PROSTATE CANCER CHALLENGES
REDUCE UNNECESSARY RADICAL TREATMENTS

INCREASE NONINVASIVE TREATMENTS

PRESERVE QUALITY OF LIFE

Treatment of prostate cancer is one of the most challenging public health issues today. Problems include undergrading and understaging,  overdiagnosis and overtreatment of nonsignificant cancers, and treatment related toxicity  with escalating costs. Standard techniques of transrectal ultrasound biopsy may detect clinically insignificant cancer by random chance. Because of fear of missing the window of opportunity for cure, all cancers, even nonsignificant ones are currently being treated by radical treatment resulting in side effects.

The morbidity and escalating costs of radical treatment prompted the US Preventive Service Task Force to recommend no screening for men with PSA  starting in 2012. The USPSTF concluded that harms of screening outweighed its benefits. The mistake of USPSTF  was that they equated diagnosis with treatment. As of April 2017, five years after their initial recommendation, USPSTF has admitted their error. They are now recommending that based on ERSPC Trial that showed PSA screening reduces chances of advanced cancer by 30% and death by 20% that PSA screening should be a shared decision between patient and physician.*

 

As the lowered side effects of partial gland treatment by HIFU becomes more understood by primary care physicians and urologists, all men will want to to diagnose  and treat prostate cancer early. HIFU is the only technology currently available anywhere in the world, with proven long term, 15 to 20 year track record of cure rates similar to radical surgery without the major life altering side effects of impotence and incontinence

According to Dr Christian Chaussy eminent Professor of Urology  at  University of Munich,Germany and one of the pioneers in HIFU development "the 15 to 20 year experience with HIFU in Europe has been a big success. It is a hope for the United States. For the rest of the world it is a reality"

*www.nejm.org/doi/pdf/10.1056/NEJMoa0810084 ; ERSPC Lancet 2014; ERSPC.org

*JAMA USPSTF Revised recommendations April 11 2017; doi:10.1001/jama.2017.4413

DR NARAYAN AT    NFLUA.HIFU@GMAIL.COM

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