Benign Prostatic Hypertrophy Overview
Benign prostatic hypertrophy , also called prostate gland enlargement, is common as men age into their late forties and beyond. An enlarged prostate can cause bladder, kidney and urinary tract problems and may lead to several uncomfortable urinary symptoms, including:
- Frequent and more urgent need to urinate
- Waking up at night to urinate
- Weak urine stream
- Difficulty and straining to empty the bladder
- Delayed onset of urination
Featured Patient Testimonial: Wayne Gregory
Family, safety, and preserving quality of life were top of mind for Wayne Gregory when he chose laser focal therapy, also known as focal laser ablation , to treat his prostate cancer.
I had lesions ultimately on both sides of the prostate near the nerve bundles, said Gregory. I knew that the skill and precision it was going to take to get that cancer ablated was going to have to be very, very high.
He shared his story while on a trip back to Houston, Texas, where he had the procedure performed by Dr. Ara Karamanian, Director of HALO Diagnostics Prostate Program and Medical Director of the Prostate Laser Center.
Featured Patient Testimonial: Dr Terry Higgins
After receiving a prostate cancer diagnosis, Dr. Terry Higgins urologist warned him of the risk of side effects of standard-of-care prostate cancer treatments like a radical prostatectomy, which carries a 50% chance of causing erectile dysfunction, and a 25% chance of causing incontinence.
At just 53-years-old, those were odds that Dr. Higgins was not willing to accept. Dr. Higgins urologist then told him about laser focal therapy, a minimally invasive prostate cancer treatment pioneered by HALO Diagnostics.
Now a few years in remission, Dr. Higgins shared his story.
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- Doctor | Health | Point of interest | Establishment955 Major MacKenzie Dr W, Maple, ON L6A 4P9, Canada
- 9600 Bathurst St, Maple, ON L6A 3Z8, Canada
Robert J Daley Md Caring For The Patient With Knee Pain
Dr. Daley gained national prominence when, as team physician for the Chicago White Sox, he performed Bo Jacksons Total Hip Replacement, allowing him to successfully return to playing professional baseball. He also performed Artificial Knee Replacement surgery on Dan Hampton, a Hall of Fame NFL defensive tackle for the Chicago Bears.
Dr. Daley is involved in the design and development of surgical implants for several manufacturers, giving him additional insight into determining the best solutions for his patients. He is a regularly featured speaker on orthopaedic topics related to arthritis and knee replacement.
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Planning Seed Placement With Varian Interface
VariSeed 8.0 is brachytherapy seed planning software that provides clear visibility of the positions of individual seeds during permanent seed implantation. VariSeed is an integrated piece of our brachytherapy solution, and provides seamless workflow with unsurpassed imaging capabilities. Contact Varian to purchase VariSeed.
Breakthrough Prostate Cancer Care
In 2019, we welcomed the Chicago Prostate Center to Duly Health and Care. The center, now part of the Duly family, was established in 1997 by Duly physician, Dr. Brian J. Moran. An experienced practitioner of prostate brachytherapy, Dr. Moran has performed thousands of prostate seed implants to treat prostate cancer and has proctored physicians all over the world. Dr. Moran has been recognized by the American Brachytherapy Society for his leadership in the advancement in the field of brachytherapy and has been awarded the honor of fellowship status.
At Duly Health and Care, our Brachytherapy team is here to provide extraordinary care. Dr. Moran and team are highly experienced in this field, developing evidence-based treatment plans using the most current research data, tailored to your individual needs. We are equipped with leading-edge technology and advanced diagnostic imaging that allows us to deliver treatments more effectively and with precision. In addition to offering brachytherapy treatment, Dr. Moran was a pioneer in developing the highly-effective diagnostic technique called Stereotactic Transperineal Prostate Biopsy that we utilize to offer you the safest form of health and care.
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Featured Patient Testimonial: Toms Story
I just felt like the technology and the skill level of HALO Dx was light years ahead of what was here available to me locally and thats why I made the choice to go down there. It just seems like a rational, logical alternative that you dont have to be a doctor to be able to appreciate.
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Fellow Of The American Brachytherapy Society
American Brachytherapy Society
Nominees were rigorously evaluated in numerous areas including: society service and participation, significant contributions in the field of brachytherapy as evidenced by research publications, accomplishments in patient care and clinical excellence, educational training, extensive presentations, providing mentorship and demonstration of leadership and service that has advanced the specialty as a whole.
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Prostate Brachytherapy: The Last 25 Years
First I think to predict the future, that was the hardest part, where we are going in 25 years. I know where weve been because I was there for most of it, so Im going to talk a little bit from a business and an economic standpoint basically because of where I think things are going to go from a payor perspective.
I was fortunate enough to get to know Willet Whitmore, whom youve all spoken so highly of. He represented the early generation of open implants and then obviously Ragda and the Seattle group came along with the transperineal. This is when I was a resident. An actual implant with a Mick Applicator. Im honored to give this talk in front of Nelson and Michael, very accomplished brachytherapists. Some of you may remember doing this. It was a bloody mess.
Then the transperineal technology came along and it was open to much criticism. Typically these are the seeds. A lot of work has been done over the years comparing iodine to cesium to palladium. Basically, the results are all very similar so were just going to keep evolving.
One of the things we learned early on in the early 90s was toxicity. This is an implant that was far too heavy, where all the seeds were loaded equally across the prostate. These patients had awful complications to the urethra and the rectum. We learned to get over that, much of the work done by John Blasko, Nelson Stone, Michael Zelefsky, and a lot of the pioneers sequentially working through toxicity. John did a lot.
References
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Why There Is A Need For Focal Therapy Treatment
That is our Chicago Prostate Center. That is the bean in downtown and Chicago has had a very hard winter. Things all frosted, now. But, I think, and this is part of my philosophy, I think prostate cancer now is being looked at as more of a spectrum disease. Where having all these advanced diagnostics, what Peter just showed us, what he talked about yesterday with all the different multi-parametric MRI data that is emerging. So, clearly, you have isolated disease, organ-confined and obviously, metastatic disease. But this spectrum, I think that many of us are referring to, would also have a morbidity spectrum or a patient spectrum, as far as age, co-morbidities, quality of life. Urodynamics in my world are very important. I do a lot of brachytherapy.
So those are things to consider and if you look at how to apply treatment to the prostate cancer spectrum, and I keep emphasizing that, you can see that it might not be an orderly progression of treatment and, thus, one size does not fit all and we have to keep this in mind. This is where I think this concept of focal therapy emerged. It really emerged from the patients.
Is it a compromise between active surveillance versus therapy? Definitely, I think.
Primary goal: Obviously the studies that I am going to show you. This is what we have to accomplish: Lower cost, it will have implications, and then, options for failure.
So, I do not think MRI is going to go away when it comes to the diagnosis of prostate cancer.
References
How Does Laser Focal Therapy Compare To Other Focal Methods
In comparison to another popular focal treatment methods like high-intensity focused ultrasound , laser focal therapy is not limited to only small glands and has demonstrated much higher levels of accuracy with lower risk of side effects such as, erectile dysfunction.
High intensity focused ultrasound uses ultrasound instead of laser to heat the tissue. To obtain the ablation diameter of the laser used in our approach, HIFU would require > 20 overlapping ablations. What if the patient moves a little and the device misses a spot? When treating cancer, its important to get all of it. The vast majority of HIFU centers use ultrasound guidance , losing the precision of MRI and the important real-time information that MRI thermometry provides in protecting vital structures. Studies show significant urinary and sexual problems after HIFU because important tissues and nerves can be damaged during the procedure.
Laser focal therapy boasts many benefits for patients compared to other treatment methods for prostate cancer. No general anesthesia is required for the therapy, and patients are able to return to work as early as the day after the operation. Additionally, laser focal therapy carries lower risk of side effects compared to other treatment methods such as, impotence, and urinary incontinence. Laser focal therapy also does not rule out the exploration of further treatment options such as surgery or radiation therapy if needed later.
*Results may vary
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Symptoms Of Prostate Cancer
While symptoms tend to differ between individuals, there are several that are characteristic of prostate cancer. Though unlikely, it is important to note that it is possible that no symptoms may occur.
- Constant pain in the back, hips, or pelvis
It is important to consult a doctor if these or similar symptoms occur.
Featured Patient Testimonial: Dr David Mantik
As a physician speaking to a patient, I have on a number of occasions disclosed to them that I myself had prostate cancer and actually had this procedure and I highly recommend it for the appropriate candidates.
Dr. David Mantik is a radiation oncologist. For more than 40 years, hes specialized in the use of radiation therapy to treat patients with prostate cancer.
However, at the age of 79 when he noticed his PSA score was rising, Dr. Mantik went to see Dr. John Feller. Now in remission, Dr. Mantik shared why he chose laser focal therapy over radiation treatment for his prostate cancer.
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Still Going Strong After 15000 Cases: Chicago Prostate Cancer Center Focuses On What Is Best For The Patient
Brian J. Moran MD, Medical Director of Chicago Prostate Cancer Center, has been performing brachytherapy procedures to treat prostate cancer since 1990, with over 15,000 brachytherapy treatments to date. In that 27+ years, he has placed a high value in the effectiveness of brachytherapy due to thecure rate and level of patient satisfaction with the procedure. When I first started with brachytherapy, the critics would contend that there was not enough follow-up in 5 years, he stated. Now, there is 20-year data that shows this treatment has outcomes the same as surgery or external beam radiation. And the outcomes can actually be considered much better when you factor in the quality of life issues.
But the doctor still sees a struggle in getting fellow physicians to adopt the treatment. In the past, 95% of my business came from referrals sent by other physicians, he shared. Now that figure has dropped to around 20%. Unfortunately, much of the medical environment does not offer brachytherapy, because doctors tend to offer the treatment that they are trained in, or, if you own a radiation center, thats where you are likely to refer patients to.
Focal brachytherapy: Same results with even fewer side effects
Brachytherapy adoption increasing worldwide, but challenges remain
Where brachytherapy is heading
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Prostate Cancer Risk Factors
While all men are at risk of getting prostate cancer, certain groups of men are more likely to develop cancer than others. Key risk factors for prostate cancer include:
AGE
The most important risk factor is age: the older a man is, the more likely he is to be diagnosed with prostate cancer, with the odds for prostate cancer increasing dramatically after men reach 50 years old.
Family History
Ethnicity
African American men are 1.8 times more likely to be diagnosed with prostate cancer and 2.5 times more likely not to survive the disease.2
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