The National Cancer Institute (NCI) has stopped a study exploring the possibility that Vitamin E and/or Selenium might prevent prostate cancer.

Last year the recommendations were modified to limit Vitamin E to 200 IU per day to prevent increased risks of strokes and heart attacks, and to preferably stop it altogether. Selenium had been recommended to no more than 100 mcg per day (rather than 200) due to the worry that prostate cancers might actually grow faster if present. Same for Zinc above 70 mg per day.

The current multi-institutional study seems to reflect not only a failure of Vitamin E and Selenium to prevent prostate cancer, but a distinctly possible increased risk in men with family histories of prostate cancer. In addition, Selenium may cause diabetes.

Stick with lycopenes (tomato products), anti-inflammatory medicines, pomegranate juice, and soy proteins.

Erectile dysfunction following Brachytherapy (radioactive seeds implanted into prostate) is commonly quoted to cause ED in 20-25% of men within 2 years after treatment. However, Dr. John Mulcahy, leading ED authority, reports in Urology Times of a French study presented at this year’s American Urology Association. As many as 71% of patients followed for 4 years experienced some form of ED.

The scheduled treatment weekends in Puerto Vallarta for 2009 thus far are:

Jan. 20-22
Feb. 20-22
Mar. 20-22
Apr. 17-19

Future dates will be posted as they are designated.

Again from Memorial Sloan Kettering Cancer Center, as reported in the Urology Times newspaper, androgen ablation was reported at the American Urology Association meeting this year to impair concentration, spatial ability, multitasking and other cognitive capacities. The researchers suggest patients be advised of this effect, and further study, including brain imaging, be pursued. The study was published in the July 28 online edition of the journal Cancer.

Earlier this year an increased risk of cardiovascular events was associated with Hormone Therapy.

From Duke University as presented at the American Urology Association meeting this year, and reported in Renal and Urology News:

Dr. Lionel L Banez’ group found that for every 1 mg/dl rise in total cholesterol or LDL cholesterol, the risk for recurrence after radical prostatectomy rose 1%. Men with total cholesterol levels of >217 had a 2.5 times higher risk for biochemical recurrence (PSA) than men with cholesterol <167. Statins may be investigated as possible agents in the treatment of prostate cancer.

The Memorial Sloan Kettering (MSK) Cancer Medical Center is one of the top 3 cancer hospitals in the country. A review of their radical prostatectomy results sought to determine how often they achieved the optimal results of: 1. cancer cure (per PSA)
2. full continence
3. no erectile dysfunction (need Viagra or equivalent only)

This “Trifecta” happened at: 1 year—30%
2 years–42%
3 years–47%
4 years–53%

These are the numbers for T1C and T2A cancers.

Aranchuk, et al., J Clin Onc, 23:18, 4146-51.

Be careful when getting overly optimistic quotes from local surgeons regarding their results.

The Sonablate HIFU Unit is made by Focus Surgery which is owned by InternationalHIFU.

Clinical publications on HIFU available from Focus Surgery include:

H. Ahmed, D. Pendse, R. Illing, C. Allen, J. van der Meulen, M. Emberton, “Will focal therapy become a standard of care for men with localized prostate cancer?” Nature Clinical Practice Oncology, accepted 13 June 2007, Vol. 4, No. 11, pp. 632-642. [Paper]

T. Uchida, M. Nitta, S. Hongo, S. Shoji, Y. Nagata, Y. Usui, T. Terachi, “High-intensity focused ultrasound for the treatment in 517 patients with localized prostate cancer,” presented at the 29th SIU-Congress in Paris, France, September 2007. [Abstract]

E. Zacharakis, H. Ahmed, A. Ishaq, R. Illing, R. Scott, G. Shaw, J. Calleary, C. Allen, M. Emberton, “Visually Directed Primary HIFU for Treating Localized Prostate Cancer,” presented at the 29th SIU-Congress in Paris, France, September 2007. [Abstract]

E. Zacharakis, H. Ahmed, A. Ishaq, R. Illing, R. Scott, G. Shaw, J. Calleary, C. Allen, M. Emberton, “Salvage HIFU effectively reduces PSA in patients with biochemical recurrence after attempted curative treatment for prostate cancer,” presented at the 29th SIU-Congress in Paris, France, September 2007. [Abstract]

R. Illing, M. Emberton, “Sonablate®-500: transrectal high-intensity focused ultrasound for the treatment of prostate cancer,” Future Drugs, Ltd., 2006. [Paper]

T. Uchida, H. Ohkusa, Y. Nagata, T. Hyodo, T. Satoh, A. Irie, “Treatment of localized prostate cancer using high-intensity focused ultrasound,” British Journal of Urology, 2006, pp. 56-61. [Paper]

R. Illing, T. Leslie, J. Kennedy, J. Calleary, C. Ogden, M. Emberton, “Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: a proposed standard for the conduct of therapy,” British Journal of Urology, 2006, pp. 1187-1192. [Paper]

N. Sanghvi, et.al, “High Intensity Focused Ultrasound for the Treatment of Recurrent Prostate Cancer,” presented at the International Society for Therapeutic Ultrasound (ISTU) Symposium in Oxford, UK, August 30 - September 2, 2006. [Abstract]

T. Gardner, M. O. Koch, “Prostate Cancer Therapy with High-Intensity Focused Ultrasound,” Clinical Gentourinary Cancer, Vol. 4, No. 3, pp. 187-192, 2005. [Paper]

R. J. Fedewa, R. Seip, R. F. Carlson, W. Chen, N. T. Sanghvi, M. A. Penna, K. A. Dines, & R. E. Pfile, “Automated Treatment Planning for Prostate Cancer HIFU Therapy,” Proceedings of the 2005 IEEE International Ultrasonics Symposium, Rotterdam, The Netherlands, 19-21 Sept, 2005. [Paper]

T. Uchida, S. Baba, N. Masumori, T. Tsukamoto, H. Nakatsu, H. Fujimoto, T. Kakazoe, et al., “Transrectal High-Intensity Focused Ultrasound In the Treatment of Localized Prostate Cancer: A Multicenter Study,” Acta Urology Japan, #51, pp.651 - 658, 2005. [Paper]

T. Uchida, S. Shoji, Y. Nagata, “HIFU for Localized Prostate Cancer: 6 Year Experience,” presented at the International Society for Therapeutic Ultrasound (ISTU5) meeting in Boston, October 2005. [Abstract]

T. Uchida, H. Yamashita, H. Ohkusa and Y. Nagata, “Clinical Outcome of HIFU for the Treatment of Localized Prostate Cancer: 5-Year Experience,” to appear in the Proc. of the International Symposium on Therapeutic Ultrasound, 2004. [Abstract]

T. Gardner, M.O. Koch, R. Seip and N.T. Sanghvi, “High Intensity Focused Ultrasound (HIFU) U.S. Experience for Localized Prostate Cancer,” to appear in the Proc. of the International Symposium on Therapeutic Ultrasound, 2004. [Abstract]

John C. Rewcastle, Ph.D., “High Intensity Focused Ultrasound for Prostate Cancer: Clinical Results and Technical Evolution,” Whitepaper (2004). [Paper]

T. Uchida, H. Tsumura, H. Yamashita, M. Katsuta, D. Ishii, T. Satoh, A. Ohkawa, T. Hyodo, N.T. Sanghvi, “Transrectal High Intensity Focused Ultrasound for Treatment of Patients with Stage T1b-2N0M0 Localized Prostate Cancer: A Preliminary Report,” Japanese Journal of Endourology and ESWL, 2003, pp. 108-114. [Paper]

T. Uchida, N.T. Sanghvi, T.A. Gardner, M.O. Koch, D. Ishii, S. Minei, T. Satoh, T. Hyodo, A. Irie and S. Baba, “Transrectal High Intensity Focused Ultrasound for Treatment of Patients with Stage T1b-2N0M0 Localized Prostate Cancer: A Preliminary Report,” Urology, 2002, pp. 394-399. [Paper]

T. Uchida, N.T. Sanghvi, T. Satoh, A. Irie, T. Omata, S. Baba, M.O. Koch, and T.A. Gardner, “Transrectal High Intensity Focused Ultrasound for the Treatment of Localized Prostate Cancer,” Proc. of the International Symposium on Therapeutic Ultrasound, 2002, pp. 8-16. [Paper]

N.T. Sanghvi, T. Uchida, M.O. Koch, and T.A. Gardner, “Total Prostate Ablation for the Treatment of Localized Prostate Cancer Using Image Guided HIFU,” presented at the 2002 IEEE Ultrasonics Symposium. [Poster]

T. Uchida, M.D., Kitasato University, Department of Urology, “Localized Prostate Cancer Treatment with HIFU,” Translated and updated from The Journal of Highly Advanced Medical Technology, Volume 15 (March 2000).

S. Madersbacher, M. Pedevilla, L. Vingers, M. Susani and M. Marberger, Department of Urology (S.M., M.P., L.V., M.M.) and Pathology (M.S.), University of Vienna, “Effect of High-Intensity Focused Ultrasound on Human Prostate Cancer in Vivo,” Cancer Research 55, 3346-3351, (August 1995) [Paper]

My preferred site for HIFU treatments is Puerto Vallarta, Mexico for its clean, private, new bilingual hospital (San Javier) located 5 minutes from the airport and hotels. The local staff work well with the USHIFU crew and American physicians, and the process is now fine tuned and routine.

The remainder of the 2008 treatment sessions are:
Oct. 17-19
Nov. 14-16
Dec. 19-21

With notice I can treat at the other locations available, but the highest volume center with the most experience is Puerto Vallarta.

The 2009 sessions will be posted soon.