Prostate Cancer's Prognosis
New therapies exist, but men still face a tough call: get treated now, or wait
Like surgery, radiation treatments such as brachytherapy may improve with technology's advance. For example, D'Amico and his colleagues have pioneered the use of magnetic resonance imaging in the or to guide doctors as they insert radioactive seeds into cancerous portions of the prostate. Compared with ultrasound guidance, which is widely used, mri guidance has reduced urinary complications, they've found.
HIFU, the sound-wave treatment that Jim Hurley received, is another emerging option. During the operation, doctors insert an ultrasound transducer into the rectum and bombard the prostate with sound waves that heat and kill tumor cells. At this point, though, HIFU is available only at clinics abroad or in one of three ongoing U.S. trials. Two of those trials, which are using different devices and running in a total of 11 states and the nation's capital, are comparing HIFU with another relatively new technique, cryotherapy. That approach, which attempts to kill tumor cells by freezing them, also may minimize urinary complications. But skeptics caution that HIFU and cryotherapy may not permanently eliminate all tumors.
Hurley has no residual problems to remind him of the cancer, and he's glad he took the time to find the treatment that suited him best. Other men also stand to gain by exploring their choices, doctors say. "Get as much information as possible," says Getzenberg. "Get second opinions. Step back a little bit, take a deep breath, and look at your options."