Our latest commentary on Robotic Surgery for Prostate Cancer
May 11, 2017
I entirely agree with Dr McBride: patient choice in their treatment is key – and that demands both access to the different treatment options, as well as accurate, informed discussion about the pros and cons of every treatment, from outcomes to process. All of the treatments approved by NICE and available in the UK have a role to play in successfully treating prostate cancer.
But we should not over emphasise one type of treatment – such as radical prostatectomy - without considering the full breadth of options.
For example, low dose rate brachytherapy has been a highly effective treatment for prostate cancer for more than two decades. In addition to offering significantly improved outcomes regarding both sexual function and incontinence, according to data from the Prostate Cancer Results Study Group, LDR-B treatment achieves 95% of patients disease free at over 10 years. And, unlike radical prostatectomy - where the shift from open surgery to robotics has had minimal impact on the overall patient outcome - brachytherapy has significantly evolved over the past two decades and now provides the ability to give a very effective, targeted prescription of radiotherapy, resulting in improvements in already excellent disease control, as well as potency preservation and continence. Critically, it is not limited in its applicability: virtually any patient with localised prostate cancer can receive a brachytherapy implant if that is the desired treatment.
The unfortunate fact for patients across the UK is that, while the NICE guidelines include low dose rate Brachytherapy (LDR-B), radical prostatectomy, radiotherapy or surveillance, the treatments being offered to patients today can be highly postcode dependent.