Petar Bajic, MD

Raevti Bole, MD


Cleveland Clinic Glickman Urological & Kidney Institute

Prostate Cancer

Pilot Grant | The Roger Hasselman Family VeloSano Pilot Grant in memory of Roger M. Hasselman

Low intensity shockwave therapy as a non-invasive treatment for erectile dysfunction and pelvic pain in prostate cancer survivors

According to the American Cancer Society, over three million prostate cancer survivors live in the United States today thanks to treatments like prostate radiation and radical prostatectomy. However these survivors often live with significant genitourinary toxicity- sexual dysfunction, urinary symptoms and pelvic discomfort being the most common.

Over the last decade, research has identified low-intensity focused shockwave therapy (fSWT) as a novel regenerative treatment for erectile dysfunction (ED) or pelvic pain. Preclinical studies on fSWT show that it can induce vascular proliferation, recruit stem cells and promote nerve regeneration. Clinical studies have showed promising effects on patient symptoms and vascular hemodynamics measurements, with few to no side effects. However, direct-to-consumer marketing often conflates fSWT with another modality called radial wave therapy (rWT). rWT is commercially marketed as a comparable treatment to fSWT for ED despite lacking supporting evidence. While fSWT creates focused shockwaves that can penetrate deep tissues, radial wave devices generate slow, shallow waves which disperse away from the tip of the device. Regardless, advertising campaigns run by private companies claim that “wave therapy” is an effective and noninvasive treatment and charge thousands of dollars for a course.

Vulnerable prostate cancer survivors with ED and pelvic pain are targeted by these marketing strategies at significant out-of-pocket financial cost. There is a need for science to clarify the effect of fSWT to help patients understand and direct their medical care. Most scientists who research shockwave therapy do not include prostate cancer survivors in their studies because of the complexity of their condition. This means that we do not have much information on whether this novel treatment could effectively help prostate cancer patients or not.

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