate cancer (PCa). One of the most difficult aspects of PCa

management is a balance of the often-competing goals of cancer control with

functional outcomes and quality of life. To address this issue, we examined

the potency, continence and overall complication rates associated with

radical prostatectomy (RP), specifically in potential candidates for active

monitoring.

From a large RP database, we compared potency, continence, and complication

rates among men meeting one of the following active monitoring criteria from

the literature: clinically localized, Gleason score of 7 or less, and no

significant comorbidities; T1b-T2b NOMO, Gleason score of 7 or less, and PSA

of 15 ng/mL or less; and T1c PCa.

There were 3458, 3533, and 2338 men who met the above criteria,

respectively. After 18 months of follow-up, potency was preserved in 70% to

74%. At least 93% of patients were continent, and the rate of surgical

complications ranged from 5% to 7%. Increasing age was significantly

associated with a greater risk of all complications.

Men with newly diagnosed low-risk PCa must carefully weigh the risks and

benefits of treatment. In young men with low-risk PCa, RP was associated

with a relatively low complication rate and good long-term functional

outcomes. However, with increasing age, RP was associated with significantly

higher complication rates. These results can be used to help guide

management decisions for men with low-risk disease.

Written by

Loeb S, Roehl KA, Helfand BT, Catalona WJ.

Reference

Urology. 2008 Mar 6. Epub ahead of print.

doi:10.1016/j.urology.2007.12.016

PubMed Abstract

PMID:18329080

[Guest guest]

I have appreciated the Uro Today abstracts that Kathy has so kindly posted.

"it is time for us to change the nature of how we live together on this planet." Al Gore Jr.

Re: UroToday - Complications of Open Radical Retropubic Prostatectomy in Potential Candidates for Active Monitoring - Abstract

Kathy

I think we just have to accept that these posts are just indicative of present research results.

From my reading they have not all had peer reviews and therefore must be taken with a pinch of salt.

I find them useful however to see what is being looked at and what may come through later with further work.

What does eveyone else think??