Re: Cryotherapy at the Cleveland Clinic

[Guest guest]

Below is a link to Cryotherapy at the Cleveland Clinic. I am not sure why this is better than having a Robotic Assisted Laparoscopic Prostatectomy by one of the country's leading surgeons. Maybe someone has the answer and will share. http://www.clevelandclinic.org/lp/natl-cryotherapy/index.html?utm_campaign=national+ads-cryotherapy & utm_medium=banner & utm_source=gdn & utm_content=300x250+rm & CS_003=5409704 Charlie D. To: ProstateCancerSupport Sent: Thursday, June 28, 2012 8:51 PM Subject: RE: Focal Surgery????

Yes, I understand about focal cryotherapy

and focal HIFU (High Intensity Focused Ultrasound) and PDT (Photo Dynamic

Therapy) which is also focal, but this article referred to focal surgery which

I took to mean cutting only the diseased portion of the gland – like a lumpectomy

in breast cancer. I’ve never come across that as a suggestion, although it

would make sense if it was accepted that it was possible to identify the precise

position of the cancer in the gland, which is the premise of the other focal

therapies. RALP (Robotic Assisted Laparoscopic Prostatectomy) would enable this

lumpectomy with very little disruption to the rest of the body.

All the best Prostate men need enlightening, not frightening Terry

Herbert - diagnosed in 1996 and

still going strong Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From: ProstateCancerSupport [mailto: ProstateCancerSupport ] On Behalf Of Nowak

Sent: Friday, 29 June 2012 2:59 AM

To: ProstateCancerSupport

Subject: Re:

Focal Surgery????

Cyrotherapy (surgery) is often focal therapy, or a

target area of the gland is eradicated leaving behind some of the gland.

On Mon, Jun 25, 2012 at 8:30 PM, Terry

Herbert wrote:

I

thought I was fairly well informed about prostate cancer matters so I was

surprised to read this piece http://tinyurl.com/7uu8pdd in an Australian paper where it

is said: <snip>

…….rather than removing the whole prostate, some surgeons now eradicate the

lump in the gland. <snip> Of

course I am aware of focal cryotherapy, focal HIFU (High Intensity Focused

Ultrasound). And even PDT (Photodynamic Therapy) all of which claim to be able

to deal with specific parts of the gland, but I hd nenver seen a write up about

focal surgery. A quick Google search threw up a few references including this

one http://prostate-cancer.med.nyu.edu/faqs/faqs-focal-therapy

Hmmmm....i’d like to see the studies that support this approach. It wasn’t

mentioned directly in Mike ’s

commentary in January this year - http://tinyurl.com/7qbznjm

All

the best Prostate

men need enlightening, not frightening Terry Herbert -

diagnosed in 1996 and still going strong Read

A

Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

--

T Nowak, MA, MSW

Director for Advocacy and Advanced Prostate Cancer Programs, Malecare

Inc.

Men Fighting Cancer, Together

Survivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancers

Speaker, Advocate and Educator

http://www.advancedprostatecancer.net/

- A blog about advanced and recurrent prostate cancer

http://www.malecare.org/ -

information and support about prostate cancer

http://health.groups.yahoo.com/group/advancedprostatecancer/

- an online support group for men and their families diagnosed with advanced

and recurrent prostate cancer

[Guest guest]

Charlie De wrote:

> Below is a link to Cryotherapy at the Cleveland Clinic. I am

> not sure why this is better than having a Robotic Assisted

> Laparoscopic Prostatectomy by one of the country's leading

> surgeons. Maybe someone has the answer and will share.

http://www.clevelandclinic.org/lp/natl-cryotherapy/index.html

Based on the above advertisement, it appears that the arguments

for it are:

  1. In and out of the hospital treatment.

    The patient doesn't have the longer hospital stay or recovery

    time associated with surgery.

  2. The doctor can see the cancer that he is treating and see it

    be frozen during the treatment.

    This is not like radiation where the radiation takes months

    or years to be fully effective.

  3. Focal therapy is possible - treating just the tumor spots.

Disadvantages not mentioned in the ad would seem to me to be:

  1. Comparative effectiveness is not established.

    This is a problem for all treatments but more so for the

    newer treatments.

    To the best of my knowledge, cryotherapy has not proven as

    effective as surgery or radiation, but that may changed since

    the early studies were done.

  2. Side effect profiles have been bad in the past.

    I read that, at one time, impotence rates were 100% and other

    nasty side effects were common. This has apparently improved

    as the practitioners have gained experience.

    Focal therapy (treating just the visible tumor spots) may be

    necessary to reduce the side effects to manageable levels. I

    don't know, but see below.

  3. Focal therapy is unproven.

    We don't know if focal therapy works as well. Imaging

    techniques each have some limit of resolution. It may be

    that an image showing one or a few tumors means that there

    are only those tumors.

[Guest guest]

Thanks for the reply. The main problem I see with the procedure is finding all the tumors with ultra sound. When I had my positive prostate biopsy, the doctor told me he

didn't see any tumors on the ultra sound, but the report came back positive. To: "ProstateCancerSupport " <ProstateCancerSupport > Sent: Saturday, June 30, 2012 2:03 PM Subject: Re: Cryotherapy at the Cleveland Clinic

Charlie De <mailto:charlie14624%40yahoo.com> wrote:

> Below is a link to Cryotherapy at the Cleveland Clinic. I am

> not sure why this is better than having a Robotic Assisted

> Laparoscopic Prostatectomy by one of the country's leading

> surgeons. Maybe someone has the answer and will share.

http://www.clevelandclinic.org/lp/natl-cryotherapy/index.html

Based on the above advertisement, it appears that the arguments

for it are:

1. In and out of the hospital treatment.

The patient doesn't have the longer hospital stay or recovery

time associated with surgery.

2. The doctor can see the cancer that he is treating and see it

be frozen during the treatment.

This is not like radiation where the radiation takes months

or years to be fully effective.

3. Focal therapy is possible - treating just the tumor spots.

Disadvantages not mentioned in the ad would seem to me to be:

1. Comparative effectiveness is not established.

This is a problem for all treatments but more so for the

newer treatments.

To the best of my knowledge, cryotherapy has not proven as

effective as surgery or radiation, but that may changed since

the early studies were done.

2. Side effect profiles have been bad in the past.

I read that, at one time, impotence rates were 100% and other

nasty side effects were common. This has apparently improved

as the practitioners have gained experience.

Focal therapy (treating just the visible tumor spots) may be

necessary to reduce the side effects to manageable levels. I

don't know, but see below.

3. Focal therapy is unproven.

We don't know if focal therapy works as well. Imaging

techniques each have some limit of resolution. It may be

that an image showing one or a few tumors means that there

are only those tumors.