Gold Standard Study?

The copy-and-past text belows refers to a new "gold standard" study that says "precision radiation with hormone therapy is just as successful as surgery"

What study is being referred to?

Does anyon believe it? Any thoughts?

"Within the prostate “world” there is what is talked about as the “old standard” treatment as a must to get all the cancer they can out of your body. Recently, a new “gold standard” study came out that says precision radiation with hormone therapy is just as successful as surgery, and maybe more so. Surgery alone has many problems and can cause many problems that you will live with the rest of your life and impacts quality of life for the rest of your life. Most men with a Gleason score below 7, should consider active survillance with your doctor. Doctors that make their living doing surgery do not readily accept the new “gold standard”. In some cases surgery may be the best treatment."

http://www.community4me.com/prostate.html

 

the source is a paid motivational speaker - Jerry Hampton -'nuff said

I would recommend continuing your research - don't self-diagnose when you do not have all the information - keep breathing and don't panic..
- divine sources are good for support - but cool the miracle route.... the "f" word is downplayed here on HW - has lead to heated debates.
sincere hugs,
BRONSON

Post Edited (tatt2man) : 2/15/2011 6:59:50 AM (GMT-7)

K2,
There are no studies that compare the efficacy of front line local prostate cancer therapies that have usable results. There are many studies that are run by various centers that claim that they have "proven" that other therapies are equal to surgery ~ and most compare to surgery ~ but there are many factors that can be at play. Study flaws, Bias, and comparisons that do not include the most critical data ~ prostate cancer specific mortality usually riddle such studies.

I was diagnosed at the age of 44. What I found about studies is nearly 95% of them lack maturity enough to give us needed information. Ten year studies are useless when comparing death rates and PSA biochemical failures is not a strong tool just as the PSA test is not a strong tool.. I have been banging that drum since my diagnosis and working extensively with advocacy groups to raise awareness to this fact. We are seeing more and more "conclusions" in studies indicating that "more follow up is need" and I applaud the study team when I see it.

But once again, there are no studies that meet the "proof criteria" of a Level 1 multi-institutional randomized study comparing treatment modalities and while some are starting, we are probably 20 years away from seeing such a study that provides us prostate cancer specific mortality. Treatments that have been around for ten to fifteen years will be completely unable to show 15 years of median data even in lower tier studies. When you read studies and see a median of say 11 years, you know that 50% were treated after 11 years, and 50% before 11 years. This can really skew data as virtual no one dies from localized or locally advanced prostate cancer in the first ten years.

I caution anyone to not "piece part" various studies available on the internet as this is not a good way of arriving at facts. In fact it can be a dangerous way of doing things. Use common sense and try to set your goals. For example I was 44 at Dx and I would sure like to live until 80. The best I can hope to find for what treatments will get me there are anecdotal single case profile studies.

Ugh...

Tony

Sancarlos,
That is quite possible. In fact it is quite possibly why prostate cancer studies are seldom long enough to prove mortality rates.

It certainly is frustrating that such data is not available. But perhaps a vaccine or an immune therapy will render much of this mute before we get 20 years comparisons. Until that time, we, and the medical community, have to reserve judgement based on studies that compare biochemical failure, that use different standards for determining biochemical failure, and understand that bias is industry wide. We have a whole slew of newer localized therapies ~ and little data for which to compare them with. I am certain that we will continue to be inundated with claims. And as we see more and more costs for treatment skyrocketing, I am certain that we will see that groups will attempt to show that they are worth it...by whatever means available.

Tony

Gold Standard - I agree with John T.

Your PC treatment has to based not only on immediate cure but long term options if PC reappears.

Family History and your biology shoud play a part in your treatment options.

 

Everybody is right here, because we haven't defined the meaning of the term "gold standard" as it relates to PCa.

If it means "generally accepted as the best treatment for most", then surgery has certainly had the title in the past, and I think still has. It takes a while for new treatments to be generally accepted and having a track record going back many years sure does help.

Modern, closely targeted radiation with HT shows promise. But does it kill all prostate cells? I don't think it does, since I haven't read of PSAs dropping to undetectable after treatment, as often happens with surgery. What happens if the prostate cells that survive later turn cancerous? Can we have do-overs? How good is it in avoiding collateral damage? Those are questions I would have.

Undoubtedly radiation with HT is the best treatment now for some men, but by my definition above, it is not yet the gold standard. If you want to define the "gold standard" some other way, then I'm sure you could make a definition that gives the title to radiation/HT, or indeed any other treatment.