By: Dan Sperling, MD
Originally published 8/19/2014
As I write this, it is Aug. 19, 2022. It’s now 8 years to the day since we posted the blog below. I revisited the four national websites listed below. Despite gigantic progress since then in prostate cancer (PCa) diagnosis accuracy, advances in genomics, new treatment options—particularly focal treatments—and technologies for delivering them, I am frankly stunned that their outdated information is still posted!
- WebMD – The copyright at the bottom of the page has been updated to 2021, but the information has not changed a single word since 2014! How can that be? Is anyone reviewing and updating their patient education?
- American Cancer Society – Good luck finding much new. Again, the information is the same as I describe below. I did a site search for “focal therapy” and “focal treatment” for prostate cancer, and all that turned up were a couple of references to focal sites of abnormal prostate cells such as high grade PIN.
- Centers for Disease Control – It grieves me to report that 8 years have gone by with no changes to their webpage.
- National Cancer Institute’s page on PCa offers no mention of focal treatment, and even their content on detection/diagnosis is out of date. For instance, there is no mention of today’s PSMA PET/CT scan for identifying microscopic PCa sites anywhere else in the body.
When I think of the thousands of newly diagnosed PCa patients who might logically turn to these nationally recognized sources to learn more about their disease and their options, I am frustrated over how underinformed they will be. If they turn to a patient organization such as the Prostate Cancer Foundation, they will get information about immunotherapy, PSMA and theranostics, etc. but not much there about focal therapy. I applaud ZERO The End of Prostate Cancer for including focal therapy on their treatment page! As for the four sites I revisited, all I can say is, time marches on so please get on board with the new PCa treatment landscape.
Out of curiosity, I took a tour of well respected websites that offer prostate cancer treatment information to patients or those worried about the disease. I was disappointed with the results of my “survey.” When it comes to treatment, I found primarily conventional information. Here are summaries of what four renowned national sites offer:
WebMD (http://www.webmd.com/prostate-cancer/guide/prostate-cancer-treatments) According to this site, men diagnosed with prostate cancer have a choice of surgery (radical prostatectomy), radiation (beam or seeds) or active surveillance. I had to search the site for information on cryotherapy, which is termed a “newer treatment” with few longterm studies. This is not correct; cryo was Medicare approved in 1999, and there are numerous longterm studies out to 10 years and beyond. As for focal laser ablation, or even HIFU, I could not find either treatment on the site. (Laser is discussed for treating benign prostate enlargement, but it’s a different type of laser from our BlueLaser® for prostate cancer.)
The American Cancer Society (www.cancer.org) The basic information offered to patients covers surgery, radiation, and mentions cryotherapy. No surprises there. I dug a little deeper and found a more forward-looking section called “What’s New in Prostate Cancer Research and Treatment?” (http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-new-research) HIFU is mentioned, as well as the use of genomic analysis to determine the nature of an individual’s disease. No mention of focal laser ablation, but much space is devoted to research into treatments for advanced (metastatic) cancer.
Centers for Disease Control (http://www.cdc.gov/cancer/prostate/basic_info/treatment.htm) The CDC offers a concise one-page list of treatments with a sentence of description of each. While HIFU made the list, the site fails to mention that it is not yet FDA-approved for treatment in the U.S. On the other hand, focal laser ablation did not make the list, even though numerous centers, including well-known academic medical centers, are starting to provide this FDA-approved prostate cancer treatment.
National Cancer Institute (http://www.cancer.gov/cancertopics/pdq/treatment/prostate/Patient/page4) By the time I got to this site, I knew what to expect. Again, there is the list (and detailed explanations) of conventional surgery and radiation treatments. Cryotherapy and HIFU are on the list, but the explanations are barely beyond a sentence or two—and no mention that HIFU cannot legally be done in the U.S.
I suppose I would be more disappointed if I didn’t recognize that medical change comes slowly, especially when it comes to getting out the word about a “new kid on the block.” The publication of more data on focal laser ablation, such as our collaborative NYU study (see an article description at https://sperlingprostatecenter.com/2014-journal-article-focal-laser-ablation/) will help gain the attention of those who write content for major patient websites. I look forward to the day when it’s as easy to learn about focal laser ablation as it is about robotic prostatectomy or proton beam radiation.