Urology Journal Publishes Papers Questioning Robots and Proton Beam Therapy
By Gary Schwitzer,
Published: May 17, 2013
Probably the two most frequent subjects on my Health News Watchdog blog regarding the proliferation of new medical technologies are proton beam radiation therapy and robotic surgery. Since this blog focuses on media messages about health care interventions, we generally focus on the marketing claims made for these technologies.
The latest edition of the journal Current Urology Reports has published papers on both topics.
A paper, “Proton Beam Radiation Therapy for Prostate Cancer – Is the Hype (and the Cost) Justified?,” concludes:
“Proton beam therapy has entered the collective consciousness of the American public, and intense hype now surrounds its utilization in prostate cancer, creating a potential low signal-to-noise ratio. Clearly, this is an elegant technology with appealing properties and data supporting its safety and efficacy that spans decades. However, medicine can no longer blindly afford expensive therapies without clearly proven benefits. As such, we need to complement the existing evidence and have the resolve to perform rigorous and randomized comparative assessments of such advanced technologies to further guide clinical decision making and policy, while continuing to promote innovation.”
That’s accompanied by a paper, “Does Robotic Prostatectomy Meet Its Promise in the Management of Prostate Cancer?” While reflecting on some evidence suggesting that robotic prostatectomy results in less blood loss, fewer transfusions, a lower risk of perioperative death, and faster physical recovery and return to work, the authors conclude:
“However, whether these advantages justify the significantly higher costs of robotic technology remains to be seen. Most notably, the robot is a tool, and tools are only as good as the surgeons who wield them.”
(1) Robotic Surgery is necessary only for more advanced cases of Prostate Cancer because there are more side effects with it that Radiation therapy or Radiosurgery. That is why the ISRG's Prostate surgery growth rate has decreased in US and will in other countries. Disclosure: I decreased my position in ISRG over a year ago when the growth rate slowed. I have the rest since all the Lawsuits started. I am not sure if the lawsuit are warranted by when the lawyers come out of the woodwork like worms it is time the take a break.
(2) Proton Beam is very expensive and there is no proof that it is as good as other methods of Prostate cancer treatment. My understanding is that it is best for cancers close to the surface of the body, e.g. cancer of the eye.
Finally, I believe that for early or middle stage Prostate cancer radiosurgery is the quickest, best and cheapest way to treat it. This is why I have stuck with ARAY and have increased my position. I just hope new management can prove me right.
Your understanding on proton therapy is completely incorrect. It is actually best for deep tumors because the entrance dose is extremely low and the exit dose is essentially zero. If you are basing your investment on ARAY on this then you are making a mistake.