Prostate Cancer Treatment Cleveland OH

Heal Thyself—Prostate Cancer

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By Barbara Hey

Turning up the heat may provide a less invasive, more promising treatment for prostate cancer. Blasting the cancer with a treatment that uses high-intensity focused ultrasound (HIFU) to kill cancer cells and surrounding prostate tissue offers myriad benefits over conventional treatments according to John Warner, MD, the medical director of the Maple Leaf HIFU Company in Vancouver, British Columbia. Maple Leaf HIFU manufactures Ablatherm HIFU, the machine currently used for this procedure.

• HIFU can be performed under a spinal block—versus general anesthesia—most often on an outpatient basis, Warner explains, with no incision and no attendant loss of blood. Studies confirm HIFU’s effectiveness in combating the disease, and because it’s noninvasive, the procedure is less likely to damage surrounding nerves and tissue. A study published in the Journal of Urology in 2003 found that five years after treatment, 87 percent of patients had stable prostate specific antigen (PSA) levels. High or rising levels suggest the presence of the disease.

• If treated early, before it spreads, prostate cancer has a nearly 100 percent five-year survival rate, according to the Prostate Cancer Foundation. Though the common methods of treatment (radiation and surgery) work effectively, they have a number of ser-ious risks associated with them. With radiation administered externally—called external beam radiotherapy—the beam can damage surrounding tissue, skin, and muscle en route to the prostate, and patients commonly require multiple treatments. Another option is brachytherapy in which radioactive pellets are inserted surgically into the prostate. The risk of this type of radiation is that the effects can extend beyond the prostate itself. A third option, surgery, requires general anesthesia and hospitalization, which both carry risks. A much more aggressive tactic, surgery involves not just removal of the prostate, but also portions of the seminal ducts and part of the bladder. Common aftereffects of all these treatments include impotence and incontinence.

• For the HIFU treatment, a probe is inserted in the rectum to guide the ultrasound to the prostate using computer imaging. The focused beam of sound reaches a heat of 85 degrees Celsius, killing the cells of the prostate (dead tissue is excreted later in the urine) while skirting the surrounding nerves and muscles. And according to Warner, 90 percent of the patients require just one treatment, which may last 90 minutes to three hours.

• Currently only the Don Mills Surgical Unit in Toronto offers Ablatherm HIFU treatment, but that may change in the near future. FDA-monitored studies comparing HIFU with cryotherapy (freezing the tissue, commonly used as a second-line of treatment) on patients with a recurrence of the disease will begin in 2006, setting the stage for the treatment to one day be available in the US.

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