UPDATE - Issue 15 - September 2003
A patient's story . . . and the treatment he received
The patient:
Stephen Barry had been having indications of prostate problems for some years but had assumed these to be benign. In January 2001 he was diagnosed with Prostate Cancer after his PSA was found to he increasing. Stephen writes 'Like all patients finding themselves in this situation, one is overwhelmed by the possible alternatives. I consulted medical friends and specialists and really attempted a beauty parade not only of the type of treatment that would be most suitable for me but also to find out who are considered to be the best specialists in each treatment. Eventually I narrowed the choice to two possible treatments radical prostatectomy and brachytherapy,
Fortunately, as my cancer appeared to be contained within the prostate and my PSA was of a suitable level, the opportunity to have a clear choice between these two treatments was available to me. Eventually I chose brachytherapy. This decision was based on consideration of certainty of treatment and discomfort arising therefrom and the implications with regard to both impotence and incontinence. After the operation its outcome was monitored by regular blood tests. Unfortunately my PSA did not fall dramatically but rather declined only gradually. It was then I realised that my own psychological well being, at that time, would have been enhanced if I had gone for the radical prostatectomy solution.
Unfortunately, after 6 months it became clear that the brachytherapy treatment had been unsuccessful, that cancer remained and was growing within the prostate.
After further research I realised that my options were limited to drugs or cryotherapy. Taking the view that drugs did not offer a long term solution, I felt that that option should be retained as a final insurance and that cryotherapy was the route. I then talked to the surgeon who put my mind to rest, particularly as the treatment could be used after my earlier failure and represented a procedure that could be revisited again in the future if there were to be a reoccurrence.
When seeking the original advice as to the method of treatment, the question of cryotherapy had been raised but at that time there did not appear to be, in this country, adequate background information as to the success of this treatment.
Fortunately, in my own case although radical prostatectomy was no longer an alternative after the failure of brachytherapy, cryosurgery remained a viable treatment, although with more difficulty than a virgin operation. I was lucky enough therefore to pursue this line of treatment. This appears to be a success, as my PSA has now gone down to less than 0.05.
No one stop shop for advice on all alternative treatments:
What conclusions do I draw from my own history? Here in the UK we have eminent specialists in their own fields but up to now there would not appear to be one Centre of Excellence that can offer all alternative treatments.
It is useful, clearly, for a patient when speaking to a specialist, if that specialist has the ability to offer a one shop stopping point for advice on all possible treatments and is also able to offer those treatments.
I would like to record my personal gratitude for the assistance and continued advice and patience given by Professor Roger Kirby and Dr Dan Ash here in the UK and to Professor Arie Belldegrun at UCLA in the USA.
The treatment:
Cryosurgery (also called cryotherapy or cryoablation) is used to treat localized prostate cancer by freezing the cells to extremely low temperatures thereby destroying them. Unlike radical prostatectomy and radiotherapy, cryosurgery can treat localized prostate cancer that has advanced beyond the prostate capsule.
The SeedNetT system with unique IceSeetIST is specifically designed for use by urologists and presents an innovative alternative to prostatectomy and radiation treatments. Based on the brachytherapy setup familiar to many urologists, this procedure is easy to learn and simple to use. Ultra-thin needles guided through a template are inserted into the prostate and generate cancer-killing iceballs that destroy prostatic tissue without damaging collateral tissue.
Cryosurgery is less invasive than radical prostatectomy so there is less blood loss, a shorter hospital stay, shorter recovery period, and less pain than radical surgery. Because the physician can focus cryosurgical treatment on a limited area, he can avoid the destruction of nearby healthy tissue. The treatment can be safely repeated and may be used along with standard treatments such as surgery, chemotherapy, and radiation. Furthermore, cryosurgery may offer an option for treating cancers that are considered inoperable or that do not respond to standard treatments. |
Cryotherapy systems are marketed by ONCURA, a new global company formed by the merger in July of this year of Amersham's brachytherapy business with Galil Medical's urology business. The bulk of the experience in cryotherapy is to be found in the US. Early results are excellent but as with all new treatments long term results are not yet available. At least four UK hospitals have already carried out operations using this advanced and minimally invasive technology. These hospitals are the Cromwell, London, the Princess Grace. London, Sunderland Royal and the Royal Surrey, Guildford. |