Prostate cancer actually is
the most common cause of cancer in men.
Fortunately, most prostate cancers are not going to be a major problem for a man's survival.
However, there are some that are dangerous,
and so our job as urologic oncologists is to figure out
which are the cancers that are dangerous
and be able to treat those.
It's really important to have all these different options,
surgery, radiation, different ablation technologies,
because the prostate is in a very challenging location.
So anything that we are doing to treat a prostate cancer
has the potential to impact urinary function,
impact sexual function and impact of bowel function.
Every man's cancer is different
and every man's priorities and approach to life
and how to manage your cancer is different.
My goal is to find that balance for each man
of how to optimize their quality of life
while giving them the best cancer control.
Ablation technologies are
this relatively new category of treatments
which uses energy of some sort
- it can use heat, cold or electricity -
to really destroy the cancer cells.
People are interested in these focal therapies are really trying
to mitigate a lot of the side effects
that are associated with prostate cancer treatment.
And these ablation therapies are able to do that very often.
It's a very interesting technology
that we can control very precisely.
We have a few different ablation technologies
here at Yale that we can offer patients.
One of them is the Tulsa procedure.
So it's a transurethral ultrasound ablation.
So we are actually able to do the procedure inside an MRI scanner.
The Tulsa procedure allows for really excellent
planning in terms of how we want to treat.
Are we are treating the whole prostate or treating part of the prostate?
Really outlining where the edge of the prostate is in relation to those important structures
the urethra, the rectum, the nerve bundles
to really try to avoid damage to those areas.
We also have other ablation technologies such as irreversible electroporation.
Which is a long name, but short name is Nano Knife, which is the brand name.
We also perform Cryoablation,
which is using cold or freezing energy to destroy prostate tissues,
and I use these each differently.
So we're very committed to evaluating these technologies
and figure out what their role is going to be in the future,
making sure that they're safe for our patients,
making sure our patients have access to these newest technologies.
We do actually have a randomized trial, which is very exciting
because that's really our gold standard for evidence in medicine
is a clinically randomized trial, and that is looking at the Tulsa procedure
to abate prostate cancer compared to radical prostatectomy or surgery.
So we're really trying to evaluate
is there much of a difference in survival?
Is there much of a difference in the time to recurrence of prostate cancer
and the side effects
for men with intermediate risk, prostate cancer and ablation
therapy is an option where you can get a treatment
that is probably 80% at least effective compared to these gold standard treatments
with significantly less side effects that can help maximize
their quality of life while still controlling their disease.