Connectivity with Iain Duncan

shutterstock_1348154541 + 1 = 3* is a useful and only counter-intuitive for a few moments. It is to be employed by all and sundry to add just a little craziness. I mean when you start to think about examples that fit this concept your realise there are many. Many times two people work much more effectively together than they do separately. The whole concept of “value-adding” revolves around getting something extra when you put the right components together.

In essence, creativity arises from the unpredictable result you get when putting two familiar concepts together and getting an unexpected output or outcome. In science there is often value getting someone in a completely unrelated field considering a perplexing issue and using tools familiar to them to solve an unfamiliar problem.

Perhaps I am starting to stretch the concept but that’s why I like it. It is a reminder to start thinking beyond the concrete, the rational, and the logical world we mostly live in.

*Remember numbers are only (man-made) concepts used to approximate the real world.

Iain.

Radiotherapy & Prostate Cancer 2020

Important trial results from 2020 include RAVES, RADICALS-RT and the GETUG-17 trials.

All these trials have results suggesting that adjuvant radiotherapy does not improve event-free survival in men with high-risk features following radical prostatectomy. In addition, salvage therapy has fewer side effects than adjuvant therapy.

It appears optimal to wait until cancer recurs, usually indicated by a PSA rising to 0.20 ng/mL, before commencing radiotherapy.

The ARTISTIC meta-analysis was prospectively designed before the results of the other three trials were known. Collectively, the analysis included 2153 men from these three trials. All results showed that there was no improvement in PSA-driven event-free survival with the use of adjuvant compared with salvage radiotherapy.

The 5-year event-free survival rate, at 89% for adjuvant radiotherapy and 88% for early salvage radiotherapy was not significantly different.

The ARTISTIC meta-analysis suggests that following surgery, patients whose cancer is confined to the prostate can safely be spared adjuvant postoperative radiotherapy and its associated side effects.