Introduction

INTRODUCTION The Management of Radiation Failure in Prostate Cancer Michael K. Brawer, MD Supplement Editor, The Management of Radiation Failure in Prostate Cancer Northwest Prostate Institute at the Northwest Hospital, Seattle, WA [Rev Urol. 2002;4(suppl 2):S1] © 2002 MedReviews, LLC rostate cancer, one of the leading causes of death in men, is treated in various ways, depending on the severity of the condition, age of the patient, etc. Although radiation therapy has proven successful for many prostate cancer patients, the number of patients who continue to fail remains too high. Although there is little information on the frequency of radiation failure in the United States, an estimate can be given utilizing the following assumptions: P • There will be approximately 200,000 diagnoses of prostate cancer in the United States this year; • Data from the National Cancer Database states that 29% of men with prostate cancer were treated with radiation therapy in 19961; • Roughly 60,000 men will undergo primary radiation therapy for clinically localized prostate cancer this year; • There is, approximately, a 30% biochemical failure rate with radiation therapy (see Table 1 in the article, “Radiation Therapy Failure in Prostate Cancer Patients: Risk Factors and Methods of Detection"). Therefore, it can be estimated that approximately 18,000 men treated in 2002 will eventually be at risk for failure of primary radiation therapy. With the increasing utilization of radiation therapy, primarily brachytherapy, for initial therapy in prostate cancer, it is likely that this number will increase. Thus, it is extremely important to evaluate the management of men who fail radiation. I am pleased to present this supplement, The Management of Radiation Failure in Prostate Cancer, in which several renowned specialists discuss management options after radiation therapy has failed. In the first article, I will discuss the risk factors and methods for detecting radiation therapy failure; Dr. Daniel Rukstalis writes on the management of radiation failure; Dr. Aaron Katz explains the criteria that should be used in selecting patients for cryotherapy; and lastly, Dr. Bryan Donnelly will discuss how he performs salvage cryosurgery. With the generous support of Endocare, Inc., we have been able to put together this valuable supplement so that physicians can continue to learn about innovative techniques to help their patients live longer and healthier lives. References 1. Mettlin CJ, Murphy GP, McDonald CJ, Menck HR. The National Cancer Database Report on increased use of brachytherapy for the treatment of prostate carcinoma in the U.S. Cancer. 1999;86:1877–1882. VOL. 4 SUPPL. 2 2002 REVIEWS IN UROLOGY S1