Surviving Prostate Cancer without Surgery: The New Gold Standard Treatment That Can Save Your Life and Lifestyle

"I found this book to be very helpful in examining the pros/cons of various radiation treatments for prostate cancer, as opposed to surgery. While the book is decidedly biased for radiation treatment, I found that the statistical data was rather weak in supporting the argument, especially for longer term results beyond 12 years after treatment. However, this may be a result of the lack of data for the medical field as a whole since I also have not found very much information in this regard for surgery as well. The book has both the doctor's viewpoint, a patient viewpoint, and that of a treatment nurse, who specializes in after-treatment care, including diet. The diet/nutrition/supplement section was very useful. Last, the copyright is 2005, and many advances have been made since then that are, naturally, not in the book. For example, the book describes radiation beam treatment as requiring a body mold to be made of the patient so that when the patient returns every day for the 2 months of radiation treatment, the radiation beams can be aimed at the prostate in the exact same manner/position day after day. Now this technique is outdated. UCLA medical center implants gold seeds in the prostate and simply uses computer software adjustments every day for treatment, to register accurately the prostate location. Therefore, the book gives a good foundation of techniques, but there is no substitute to seeking advice from medical professionals. If you are considering treatment, read this book first, and also read Dr. Peter Scardino's book on Prostate Cancer, then seek out opinions from respected doctors in both surgery (Urologists) and radiation (Radiaton Oncologists)."
~ Written on 2008-03-29

"Although technically well done, radiation therapy may not be the answer or at least the whole answer to prostate cancer treatment and survival. You will need to consult a number of current references on the broad subject of prostate cancer, as well as critically surf the Internet. Keep in mind that advances in treatment continue to offer hope.

A thorough and accurate diagnosis is essential to your understanding of what the best course of treatment may be given your age, PSA, Gleason Score, tumor type and stage (metastasis), etc. It is also essential that you discuss your options with your urologist, oncologist, radiologist and surgeon, each of whom may have different recommendations or options depending upon your choice of how you want to live and survive.

I have advanced prostate cancer [initially a PSA of 19.8, Gleason of 9, and (at least) local lymph node metastasis]. My cancer is presently undetectable (i.e., not hormone therapy refractive), and I just celebrated my 5th anniversary post-surgery. My choices, based on the severity of my cancer, included all recommended treatments available to me at the time, namely radical prostatectomy, external beam radiation and hormone ablation therapy. Recent studies have validated those three aggressive treatment regimens for advanced prostate cancer survival.

The side effects of those treatments were very troublesome for the first two years post-surgery. With additional medication for the menopausal-like symptoms (nausea, hot flashes, etc.) and bone calcium depletion effects (osteoporosis), I've been able to adjust to some of them. So, as you may see, the answers may be very different for each of us. Best wishes. "
~ Written on 2007-01-13

"Dr. Dattoli touts brachytherapy above all else, even though studies have shown that surgery offers surer long-term results, important especially for younger men who don't want their cancer to recur down the road. Seed implants can leave areas of the gland undertreated. Also, the idea that radiation causes fewer side effects is bogus. In fact, in addition to urinary and erectile problems, men getting radiation in any form run the risk of bowel problems."
~ Written on 2005-06-17

"The book suffers from a rhetorical bias against surgery -- a bias that leads to little good being said about surgery. A study reported in the Journal of the American Medical Association concluded that if you see a surgeon about treatment options he/she will likely represent surgery; if you initially see a radiologist, the recommendation is likely to be radiation.

As other reviewers have pointed out, a man facing treatment options must determine if surgery that is right for him. IMRT/seeds is a great approach but many patients aren't eligible due to the progression of the cancer. Similarly, expansion of the cancer beyond the prostate gland may mean that surgery is not feasible. But surgery is, in my experience, one of the best options for a T2a or T2b diagnosis. Obviously much depends on the skill of the surgeon but if the surgeon manages to excise all the cancerous tissue, you will be in great shape re recurrence of cancer. The same cannot be said about hormone therapy.

I would make two points about surgery versus other options (all the while emphasizing that the best option depends on the state of your cancer). First, I found that men facing the treatment decision often recoil in horror at the idea of being cut open, nerve bundles being severed and a Foley catheter in their penis for two or three weeks. A tough call. But remind yourself that once the surgery is over and the catheter is out, you are done. Hopefully the surgeon will save enough nerve bundles that you will be able to function sexually, with a little help from the blue pill. I had the surgery and have not taken one bit of medication or treatment since. Luckily for me, the surgeon got it all and my PSA remains zero. You will also have the psychological relief of knowing that the cancerous object is gone from your body. (I was influenced by a certain famous football coach who said, 'as soon as I got the diagnosis I wanted this thing out of me')

Second, surgical techniques are getting better. Robots, cryogenic techniques and other technology are starting to move into the mainstream. Many surgeons have done hundreds of these operations. Success stories are increasing. The same cannot be said of radiation -- it still is likely to devastate surrounding tissue. Hormone therapy can be useful but the patient really needs to talk at length with his doctor about how long the course of treatment will take and the side effects, which can be terrible.

A final bonus re surgery. If it does not succeed, ADT therapy remains an option.

To all prostate patients: evaluate every option carefully and develop a good sense of the prospects for success of each option. Hang in there."
~ Written on 2005-06-01

"Radiation oncologist Michael J. Dattoli, M.D., Advanced Registered Nurse Practitioner Jennifer Cash, and prostate cancer survivor and executive director of the Dattoli Cancer Center and Brachytherapy Institute Donald Kaltenbach present Surviving Prostate Cancer Without Surgery, a potentially lifesaving book brimming with information on the treatment options for those diagnosed with prostate cancer. In addition to possible choices of radiation, radical surgery, or some form of hormonal therapy, Surviving Prostate Cancer Without Surgery offers the latest medical data on state-of-the-art radiation therapy such as seed implants and IMRT (Intensity Modulated Radiation Therapy). From its title, Surviving Prostate Cancer Without Surgery may appear to strongly advocate non-surgical approaches, but in fact the title is simply a reaction against the long-standing favoritism of surgery to the extent of perpetuating myths concerning how effective it truly is. Surviving Prostate Cancer Without Surgery gives an evenhanded assessment of various options, including statistical data with an eye toward possible contradictions or innacuracies hidden within the numbers. The goal is to provide the reader with as much information as possible, in clear, easy-to-understand terms, concerning prostate cancer, how it can be treated, why some men are more or less likely candidates for surgery than others, the risks involved in different types of treatment including risks of temporary or permanent incontience or impotence and how to get help - not only medical help, but also emotional and financial help. A "must-read" for anyone researching or personally grappling with difficult questions and problems concerning prostate cancer, the better to confront one's doctor and discuss options with as much knowledge about the situation as possible. Highly recommended.
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~ Written on 2005-05-07