Furthermore, analysts are still debating that the prostate cancer screening test, prostate-specific antigen (PSA), results in unneeded prostate cancer treatment, something Dr. Samadi does not believe. "The androgen deprivation therapy risk just further complicates the whole prostate cancer treatment issue," he said, "Androgen deprivation therapy patients are undergoing the procedure when there is an elevated PSA as a result of a biochemical tumor recurrence. So the benefit is not definitive," says Samadi.
Additionally, the length of time patients received the hormone therapy increased their risk of developing colorectal cancer. Men who had their testicles removed had the highest risk. "Obesity has always been a significant risk factor, especially for men, for a wide variety of diseases, including colorectal cancer," said Dr. Samadi, a da Vinci prostatectomy expert who is also skilled in open prostatectomy as well as laparoscopic prostatectomy, "Obese men have lowered androgen levels, which suggests a direct link to colorectal cancer development."
Critics of the study believe that men receive a prostate cancer diagnosis usually undergo colorectal cancer screening for the first time, so cancer is detected only because of screening and not the hormone treatment for prostate cancer. A study would have to be conducted to assess the incidence of colorectal screening in men who received hormone therapy, a radical prostatectomy or no treatment.
Dr. Samadi explained that random biopsies are not accurate enough to image the entire prostate. Therefore it's insufficient to provide doctors with enough information on staging. "Not many patients realize that there is usually a 40 percent upgrading of the disease after the prostate is removed, which is also a strong argument against radiation as the primary treatment for prostate cancer," he said.
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