Every year, there's approximately 200,000 men diagnosed with prostate cancer. It's the second most common cancer amongst men in the United States.
And I did a lot of research and studies. Because one thing I did not want to do is remove the prostate.
I feel so blessed that the treatment is right here in Chicago. And it's being done here by a doctor he feels very, very comfortable with.
One of the issues we face is what men might be the best candidates for focal therapy. And the way we've done it in the trials is if a man, based on his PSA, his prostate exam, multiple biopsies, and an MRI-- if all that evidence suggests there's a cancer limited to one or two areas of the prostate, and we confirm that on the biopsy, and the location of the cancer on the biopsy matches what we see on the MRI, we might consider that man for focal therapy.
We identify the target that we want to hit. We put our needles through the holes.
What we're studying here with focal therapy-- it's an investigational technique to try to treat just the cancer itself and not the entire prostate. And it's very similar in concept to a lumpectomy for breast cancer.
We know exactly where his cancer is in the prostate. We are going to use that information to target our needle. And then through that needle, we are going to put our laser fiber into the area of cancer. And then once we confirm that the laser fiber is in the region of the cancer, then we are going to turn to laser machine on, which will allow us to increase the temperature in that location.
And we know that if the temperature goes focally about 60 degrees centigrade, then the cells in that area irreversibly get necrosed, die off.
In the site or the location of the previous lesion, you see this big non-enhancing hole. So that's the dead prostate tissue covering the entire area where the cancer was.
Working together with our colleagues in neurology at the University of Chicago, we completed a phase 1 study and published its results last year. And the results were promising.
Another important advantage of this procedure is that you don't close the door for any other procedure for the future. So if there is a need, we can do it-- a repeat laser ablation, the patients can undergo prostatectomy, radiation therapy, or any other therapy that they would like.
This is an outpatient procedure. I'll be home at 3 o'clock this afternoon.
Some men with early stage (localized) prostate cancer who previously had to choose between active surveillance and aggressive treatment with a greater risk for side effects, now have a new option for treatment: focal therapy.
Focal therapy is an overall term that refers to several minimally invasive treatments that target only the parts of the prostate gland where cancer is located. The goal of the treatment is to ablate, or destroy, the tumor and a safety margin within the prostate, while leaving the remainder of the gland intact.
Potential Benefits of Focal Therapy for Patients with Early-Stage Prostate Cancer
- Lower risk for side effects such as urinary incontinence, impotence and compromised bowel function, as compared to surgery or radiation therapy
- Minimally invasive, outpatient procedure
- If necessary, focal therapies can be repeated in the future
- Unlike some prostate cancer treatments, focal therapies do not limit the option to have radiation therapy or surgical treatment at a later time
- Quick recovery; it is an outpatient procedure and patients can return to desk work the following day
Our prostate cancer experts describe focal therapy as being similar in concept to a lumpectomy for breast cancer. Rather than removing the entire prostate, focal therapy is a less invasive way to destroy just the cancer while leaving healthy tissue in place. Patients are followed closely after focal therapy. Short-term cancer outcomes are very favorable but longer-term outcomes are largely unknown.
Different Types of Focal Therapy
- HIFU (High-Intensity Focused Ultrasound): HIFU focuses the energy of sound waves to create heat and destroy cancer cells. Just like a magnifying glass concentrating sun rays to burn a hole in the paper. During the procedure, an ultrasound probe is inserted into the patient’s rectum while the patient is asleep from anesthesia. Guided by MRI and ultrasound 3D-images, the physician finds the tumor, plus the area to be treated, and delivers the energy aimed at the diseased tissue in the prostate gland. HIFU is a noninvasive precision treatment that spares healthy tissue and lowers the chances of negative side effects associated with radical prostate surgery or radiation, such as impotence, incontinence and bowel function disturbance.
UChicago Medicine is the first medical center in the Midwest to offer and perform this procedure with the newest Focal One advanced robotic HIFU technology. This fills a significant treatment void for men with localized prostate cancer who find themselves in between active surveillance and whole gland treatments such as radiation or surgery. The treatment has been used for years in both Europe and Asia.
- MRI-guided laser ablation: Focal laser ablation uses highly targeted heat to eradicate cancerous tumor(s) within the prostate. During an MRI-guided focal laser ablation procedure, the patient is given intravenous (IV) sedation while lying in an MRI machine. After injecting a local anesthetic, physicians insert a small catheter to deliver a tiny optical fiber, the laser and a cooling device into the prostate. Under real-time MRI guidance, the laser is positioned within the tumor and used to heat the area to a temperature that kills cancer cells. The physicians monitor the temperature within and around the treatment region to protect healthy tissue, especially areas near critical structures such as the urethra, erectile function nerves and the rectal wall.
Urologists Ariel Shalhav, MD, and Scott Eggener, MD, answer questions about new treatment options for prostate cancer, including focal therapy and HIFU, as well as specialized care programs for men diagnosed with advanced prostate cancer or at high risk for the disease.Watch Video Watch Video With Transcript
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