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Increasingly, many surgical disciplines have come to grips with the significant complications associated with radical cancer surgery and have modified their approach to cancer excision. For example, surgery for breast cancer has moved away from a radical approach and adopted the lumpectomy or local excision instead of removing the whole organ. This modified approach preserves survival and is associated with significantly less complications and improved quality of life (QoL).
However, since urologists developed the radical surgical procedure as a treatment option for prostate cancer they have wrestled with how to deal with the very significant downsides and after effects associated with this treatment option.The urology hierarchy however, chose intentionally to stay the course with the radical approach. The common post operative complications associated with this radical surgical approach are impotence and incontinence (limp and leaking). As well, these complications result in a significant negative impact on QoL not only for the man, but his wife and their partnership (see prostate cancer treatment:the good, the bad and the ugly).
Eventually, recognizing this disposition for complications after surgical removal of the prostate, surgeons refined their radical approach to prostate cancer treatment and developed the “nerve sparing” technique in attempts to lessen this propensity for “limp and leaking”. However, this “nerve sparing” approach for prostate cancer excision did not realize the expected great improvement in results with better preservation of erectile function and urinary continence. This dilemma then led some surgeons to cheat by creating “new” definitions for impotence and incontinence so that their radical surgery was now associated with acceptable levels of these complications.
Subsequently, when the bio-tech industry found a use for their robotic machines in prostate cancer treatment, technology firms soon discovered that they could report even more impressive post operative results. These impressive treatment results for radical surgery/robotics were achieved through the coupling of these spurious definitions for limp and leaking with more misleading information. This so called data for the non FDA trialed treatment option was then spiced with unbridled and unabashed marketing and propelled into the forefront of prostate cancer treatment as some quasi gold standard. When financial rewards and lobbyists were added to this mix it was not hard to realize that some physicians had lost their soul and credibility. Furthermore, the endorsement of a surgical technique by a professional of stature under these circumstances does not necessarily equate with physician competence or honesty. In fact, some educated people are not above bending science with pseudoscience.
Certainly, there was a time when physicians, as true patient advocates, reported sincerely and honestly on cancer treatment options. However, these ideals have seemingly evaporated and the need for standardization of evaluation criteria and definitions of treatment complications are, apparently, no longer important. Indeed, Hippocrates affirmation: “As to diseases, make a habit of things to help or, at least do no harm” has been made redundant. More over, we have become comfortable with manufacturers speaking for the medical fraternity. In fact, now we do not even need rigorous blinded FDA trials scrutinizing the validity of localized prostate cancer treatment options (for hifu, cryoablation, radiation and surgery). This indolent approach by urologists is an injustice to patients that requires immediate attention and correction.
Important issues regarding negative aspects to prostate cancer treatment have been detailed before in several different media formats.
BOOKS
Gary Onik, Male Lumpectomy: focal therapy for prostate cancer
Several other books have underscored the concerns in prostate cancer treatment as well as the business side of the prostate cancer industry.
MAGAZINES
Men’s Health
L. Stains, I want my Prostate Back. March, 2010
WEB BASED

Fox News/Reuters
Life after Prostate surgery worse than expected. July 1, 2011
Hifurx.com
Bert Vorstman MD, Why should the after effects of some prostate cancer treatments be worse than the disease itself? August,2011
NEWSPAPER
Miami Herald
Prostate Cancer Treatment: the good the bad and the ugly. August 22, 2011
Sun Sentinel
Prostate Surgery is Booming, but at what cost? September 11, 2011

Although September is officially designated as Prostate Cancer Awareness Month (blue month), every month should be recognized for prostate cancer awareness.

Be aware that prostate cancer is for the most part without symptoms and a silent disease.
Be aware that prostate cancer deaths are the second leading cause of male cancer deaths after lung cancer. Furthermore, NOT ALL prostate cancers are slow growing or only found in the elderly.

Be aware that some men have an increased risk for prostate cancer especially those of African heritage or those men with a family history of prostate cancer.

Be aware that the digital rectal examination (DRE) or the rectal exam, only has about a 50% accuracy in picking up a prostate cancer.
Be aware that some 15-20% of all men with a NORMAL PSA of 4ng/ml or less have significant prostate cancer and this cancer will only be identified by measuring the FREE PSA as well as the total PSA in order to determine the %free PSA and your estimated probable risk for having prostate cancer.
Be aware that there are four classes of drugs ( STATINS, NSAIDS, THIAZIDES and 5 alpha reductase inhibitors) that will lower your PSA WITHOUT possible protective benefits and give you a false sense of security, underscoring the need to determine your FREE PSA.
Be aware that ONLY a well-conducted prostate biopsy can determine the presence of prostate cancer and NOT an MRI.
Be aware that there are many subjective issues in reading your prostate biopsy slides and validation of your pathology by a reference laboratory is strongly recommended.

Be aware that early prostate cancer is curable

Be aware that a prostate cancer diagnosis does NOT constitute an emergency.
Be aware of ALL of your treatment options for your particular cancer as NOT ALL prostate cancers are the same.
Be aware that that the SURVIVAL benefits of the four treatment options for LOCALIZED prostate cancer, HIFU, Cryoablation, ALL radiation options (including brachytherapy and proton beam) and the radical surgical/robotic options are SIMILAR, but their COMPLICATIONS are significantly different.

Be aware that the complications of prostate cancer treatment especially those of impotence and urinary incontinence (limp and leaking) AFFECT both YOU and YOUR PARTNER.

Be aware that you and your wife/partner need to EMPOWER yourself with knowledge as knowledge is king. Get several opinions and check prostate cancer resource websites like www.hifurx.com, particularly about prostate cancer treatment options and articles about prostate cancer referencing “The good, the bad and the ugly” in the prostate cancer treatment arena.