Surgeon Dr. Daniel Costa, Associate Professor of Radiology at UT Southwestern Medical Center, tells KERA’s Sam Baker the new procedure uses ultrasound to destroy tumors in the prostate.
How does the procedure work?
A probe is placed in the urethra. They read through. Sits right in the middle of the prostate. This is all done under real-time MRI guidance so we can see where the heat has been delivered to make sure that the cancer is properly treated. And we don't want to cause any damage to areas such as the nerves responsible for sexual function, or the bladder and the sphincter responsible for urinary function.
Why use ultrasound?
We don't have to make an incision. So there is no cutting, no wound, and there is no blood loss.
We know that exposing certain tissues for a certain period of time, for a certain temperature will result in permanent cell death. And that is true for cancerous tissues and non-cancerous tissues.
Who's the prime candidate for the ultrasound approach?
The typical patient is a patient that has what we call intermediate-risk prostate cancer. Prostate cancers are graded on a one to five scale, with one being the least aggressive, and five being the most aggressive. The intermediate risk is grades two and three. So that's one of the conditions.
The other condition is the patient's prostate. And where the cancer is located has to be within a certain distance, three centimeters from where the probe sits. So that is one of the reasons why it's important for patients interested in this treatment option to be vetted by somebody familiar with prostate imaging.
Also, there are things that can make this treatment not a good option, such as calcium deposits that certain men develop in the prostate. And this is also part of the workup that the man undergoes before this treatment is offered to him.
At what point does surgery become necessary?
Prostate cancer is extremely common. It's expected that one in seven men in the United States will develop prostate cancer over their lifetime because many of these cancers are not aggressive or rapidly progressed. And this may lead to the misconception that every prostate cancer can be left alone and won't be a source of problems. Many men are, in fact, threatened by prostate cancer as a lethal disease.
In order to know which cancers will pose a threat to a patient, it is important to be offered good-quality biopsies and follow up by your urologist. The way to be able to have a good baseline risk stratification, meaning understanding to each extent a certain patient requires more or less aggressive treatment, involves several pieces of an intricate puzzle. And that is why it's important to be followed by a physician, a urologist who is familiar with this clinical scenario.
What can you do to avoid the surgery or even prostate cancer itself?
There is no known way to prevent prostate cancer.
We do know that there are certain risk factors:
- Things like ethnicity. We know that African-Americans are more likely to not only develop prostate cancer, but develop more aggressive forms of prostate cancer.
- Family history is also an important risk factor.
- Age, for sure. The older a man is, the more likely he is to develop prostate cancer.
Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.