Abstract
Radical retropubic prostatectomy and radiation therapy remain the mainstay of treatment for localized prostate cancer. However, with the advent of the Internet, more patients are arriving in physicians’ offices questioning novel techniques for their treatment that they otherwise would not have discovered. This paper discusses several of these techniques, including focal cryotherapy, high-intensity focused ultrasound, robotic-assisted laparoscopic prostatectomy, diets, supplements, and hormonal therapy. We also render our opinion on their efficacy for treatment based on the available published studies.
Similar content being viewed by others
References and Recommended Reading
Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2006. CA Cancer J Clin 2006, 56:106–130.
Farkas A, Schneider D, Perrotti M, et al.: National trends in the epidemiology of prostate cancer, 1973 to 1994: evidence for the effectiveness of prostate-specific antigen screening. Urology 1998, 52:444–448.
Stephenson RA: Prostate cancer trends in the era of prostate-specific antigen: an update of incidence, mortality, and clinical factors from the SEER database. Urol Clin North Am 2002, 29:173–181.
Mouraviev V, Polascik TJ: Update on cryotherapy for prostate cancer in 2006. Curr Opin Urol 2006, 16:152–156.
Grubb RL III, Vardi IY, Bhayani SB, Kibel AS: Minimally invasive approaches to localized prostate cancer. Hematol Oncol Clin North Am 2006, 20:879–895.
Onik G, Narayan P, Vaughan D, et al.: Focal “nerve-sparing” cryosurgery for treatment of primary prostate cancer: a new approach to preserving potency. Urology 2002, 60:109–114.
Janzen NK, Han K-R, Perry KT, et al.: Feasibility of nerve-sparing prostate cryosurgery: applications and limitations in a canine model. J Endourol 2005, 19:520–525.
Djavan B, Susani M, Bursa B, et al.: Predictability and significance of multifocal prostate cancer in the radical prostatectomy specimen. Tech Urol 1999, 5:139–142.
Polascik TJ, Mouraviev V, Sun L, et al.: Prostate cancer laterality as a rationale for the clinical application of focal ablative therapy: an analysis of 1184 prostatectomy specimens. Seventh Annual Surgical Urologic Oncology meeting to discuss current topics and strategies [abstract]. Urol Oncol 2006:92.
Masson P, Prepelica KL, Lambert EH, et al.: Focal cryosurgery: encouraging health outcomes for unifocal prostate cancer. J Urol 2005, 173:179.
Beerlage HP, van Leenders GJ, Oosterhof GO, et al.: High-intensity focused ultrasound (HIFU) followed after one to two weeks by radical retropubic prostatectomy: results of a prospective study. Prostate 1999, 39:41–46.
Blana A, Walter B, Rogenhofer S, Wieland WF: High-intensity focused ultrasound for the treatment of localized prostate cancer: 5-year experience. Urology 2004, 63:297–300.
Thuroff S, Chaussy C, Vallancien G, et al.: High-intensity focused ultrasound and localized prostate cancer: efficacy results from the European Multicentric Study. J Endourol 2003, 17:673–677.
Chaussy C, Thuroff S: The status of high-intensity focused ultrasound in the treatment of localized prostate cancer and the impact of a combined resection. Curr Urol Rep 2003, 4:248–252.
Vallancien G, Prapotnich D, Cathelineau X, et al.: Transrectal focused ultrasound combined with transurethral resection of the prostate for the treatment of localized prostate cancer: feasibility study. J Urol 2004, 171:2265–2267.
Poissonnier L, Chapelon J-Y, Rouviere O, et al.: Control of prostate cancer by transrectal HIFU in 227 patients. Eur Urol 2007, 51:381–387.
Lee HM, Hong JH, Choi HY: High-intensity focused ultrasound therapy for clinically localized prostate cancer. Prostate Cancer Prostatic Dis 2006, 9:439–443.
Uchida T, Ohkusa H, Nagata Y, et al.: Treatment of localized prostate cancer using high-intensity focused ultrasound. BJU Int 2006, 97:56–61.
Menon M, Tewari A, Baize B, et al.: Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology 2002, 60:864–868.
Tewari A, Srivasatava A, Menon M: A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int 2003, 92:205–210.
Ahlering TE, Woo D, Eichel L, et al.: Robot-assisted versus open radical prostatectomy: a comparison of one surgeon’s outcomes. Urology 2004, 63:819–822.
Ball AJ, Gambill B, Fabrizio MD, et al.: Prospective longitudinal comparative study of early health-related quality-of-life outcomes in patients undergoing surgical treatment for localized prostate cancer: a short-term evaluation of five approaches from a single institution. J Endourol 2006, 20:723–731.
Menon M, Tewari A: Robotic radical prostatectomy and the Vattikuti Urology Institute technique: an interim analysis of results and technical points. Urology 2003, 61:15–20.
Kaul S, Savera A, Badani K, et al.: Functional outcomes and oncological efficacy of Vattikuti Institute prostatectomy with Veil of Aphrodite nerve-sparing: an analysis of 154 consecutive patients. BJU Int 2006, 97:467–472.
Walsh PC, Marschke P, Ricker D, Burnett AL: Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000, 55:58–61.
Litwin MS, Melmed GY, Nakazon T: Life after radical prostatectomy: a longitudinal study. J Urol 2001, 166:587–592.
Guazzoni G, Cestari A, Naspro R, et al.: Intra-and peri-operative outcomes comparing radical retropubic and laparoscopic radical prostatectomy: results from a prospective, randomised, single-surgeon study. Eur Urol 2006, 50:98–104.
Ghavamian R, Knoll A, Boczko J, Melman A: Comparison of operative and functional outcomes of laparoscopic radical prostatectomy and radical retropubic prostatectomy: single surgeon experience. Urology 2006, 67:1241–1246.
Bentas W, Wolfram M, Jones J, et al.: Robotic technology and the translation of open radical prostatectomy to laparoscopy: the early Frankfurt experience with robotic radical prostatectomy and one year follow-up. Eur Urol 2003, 44:175–181.
Patel VR, Tully AS, Holmes R, Lindsay J: Robotic radical prostatectomy in the community setting: the learning curve and beyond: initial 200 cases. J Urol 2005, 174:269–272.
Webster TM, Herrell SD, Chang SS, et al.: Robotic assisted laparoscopic radical prostatectomy versus retropubic radical prostatectomy: a prospective assessment of postoperative pain. J Urol 2005, 174:912–914.
Freedland SJ, Aronson WJ: Obesity and prostate cancer. Urology 2005, 65:433–439.
Rodriguez C, Freedland SJ, Deka A, et al.: Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 2007, 16:63–69.
Ornish D, Weidner G, Fair WR, et al.: Intensive lifestyle changes may affect the progression of prostate cancer. J Urol 2005, 174:1065–1070.
Mavropoulos JC, Isaacs WB, Pizzo SV, Freedland SJ: Is there a role for a low-carbohydrate ketogenic diet in the management of prostate cancer? Urology 2006, 68:15–18.
Yancy WS Jr, Olsen MK, Guyton JR, et al.: A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 2004, 140:769–777.
Meckling KA, O’sullivan C, Saari D: Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab 2004, 89:2717–2723.
Boileau TWM, Liao Z, Kim S, et al.: Prostate carcinogenesis in N-methyl-N-nitrosourea (NMU)-testosterone-treated rats fed tomato powder, lycopene, or energy-restricted diets. J Natl Cancer Inst 2003, 95:1578–1586.
Nebeling LC, Miraldi F, Shurin SB, Lerner E: Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports. J Am Coll Nutr 1995, 14:202–208.
Pantuck AJ, Leppert JT, Zomorodian N, et al.: Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer. Clin Cancer Res 2006, 12:4018–4026.
Freedland SJ, Humphreys EB, Mangold LA, et al.: Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 2005, 294:433–439.
Demark-Wahnefried W, Price DT, Polascik TJ, et al.: Pilot study of dietary fat restriction and flaxseed supplementation in men with prostate cancer before surgery: exploring the effects on hormonal levels, prostate-specific antigen, and histopathologic features. Urology 2001, 58:47–52.
Schuurman AG, van den Brandt PA, Dorant E, et al.: Association of energy and fat intake with prostate carcinoma risk. Cancer 1999, 86:1019–1027.
Gann PH, Hennekens CH, Sacks FM, et al.: Prospective study of plasma fatty acids and risk of prostate cancer. J Natl Cancer Inst 1994, 86:281–286.
Morton MS, Chan PSF, Cheng C, et al.: Lignans and isoflavonoids in plasma and prostatic fluid in men: samples from Portugal, Hong Kong, and the United Kingdom. Prostate 1997, 32:122–128.
Lin X, Gingrich JR, Bao W, et al.: Effect of flaxseed supplementation on prostatic carcinoma in transgenic mice. Urology 2002, 60:919–924.
Demark-Wahnefried W, Robertson CN, Walther PJ, et al.: Pilot study to explore effects of low-fat, flaxseed-supplemented diet on proliferation of benign prostatic epithelium and prostate-specific antigen. Urology 2004, 63:900–904.
Chodak GW, Keane T, Klotz L: Critical evaluation of hormonal therapy for carcinoma of the prostate. Urology 2002, 60:201–208.
Kawakami J, Cowan JE, Elkin EP, et al.: Androgen-deprivation therapy as primary treatment for localized prostate cancer. Cancer 2006, 106:1708–1714.
Ueno S, Namiki M, Fukagai T, et al.: Efficacy of primary hormonal therapy for patients with localized and locally advanced prostate cancer: a retrospective multicenter study. Int J Urol 2006, 13:1494–1500.
Labrie F, Candas B, Gomez J-L, Cusan L: Can combined androgen blockade provide long-term control or possible cure of localized prostate cancer? Urology 2002, 60:115–119.
See WA, Wirth MP, McLeod DG, et al.: Bicalutamide as immediate therapy either alone or as adjuvant to standard care of patients with localized or locally advanced prostate cancer: first analysis of the Early Prostate Cancer Program. J Urol 2002, 168:429–435.
Wirth MP, See WA, McLeod DG, et al.: Bicalutamide 150 mg in addition to standard care in patients with localized or locally advanced prostate cancer: results from the second analysis of the Early Prostate Cancer Program at median followup of 5.4 years. J Urol 2004, 172:1865–1870.
Iversen P, Johansson J-E, Lodding P, et al.: Bicalutamide (150 mg) versus placebo as immediate therapy alone or as adjuvant to therapy with curative intent for early nonmetastatic prostate cancer: 5.3-year median followup from the Scandinavian Prostate Cancer Study Group Study Number 6. J Urol 2004, 172:1871–1876.
McLeod DG, Iversen P, See WA, et al.: Bicalutamide 150 mg plus standard care vs standard care alone for early prostate cancer. BJU Int 2006, 97:247–254.
Thompson IM, Goodman PJ, Tangen CM, et al.: The influence of finasteride on the development of prostate cancer. N Engl J Med 2003, 349:215–224.
Bostwick DG, Qian J, Civantos F, et al.: Does finasteride alter the pathology of the prostate and cancer grading? Clin Prostate Cancer 2004, 2:228–235.
Leibowitz RL, Tucker SJ: Treatment of localized prostate cancer with intermittent triple androgen blockade: preliminary results in 110 consecutive patients. Oncologist 2001, 6:177–182.
Scholz MC, Jennrich RI, Strum SB, et al.: Intermittent use of testosterone inactivating pharmaceuticals using finasteride prolongs the time off period. J Urol 2006, 175:1673–1678.
Aus G: Current status of HIFU and cryotherapy in prostate cancer: a review. Eur Urol 2006, 50:927–934.
Smith JA Jr, Herrell SD: Robotic-assisted laparoscopic prostatectomy: do minimally invasive approaches offer significant advantages? J Clin Oncol 2005, 23:8170–8175.
Wiygul JB, Evans BR, Peterson BL, et al.: Supplement use among men with prostate cancer. Urology 2005, 66:161–166.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Robinson, M.R., Moul, J.W. Novel techniques for the treatment of localized prostate cancer: Evidence of efficacy?. Curr Urol Rep 8, 203–210 (2007). https://doi.org/10.1007/s11934-007-0007-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11934-007-0007-7