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Return to Article: VA suspends prostate cancer treatment programs at four hospitals

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  tell how can i receive 100% from the va i was medically retired from thhe army for prostate cancer they remove my entire gland and noe i suffer from ed among other problem

  gordon sanders Posted December 2, 2008 9:15 PM
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  Cudos to Rick Ward for the great explaination of what needs to be looked into. The procedure is a wonderful tool for those seeking Prostrate Cancer Treatment. Part of the key to success of the treatment is to seek it in the early stages. Postponing the treatment will most often require an inordinate number of seeds and the swelling following implant can cause other severe problems, lack of the ability to urinate being one. Even the MOST skilled oncologist do on occasion have to remove seeds from the bladder after implant. I had the opportunity to watch the procedure. I can say if I were a man and was faced with the diagnosis of prostate cancer...I would choose it.

  A key to obtaining compensation for service connected disability is personal involvement and a skilled, knowledgable advocate. If you are not fully involved and willing to work to obtain the needed information and documentation to prove your case, you are defeating yourself. When my husband was originally diagnosed with Agent Orange Connected cancer, he was on 100%. He did lose part of that after 2 years of remission. However, we have since won a permanent and total rating = 100%. It took work, but the end results were worth it.

  I will add that at no time was his treatment anything but excellent.

  Wife of 100% Disabled Vet Posted October 17, 2008 10:33 PM
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  This just solidifies that the VA is not your firend if you are a veteran. As a disabled veteran who has had to fight for compensation and treatment for a service connected disability for over 20 years, I never had one good experience with teh VA. I know that some people do - but women veterans receive a disaparate amount of compensation from the VA because after all - we can be somebody's wife and "be taken care of", where is the justice in that? It does not surprise me that veterans are receiving lower than normal does of treatment for prostate cancer - the VA is probably trying to save money. It would be interesting to find out the ages of those men who received the low doses - are they elderly and the VA had "written them off"? Where is GAO when you need it and what are they doing about the problems inherent in the VA?

  Kathy Posted October 17, 2008 8:39 AM
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  I agree with everything previously said, especially the part about the high level of skill required to perform a good quality seed implant. I would also like to add that even with good seed implants there is a high amount of acute toxicity. Because of the quality problems and toxicity veterans with prostate cancer should investigate the newer alternatives to seed implants. High Dose Rate temporary implants require less skill (dose adjustments can be made after the implant) and have shown less toxicity. Also, one of the newest prostate treatments, robotic image guided stereotactic radiosurgery is totally noninvasive and early results (3-4 years PSA follow up) have been excellent with very low toxicity. Since long term data is still needed men considering this type of treatment should consider enrolling in a clinical trial.

  Walter Nikesch Posted October 17, 2008 8:28 AM
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  I know one of the VA hospitals that were not involved with the problem. Unfortunately, what I saw was an understaffed and low experienced of what staff they had. Most of the implants were training cases. Residents, oncologists and urologists fought all were placing the seeds into the patients. Some residents were very good. Some were not.

  I even saw a few seeds placed poorly by the chief oncologist. After which the urologist that was in charge of the case asked him to back out.

  The difficulty with seed implants is that it takes someone with a high amount of experience to get a good implant. Guiding a needle and preventing "pull back" when you remove the needle is almost an art form. If a seed is not placed correctly, there is no way to remove it. (One exception was a few seeds that ended up in a patient's bladder and were removed with a scope.)

  Equipment was also a problem. The ultrasound guidance system was ancient and made it difficult to see anatomy.

  In the end it becomes a question of experience. How can you train a new MD to become expert implanters without allowing them the opportunity to train?

  Zaakar Posted October 16, 2008 11:58 AM
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  Oh well they are only veterans, as long as we keep our jobs and get our annual raises the CS workforce at the VA is happy

  Dan ketter Posted October 16, 2008 10:45 AM
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  It is a real shame to let the Vets continue suffering because somebody can not do their job right until someone dies or does not get the proper treatments and live a long a properous life instead of being treated like a ginny pig and get their medical care needed and what should be given to the Vets of this Nation, They need to get it together and quit fooling around. This is not a laughing mater.

  Quartercircle Posted October 16, 2008 7:03 AM
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  Brachytherapy is at its core skill-intensive. Though not stated in the article, apparently the standard measure of individual brachytherapy treatment, the dose-volume histogram (DVH), fell below acceptable levels, usually 90% of the planned dose. This is deplorable, but it shouldn't deny veterans access to brachytherapy treatment for their prostate cancer. In each of the cities where the VA program was closed down there are brachytherapy practioners of proven capability that the veterans can be contracted out to, and who could provide remedial training.

  If the VA brachytherapy programs at these VAs were provided by university medical departments, the problem may lie with the use of veterans as training cases for residents, with inadequate supervision. That, unfortunately, happens often in the VA-unvirsity lash-ups.

  Fix the immediate problem so veterans have uninterupted access to brachytherapy for prostate cancer, but investigate thoroughly what the underlying cause was, then fix that.

  Rick Ward Posted October 15, 2008 11:57 PM