Prostate cancer is the fourth most common male malignancy worldwide. Incidence and death rates vary tremendously among countries, however in the Philippines, more and more cases are being seen every year.
The chance of getting prostate cancer gets higher as one gets older. Thus, the older man gets, the higher is his chance of developing prostate cancer.
In the past, most men were diagnosed to have prostate cancer during the later stages of the disease. This is due to the fact that the prostate is a deeply imbedded organ, that is poorly understood by the layman as well as
PSA or Prostate Specific Antigen changed the way urologist receive prostate cancer patients. When a PSA is done on routine check-up for all men 50 years old and above, the chance of diagnosing asymptomatic prostate cancer increases over ten fold! Thus at present, we are ables to catch prostate cancer patients at an earlier and curable stage.
Localized prostate cancer is classically cured via a surgical procedure known as radical prostatectomy. This operation is one of the most complex surgeries in urology and is frequently associated with many problems afterwards. Most common among these include inability to control your urine (incontinence), obstruction, and impotence. Dissatisfaction with these results has decreased the quality of life of patients who have undergone this operation. Thus, different alternative treatment options have been developed to answer this need.
The classic alternative option for localized prostate cancer is brachytherapy. This is a procedure where radioactive iodine seeds are permanently implanted within the prostate.
Although statistics show that the treatment is effective, brachytherapy has certain drawbacks. The greatest of which is that once done, no other alternative treatment for localized prostate cancer can be done. The only other treatment that can done is palliative hormonal therapy. Other drawbacks include the presence of permanent radioactive substance which theoretically disallows patients to be in close contact with children and pregnant women, and it takes around two years before your urologist can definitely find out whether or not the treatment has been effective.
Other alternative treatments have their own disadvantages, namely, quality of life and long term complications.
Last year, Ricardo, who had turned 65 years old, although he had exercised regularly and knew for a fact that his blood pressure and sugar was normal, decided to have himself check-up more extensively, in spite of the fact that he did not feel anything. Among he tests that his cardiologist did was PSA blood test, which was routine to do for all men 50 years old and above. To his surprised, it was elevated, but not by much. His cardio, referred him to a urologist, who after a thorough examination and some imaging studies, advised him to have a prostate biopsy.
The biopsy, which took around ten minutes under mild intravenous anesthesia, later showed that his prostate was indeed positive for cancer. After further test, including a Magnetic Resonance Imaging (MRI) scan and a Nuclear Bone Scan, the cancer was assessed to be localized, organ-confined, which means that it was limited only to the prostate and had not spread outside its confines. At this point, Ricardo’s urologist gave him several options, including surgery and brachytherapy.
High-Intensity Focused Ultrasound is done most safely using the EDAP-TMS Ablatherm device. Under epidural anesthesia, Ricardo lied down on his side. Once asleep, the Ablatherm probe was inserted into his backside where his prostate was measured, the structures identified, and the extent of treatment computed. HIFU is a method developed in Lyon, France, wherein high powered ultrasound waves that are focused and are thus converged to a single spot where heat and thermal damaged destroy tissue sparing the surrounding structures. The tissue damaged is very precise and consistent, thus can be applied with a great degree of control and thus, safety.
The treatment probe goes transrectally controlled manually by the urologist, who then plots the treatment course guided by computer and ultrasound. Once the prostate is mapped, treatment starts and the probe is completely computer controlled for accuracy and precision.
The probe is used both to scan and treat the prostate. Because of he safety design and precision computerized motion control, the burnt areas are accurately confined just to those areas that the urologist had pre-target.
After the procedure, Ricardo awoke to find no incision, very little pain. He had urinary catheters attached to him, but these were removed in a few days. In a month, he followed up his PSA result which to his amazement was only 10 percent. In three months, his PSA had dropped down to less than 0.01 nonograms per liter, which is the lowest value the PSA machine can give. By that time, his voiding was practically normal.
It would take five years, as it does all other options, to really find out whether or not he is cured of prostate cancer, but these initial results gave him good reasons to be optimistic. If his PSA remains stable for that time, with only minor increases, then he can count on a continued natural lifespan prostate cancer free.
HIFU has changed the way urologist in Europe treat prostate cancer patients. It is versatile, comparably cost effective, repeatable, and does not prevent other treatment options to be done in case of failure. It is in fact, at present being widely investigated as a treatment for prostate cancer when other options have failed.
If your or someone you know has just been diagnosed to have prostate cancer, perhaps we can offer a treatment option that is acceptable, cost effective, well tolerated, and safe.