ProstRcision® – What is it?
Patients have asked me, “What is ProstRcision®?” A new ad has hit the Louisville radio airwaves and billboards touting “the highest documented cure rate* of any prostate cancer treatment”. It appears that the Radiotherapy Clinics of Georgia (RCOG) have trademarked a clever word “ProstRcision®” to designate a well know treatment option, that is combination radioactive seed implantation followed by external beam radiation therapy.
The add directs you to a web site which attempts to get your email address in addition to other demographic data. You are then sent a very well produced color brochure describing what ProstRcision® entails. After reading the pamphlet, one gets the impression that the RCOG are a research foundation rather that just a large radiation therapy group out of Decatur Georgia. It sounds as though they invented this technique, which they did not or that they are doing something truly unique, which they are not. I have confirmed this with a Professor of Radiation Therapy at the University of Louisville Brown Cancer Center. RCOG appear to base most of their claims on a single publication by one of their physicians that reviews their results of combination radiotherapy in men treated with 5 or more years of followup. They state that their table of comparisons to other treatment modalities is “an apples-to-apples comparison of cure rates” which in my professional opinion it is not. They promote an Individual Cure Rate or ICR based on six clinical parameters which they claim “provides you with a precise chance of being cured”. Their ICR claims over simplify the complexity of predicting outcomes with a particular treatment for prostate cancer. No clinician can precisely predict how any individual patient’s treatment will turn out, mainly because prostate needle biopsies can frequently under stage and under grade the patient’s cancer. Only after surgical removal of the entire prostate and lymph node dissection do you have a reasonably accurate pathological staging of your cancer and even that can sometimes be wrong.
Combination radiotherapy utilizing seed implantation followed by external beam radiation is a sound approach to treating men with clinical low grade, low stage prostate cancer in men with small prostates and minimal pre-treatment voiding complaints. It can result in complications of impotence and incontinence, like all other modalities in addition to more serious problems like rectal injury, fistulas or scarring of the bladder neck. Surgical removal of the prostate is generally not an option for men who have failed this type of radiation treatment. I am unable to find any peer reviewed articles in the medical literature which claim ProstRcision® has the highest documented cure rate.
Since I first put up this post I was contacted by a law firm representing the Radiotherapy Clinics of Kentuckian (RCOK). They are apparently affiliated with RCOG and threatened me with a law suit if I did not remove the article from my website. I am not implying any intentional misrepresentation by either RCOK or RCOG. This is my professional opinion after reading through their literature.