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SPCG-4 trial: Update on watchful waiting versus radical prostatectomy
March 23, 2009In 2005, the Scandinavian Prostate Cancer Group Study 4 (SPCG-4) reported that radical prostatectomy improved prostate cancer survival compared with watchful waiting after a median of 8.2 years of follow-up. At the 24th Annual EAU Congress in Stockholm, Sweden the results after 3 more years of follow-up were reported by Professor Lars Holmberg from Uppsala, Sweden.
The SPCG-4 trial - which predominantly included men whose prostate cancer was not detected by PSA screening - was the first randomized trial to show that radical prostatectomy reduces the risk of prostate cancer mortality and the risk of developing metastases.
Lars Holmberg: "Key questions following our previous analyses of this trial, which were based on a median of 8.2 years of follow-up, include whether the absolute and relative benefits of surgical treatment would increase during longer follow-up, as we hypothesized; whether overall mortality would remain reduced; whether the benefit is larger among younger than among older patients; and whether histopathologic parameters can predict lethal outcome following surgery. We think the answer may well be affirmative".
The conclusion of the study is that radical prostatectomy reduces prostate cancer mortality and risk of metastases with little or no further increase in benefit 10 or more years after surgery.
Lars Holmberg: "One of the most striking results of this study was the fact that, in a follow-up of side effects, symptoms and quality of life within the randomised study, the symptom profile was different in the two randomisation groups but the overall rating of quality of life was similar. This may mean that the side effects of radical prostatectomy wear off, people get used to it perhaps." This indicates that well structured pre-treatment information, understanding of the patient's preferences and support during follow-up are central to the management of prostate cancer.
"Radical prostatectomy has changed the natural history of prostate cancer. Furthermore it is not sufficient to only to perform PSA tests in post-prostatectomy patients, we do need more tests", says Holmberg.
The SPCG-4 study continues its follow-up. The randomised patients are becoming older men by now which may again result in new and challenging data in the future.
European Association of Urology
The conclusion of the study is that radical prostatectomy reduces prostate cancer mortality and risk of metastases with little or no further increase in benefit 10 or more years after surgery.
Lars Holmberg: "One of the most striking results of this study was the fact that, in a follow-up of side effects, symptoms and quality of life within the randomised study, the symptom profile was different in the two randomisation groups but the overall rating of quality of life was similar. This may mean that the side effects of radical prostatectomy wear off, people get used to it perhaps." This indicates that well structured pre-treatment information, understanding of the patient's preferences and support during follow-up are central to the management of prostate cancer.
"Radical prostatectomy has changed the natural history of prostate cancer. Furthermore it is not sufficient to only to perform PSA tests in post-prostatectomy patients, we do need more tests", says Holmberg.
The SPCG-4 study continues its follow-up. The randomised patients are becoming older men by now which may again result in new and challenging data in the future.
European Association of Urology
Prostate Cancer Current Events and Prostate Cancer News RSSNew figures on cancer in Europe show a steady decline in mortality but big variations
New figures on deaths from cancer in Europe show a steady decline in mortality between the periods 1990-1994 and 2000-2004. Deaths from all cancers in the European Union (EU) between these two periods fell by nine percent in men and eight percent in women, with a large drop among the middle-aged population.
Researchers Identify Role of Gene in Tumor Development, Growth and Progression
Virginia Commonwealth University Massey Cancer Center and VCU Institute of Molecular Medicine researchers have identified a gene that may play a pivotal role in two processes that are essential for tumor development, growth and progression to metastasis.
Common pain relief medication may encourage cancer growth
Although morphine has been the gold-standard treatment for postoperative and chronic cancer pain for two centuries, a growing body of evidence is showing that opiate-based painkillers can stimulate the growth and spread of cancer cells.
Young athletes need dual screening tests for heart defects, study suggests
To best detect early signs of life-threatening heart defects in young athletes, screening programs should include both popular diagnostic tests, not just one of them, according to new research from heart experts at Johns Hopkins.
Routine evaluation of prostate size not as effective in cancer screening, Mayo study finds
New Mayo Clinic research studied the association between prostate-specific antigen (PSA) levels and prostate size and found that routine annual evaluation of prostate growth is not necessarily a predictor for the development of prostate cancer.
Carnegie Mellon researchers link health-care debate to risk of dying in US and Europe
The current health care debate in the United States is complicated. Trade-offs between heath care expenditures, lifestyle choices and life expectancy have been suggested but seldom clearly demonstrated.
New finding suggests prostate biopsy is not always necessary
Researchers at Wake Forest University School of Medicine and the University of Wisconsin-Madison have discovered that some elevated prostate-specific antigen (PSA) levels in men may be caused by a hormone normally occurring in the body, and are not necessarily a predictor of the need for a prostate biopsy.
Does prostate-specific antigen velocity help in early detection prostate cancer?
The November issue of European Urology, the official journal of the European Association of Urology, features an article focussing on prostate specific antigen (PSA) velocity and early cancer detection. It has been suggested that changes in PSA over time aid prostate cancer detection.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
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Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, Second Edition by Patrick C. Walsh (Author), Janet Farrar Worthington (Author) EVERY MAN NEEDS THIS BOOK! Each year, more than 200,00 American men are diagnosed with prostate cancer. The good news is that more men are being cured of this disease than ever before. Now in a revised second edition, this lifesaving guide by Dr. Patrick Walsh and ard-winning science writer Janet Farrar Worthington offers a message of hope to every man facing this illness. Prostate cancer is a different disease in every man--which means that the right treatment varies for each man. Giving you a second opinion from the world's top experts in surgery, pathology, urology, and radiation and medical oncology, this book helps you determine the best plan for you. Learn:What causes prostate cancer--your risk factors, including heredity, diet, and environmentHow some simple changes in your... |
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You Can Beat Prostate Cancer by Robert J. Marckini (Author) The task of choosing the right prostate cancer treatment is daunting. It is further complicated by conflicting information the patient receives from physicians and the Internet. This book is written by a prostate cancer survivor who now runs an international prostate cancer support group. It's about his journey and the important things he learned along the way. It is the book the author wishes had been available when he was diagnosed 6 years ago. It is intended to provide specific information for men who are at risk or have been recently diagnosed with prostate cancer. All major treatment options are examined and the pros and cons of each are summarized. A relatively new, non-invasive, highly effective treatment is highlighted. It is an option that cures cancer as well as any other... |
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How We Survived Prostate Cancer: What We Did and What We Should Have Done by Victoria Hallerman (Author), Peter S. Albert M.D. (Foreword) Finally, a much-needed voice for the spouses and partners of prostate cancer survivors--an unflinchingly honest and beautifully written memoir about one couple's struggles and transformation that serves as a guide for others dealing with the disease. Facts: Though many sources exist for men dealing with this dreaded disease, their partners are often left on their own to figure out how to deal with personality changes and sudden "male menopause," how to redefine love and intimacy, and how to deal with side effects of the treatment. Victoria Hallerman, an accomplished... |
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The Cleveland Clinic Guide to Prostate Cancer (Cleveland Clinic Guides) by Eric Klein (Author) Expert medical advice from one of the nation’s top-ranked hospitals for urology and cancer care
This year, more than 230,000 men will be diagnosed with prostate cancer, while 1 in 6 men will fight prostate cancer in their lives. Prostate cancer is the most common cancer in men over age 50.
In The Cleveland Clinic Guide to Prostate Cancer, Dr. Eric A. Klein, ranked one of America’s best doctors, offers men the substantive information they need to prevent, treat, and even live well with prostate cancer. This excellent resource gives readers the trusted medical guidance Dr. Klein offers his patients, including:
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A Primer on Prostate Cancer: The Empowered Patient's Guide by Stephen Strum (Author), Donna L. Pogliano (Author) ¡§A Primer on Prostate Cancer, The Empowered Patient¡¦s Guide¡¨ is a basic resource to be used by patients and physicians when there has been a diagnosis of prostate cancer. It outlines a strategy of disease management that is designed to maximize outcomes for the patient and his loved ones. All aspects of diagnosis and testing are discussed; all currently approved treatments for prostate cancer are described. Discussion of treatment options includes information on side effects and includes questions the patient may not think to ask his doctor. Discussions of various treatments include the salvage therapies that might be employed if primary treatment fails. There is an extensive section on the theory and practice of androgen deprivation therapy in it¡¦s various forms, since... |
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Prostate Cancer for Dummies by Paul H. Lange (Author), Christine Adamec (Author), Christine Adamec (Author) Hearing that you have prostate cancer, or even that you may have it, is very scary. But this disease, in many cases, is curable. Even if you have advanced cancer that's spread beyond the prostate, many treatments help extend your life for years. You need good information to help you with the decisions that lie ahead, and this book provides you with this information. Prostate Cancer For Dummies can help you if You have prostate cancer (or you think that you have it), or someone close to you has it. You want information on treatments for prostate cancer as you form a treatment plan with your doctor. You are curious about alternative therapies for prostate cancer. You want to know what actions you can take over the long-term to continue to fight your... |
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Eat to Beat Prostate Cancer Cookbook by David Ricketts (Author) Prostate cancer is now the most common nonskin cancer among men in the United States. In 2005 alone, 250,000 new cases were diagnosed, and that number is certain to rise with each passing year. No one is more aware of this than David Ricketts, experienced cookbook author and recent prostate cancer survivor. Shortly after surgery and radiation treatments, Ricketts began to research food and lifestyle changes that might inhibit the likelihood of prostate cancer as well as its progression. The result is this uniquely specific cookbook, which takes full advantage of foods thought to fight prostate cancer while eliminating those believed to contribute to the disease. Eat to Beat Prostate Cancer Cookbook features more than 200 delicious recipes for everything from snacks, sandwiches,... |
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Prostate and Cancer: A Family Guide to Diagnosis, Treatment, and Survival by Sheldon Marks MD (Author) Prostate cancer is one of the most common cancers affecting American men, with over 186,000 new cases diagnosed in the United States annually; 1 in 6 men will be diagnosed with prostate cancer during his lifetime. Renowned prostate cancer specialist Sheldon Marks offers the definitive guide for men concerned about or diagnosed with prostate cancer, and for their families. Since the third edition (2003), there have been significant changes in treatment and resources. Working with Dr. Judd Moul, the Chairman of Urology at Duke and one of the world’s top experts on prostate cancer, Marks provides the most up-to- date information on diagnosis, treatment, and common questions. |
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Surviving Prostate Cancer: What You Need to Know to Make Informed Decisions (Yale University Press Health & Wellness) by E. Fuller Torrey M.D. (Author), Carlton Stoiber (Illustrator) When Dr. E. Fuller Torrey was diagnosed with prostate cancer, none of the books he could find was current enough or comprehensive enough to satisfy his need for information. This book is for the hundreds of thousands of other men who each year receive the same frightening diagnosis. It is the book Dr. Torrey wished he had when he was facing the countless questions that a man with prostate cancer, and his family and friends, all confront. Complete, up-to-date, and readable, the book explains how to come to terms with the diagnosis of prostate cancer, evaluate the severity of the disease, and assess the variety of treatment options and their complications. Many chapters provide information other books barely consider, such as a full discussion of the causes of prostate cancer and an... |
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