GLG News by Physicians who Perform Procedures using the Da Vinci Robotic Surgical System

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Provenge - Do we really have a choice?

November 19, 2010

Analysis of:Medicare Panel Supports Use of Provenge in FDA-Approved Population | blogs.wsj.com

Provenge has received FDA clearance for the use in hormone resistant prostate cancer, a disease that kills over 30,000 American men each year. The data says this will extend life for several months on the average, but some may achieve surprising results of regression of disease and even years. The cost is rather high, over $90k for the treatment.

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Prostate Cancer Genetic Testing - Is it real or is it boutique lab work?

January 20, 2009

Analysis of:Clarient Launches Gene Expression Test for Prostate Cancer | www.medcompare.com

Genetic testing for clinically significant prostate cancer is vital to allow clinicians to treat patients.  This appears to be a step in the right direction, although it does not seem this will have a major impact for the majority of cases. The study represents only a small subgroup of patients that may have some benefit from this new molecular biology test.

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Intermittent hormonal therapy for Prostate Cancer: Is it here yet?

January 2, 2009

Analysis of:Finnish Multicenter Study Comparing Intermittent To Continuous Androgen Deprivation For Advanced Prostate Cancer | www.medicalnewstoday.com

prostate cancer, hormonal therapy, intermittent treatemtent

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Prostate cancer DNA vaccine trial - a necessary step

December 29, 2008

Analysis of:Approval From The Swedish Medical Products Agency To Start A Clinical Trial Using A Xenogenic PSA DNA Vaccine | www.medicalnewstoday.com

prostate cancer, vaccine, dna

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Robotic Prostatectomy ?Too soon to tell?

May 29, 2008

Analysis of:Mixed Outcomes in Laparoscopy for Prostates | www.nytimes.com

The data gives a mixed review regarding the robotic assisted radical prostatectomy for prostate cancer.  There is a clear advantage in regards to a significantly decreased risk of bleeding, post operative pain, and earlier return to normal activities.  However, the data does not show a clinical advantage in cancer cure or clinically significant improvement in cancer control.  Much more data is needed over a longer period of time.  The article does not mention surgeon experience, i.e. those who have done many robotic prostatectomies vs. a surgeon with a limited experience.  Nor does the article mention post operative complications such as preservation of erectile function and continence control.

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Novel immunotherapy for prostate cancer

April 16, 2008

Analysis of:Cell Genesys Announces Encouraging Results from Phase 1/2 Trial of GVAX Immunotherapy for Prostate Cancer in Recurrent Disease | www.pipelinereview.com

Novel therapy for advance recurrent prostate cancer that does not rely upon traditional standard hormone therapy. This has the potential for men to continue to be sexually active while receiving treatment for advanced disease.  It also opens the door to other therapeutic interventions.

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

Preventing Bariatric Surgery Deaths

January 25, 2008

Analysis of:Pinning Down Mortality Rates After Bariatric Surgery | www.medscape.com

 Bariatric surgery is a major operative procedure that caries significant morbidity and mortality risks due to the comorbid diseases seen in this patient population.  This procedure is increasing in frequency as more patients are willing to have it and more surgeons are becoming proficient. The mortality rate is ~ 1 % at 1 year and 6% at 5 years which is greater than the population at large.

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

Wet pajamas must be back in style???

December 6, 2007

Analysis of:Desmopressin Acetate (marketed as DDAVP Nasal Spray, DDAVP Rhinal Tube, DDAVP, DDVP, Minirin, and Stimate Nasal Spray) | www.fda.gov

The FDA has made the nasal spray formulation of DDAVP be withdrawn due to potential significant side effects of life threatening hyponatremia (low blood sodium) as well as potential seizures. I an unable to identify the data from this announcement as to why this occured. DDAVP nasal spray has been used for over 10 years for the treatment of primary noctural eneuresis (bedwetting) with good success.

Mitchell BambergerAttending PhysicianTRICOUNTY MEDICAL ASSOCIATES INC

?Role of IMC-A12 for metastatic prostate cancer

September 3, 2007

Analysis of:Phase II Study of IMC-A12 for Advanced Prostate Cancer Commences Patient Enrollment | www.pipelinereview.com

This immunotherapy is based upon Insulin-like growth factor which may be expressed in prostate cancer.  There is not much data on this.  The study is very limited, 30 patients, and must not have received any chemotherapy prior to enrolling.  The sponsor is IM Clone.  I do not know what research institutions will be enrolling patients.  A limited investigation is warranted, but the data will be crucial if to go on to a Phase III trial

Forrest RubensteinCardiac, Thoracic and Vascular SurgeonST. MARY'S HOSPITAL, STREATOR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS

CMS regulations penalize hospitals for taking care of sickest patients

August 28, 2007

Analysis of:New Medicare Regulations Adopted To Reduce Certain Hospital Infections And Medical Errors | www.medicalnewstoday.com

This article presents the new CMS guidelines that deny higher payments for the additional costs associated with treating patients for certain hospital - acquired infections and medical errors. While these are laudable goals, to assume that all infections are the result of poor medical practice is an oversimplification. The development of nosocomial infections also has to do with the patients disease processes such as diabetes, morbid obesity, immunosuppression, tobacco abuse, etc. While few physicians would argue against enforcing these rules for documented mistakes (medication errors, transfusion mistakes, and objects left in patients bodies), most recognize there is a certain baseline of these other infections which cannot be avoided. Hospitals should only be penalized when their risk adjusted incidence exceeds a standardized baseline.

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