During 2004 a total of 60 patients (Figure 1) were treated for prostate cancer. Over one third of the patients were treated with surgery only and 5 percent were treated with surgery and then radiation therapy. Gradually, more patients are given the option of a nerve-sparing procedure if they are an appropriate candidate. Typically, they need to have low-volume, low-stage, and less aggressive cancer. A nearly equivalent number of patients were treated with brachytherapy. Brachytherapy involves the placement of radioactive seeds within the prostate to treat prostate cancer. Typically, patients receive either palladium or iodine. At Rice, patients receive palladium stranded seeds. Only 5 percent of the patients were treated with external beam radiation therapy only. Most of the patients at Rice that pursue brachytherapy will receive an abbreviated course of external beam radiation therapy prior to the placement of the radioactive seeds. When comparing the Rice data to the large cohort of 486 hospitals (Figure 2), the percentage of patients receiving surgery versus radiation therapy is similar. Essentially, approximately an equivalent number of patients receive surgery versus radiation therapy.

The demographics of prostate cancer at Rice are slightly different than the large hospital study group. Sixty-eight percent of the patients diagnosed at Rice were between the ages of 50 and 69 (Figure 3). The comparison group had approximately 50 percent (Figure 4). Twenty-seven percent of the Rice group was between the ages of 70-79. In comparison, 35 percent of the comparison group was between the ages of 70-79. This may be due to a smaller sample size of statistical insignificance or possibly more aggressive screening of younger, healthier men that may benefit from curative local treatment of prostate cancer. Though the demographic data is different, the stage of prostate cancer at Rice (Figure 5) is very similar to the large hospital group (Figure 6). When comparing stages 1-4 the vast majority of patients are stage 2 with a very small percentage in either stage 3 or 4.

The five-year survival prostate cancer data at Rice (Figure 7) is much better when compared to the large hospital group (Figure 8). Patients in stages 1 and 2 had a 100 percent survival rate. Stage 3 patients had a 99.6 percent survival rate. Stage 4 patients had a 54 percent survival rate. In the large hospital comparison group the survival rates were much lower. Stage 1 patients had a 74 percent survival rate. Stage 2 patients had an 82 percent survival rate. Stage 3 patients had an 81 percent survival rate. Stage 4 patients had a 35 percent survival rate. The above noted differences are substantially better at Rice hospital. Some of the differences may be attributed to demographics as there are more patients diagnosed at an earlier age with fewer patients diagnosed between the ages of 70-79. Another aspect may be reflective of the medical culture at Rice hospital. Historically, the urologists have worked closely together during prostate cancer surgery and also work closely with the radiation oncologist. We think the teamwork and expertise of these treating physicians have also contributed to our success.

Kevin W. Unger, M.D.
Department of Urology

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