Best Treatment  - How's a Man to Decide?

Men with a diagnosis of prostate cancer have decisions to make on the treatment to go down.  Depending on the unique facts of their diagnosis, they may be asked to choose between surgery alone to remove the prostate (conventional or nerve sparing) , radiation therapy (brachytherapy or external beam), hormone therapy, or a combination of the above. While survival outcomes may be comparable, each form of treatment carries its own mix of physical side effects including incontinence, bowel disruption, and erectile dysfunction. These physical effects, in turn, often affect the prostate cancer survivor's quality of  life.  These side effects may be mild to severe, may eventually get better or last for years. The results of the report on the New England Journal of Medicine in a nutshell:

"Adjuvant hormone therapy was associated with worse outcomes across multiple quality-of-life domains among patients receiving brachytherapy or radiotherapy. Patients in the brachytherapy group reported having long-lasting urinary irritation, bowel and sexual symptoms, and transient problems with vitality or hormonal function. Adverse effects of prostatectomy on sexual function were mitigated by nervesparing procedures. After prostatectomy, urinary incontinence was observed, but urinary irritation and obstruction improved, particularly in patients with large prostates. Treatment- related symptoms were exacerbated by obesity, a large prostate size, a high prostate-specific antigen score, and older age....."

Read the whole story here on cancerpage. Survey Gauges Side Effects of Prostate Treatments
Cancerpage.com  Prostate Cancer page

Health Literacy

"Take two tablets by mouth daily."  Sounds simple enough, but  being able to read the label on the pill bottle doesn't mean  the instructions are understood.  A research study last year found that  in people with low literacy, while 70.7% could read the label, less than half could follow the directions. And of 84% of people with marginal literacy who could read the label, more than a third could not follow it.  The researchers said don't blame the patients. "While limited literacy is associated with misunderstanding, the instructions themselves are awkwardly phrased, vague, and unnecessarily difficult," they concluded. Make the labels clear and " use explicit dosing intervals, clear and simple language." Read an abstract of the report here.

You can read  more about health literacy and cancer patients here.

The "Best" or "Needs Improvement"?

Whether you believe the U.S. healthcare system is the best in the world or needs improvement is likely reflected in your political affiliation. The Harvard School of Public Health released a survey this week that dissected attitudes about healthcare in America.  The survey compared beliefs about the U.S. system with the healthcare delivery systems in other countries. Perhaps one of the most striking findings this year is how close Independents are to the views of Democrats. "On each of the four elements tested, Independents are within a few percentage points of agreement with Democrats, and both are significantly separated from Republicans, " the report points out.  All parties, however, agreed on one thing: the U.S. has fallen behind in providing affordable care and controlling costs.

Early Mammogram Advocate Dies

Nathaniel Berlin, the NCI's clinical director from 1961 to 1971, passed away in Florida last week. He was 87 years old.  Berlin was one of the first advocates of  mammography for breast cancer screening.  He worked at NCI for 20 years before becoming the director of the Northwestern University Cancer Center in Evanston, Ill.  After other positions, he retired in 1992 and re-turned as a visiting scholar to the National Institutes of Health. You can read more about Dr. Berlin in the Washington Post, here.