Add hormone therapy to a growing list of options available to men in the treatment of prostate cancer. But the treatment is not suitable for everyone. A new study in the Journal of the American Medical Association (JAMA) appears to support the theory outlined in earlier studies that men with more advanced forms of prostate cancer don't benefit from a combination of hormone and radiation therapy. In fact, hormone therapy used alone has been linked to a slightly heightened risk of death in older men. This higher risk of death is more prevalent in older men with serious heart problems or a history of heart failure.
This hormone-blocking treatment is administered prior to brachytherapy, a type of radiation treatment used to reduce the size of the prostate. It suppresses testosterone production, which can cause prostate tumors to shrink or grow more slowly and improve the ability to perform the brachytherapy. It can be beneficial to some men in more advanced stages of the disease when used in combination with surgery or radiation.
However, these hormones may be dangerous to others, because while the drug increases insulin resistance and raises cholesterol, it also increases fat, which increases the risk factor for men with pre-existing heart disease. Dr. David B. Samadi, Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City, advises that it's important to know all available options and work with your doctor to determine the best one for you.
Dr. Samadi outlines all of the benefits and disadvantages of the available prostate cancer treatment options on his website: www.roboticoncology.com. Samadi treats his patients on an individual basis, taking into consideration many factors before recommending the ideal treatment; surgery is only one of the many options. He has successfully performed over 2,000 robotic prostatectomy surgeries (whereby the prostate gland is surgically removed).
Many men understandably dread surgery because of the recovery period and side effects such as impotence and incontinence. Modern-day robotic prostate surgery is a far cry from the traditional open or laparoscopic surgeries of the past. Nowadays, an experienced surgeon like Dr. Samadi can use the precision technology of the robot to remove the prostate gland, with less blood loss and increased accuracy. Robotic surgery can salvage the delicate nerves surrounding the gland that preserve sexual function and continence.
This JAMA study will inevitably influence the decision-making process for prostate cancer patients, especially for those with heart problems or history of heart failure. Though more investigation will be needed, there had long been a suspected link between cardiac problems and long-term use of hormones. For those patients who may not be candidates for hormone therapy, Dr. Samadi encourages robotic surgery as an alternative way to treat prostate cancer, to increase the cure rate success, lessen the side effects and decrease the risk of morbidity.
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