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National Institutes of Health Suggests Renaming of Low-Risk Prostate Cancer Diagnosis


December 9, 2011 - NEW YORK, NY

This week the National Institutes of Health (NIH) fueled ongoing medical debate over the diagnosis and treatment of prostate cancer by suggesting the possibility of removing the label "cancer" from low-risk prostate cancer. Further, the 14-member independent panel favors active monitoring of the disease verses early treatment. For many in the urologic oncology community, including Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, this appears to be yet another government panel's recommendation that has the potential to put many men at risk.

The panel's consensus stems from estimations that 240,000 men will be diagnosed with Prostate cancer in the U.S. this year, yet only an estimated 33,000 will die from the disease. Compounding their recommendation is the fact that some experts believe prostate cancer treatment introduces unnecessary health risks such as impotence and incontinence.

Dr. Samadi commented by saying, "True not all Prostate cancers are deadly, but what the panel cannot avoid is the reality of our testing limitations. Today, I cannot tell a man with certainty that his prostate cancer won't develop into one of the unfortunate 33,000." Currently, prostate cancer is diagnosed through a PSA test to identify spikes in the level of prostate-specific antigens within the blood. Once detected, a prostate biopsy is usually performed to evaluate the tissue and assign a Gleason score for the risk level of the disease. "Regrettably, the Gleason score gives us some information, but not nearly enough to guarantee a slow progression," Dr. Samadi says.

Versus immediate treatment, the panel suggests "active monitoring" of the disease after diagnosis to include ongoing PSA testing and surveillance. The challenge, they admit, is determining the right point for introducing treatment. There is great difficulty in establishing "optimal protocol" for a disease that presents so differently in each patient. Often dubbed the silent killer, Prostate cancer can exist without any symptoms, making it possible for the disease to spread throughout the body unbeknownst to its owner.

Regarding risks, Dr. Samadi believes a careful approach to treatment selection is critical. "Men have to do their research," he urges, "what's right for one man may not be right for another, but I do believe the best course for most men is to remove the cancer through prostatectomy." As a seasoned expert in robotic prostate surgery, Dr. Samadi has performed over 3,600 procedures with successful results. Based on his patients' experience, men who undergo robotic surgery in his hands can hope to resume normal urinary control within several months and sexual function within 12 to 24 months.

"Delaying treatment under the guise of active monitoring sounds like a spin to me," says Dr. Samadi. "In reality, it's the same passive, reactionary approach as watchful waiting." The panel's contemplation of changing the diagnosis altogether is also shocking to Dr. Samadi. "The idea that simply taking the word cancer out of a disease's name will change its implications is of concern to me," he said, "Downplaying a Prostate cancer diagnosis to ease men's fears is not the answer."

Related links:
http://www.roboticoncology-il.com/
http://www.smart-surgery.com
http://il.smart-surgery.com/

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