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Comparing Treatments for Prostate Cancer: Radical Prostatectomy, Radiotherapy and Hormonal Therapy

screening is widely used as an aid to early detection of prostate cancer. Early detection increases the opportunity for long-term progression-free survival. Presently, the selection of treatment for early stage prostate cancer involves four choices: radical prostatectomy, brachytherapy, external beam radiation therapy and hormonal therapy.



Question: Does a patientís choice of treatment for prostate cancer affect his progression-free survival rate?

(Progression-free means no cancer recurrence. Progression means cancer recurrence.)

We updated and evaluated results for progression-free survival rates in patients diagnosed with prostate cancer from a screening study.

Cancer progression was defined as follows:

PSA was greater than 0.2 ng/ml for surgery patients.

PSA rose in three consecutive tests for radiotherapy patients.

PSA was rising for patients treated with hormonal therapy.

Conclusion: Radical prostatectomy and brachytherapy had similar progression rates that are lower than other treatments.

However, if, as evidence seems to show, all PSA rises will become progressions, then the intermediate rises in patients treated by brachytherapy will ultimately become progressions.

Then, RRP has a lower progression rate than other treatments with intermediate term follow-up.

Kimberly A Roehl, Jo Ann V Antenor, Kiersten Ray-Kuhn, St. Louis, MO; William J. Catalona, Chicago, IL; Brain K Suarez, St. Louis, MO

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