Milestone for ‘life-changing’ prostate option

Professor Nathan Lawrentschuk

A groundbreaking treatment for prostate cancer has already helped 100 men in Victoria.

Epworth Freemasons was the first hospital in the state to introduce the minimally invasive treatment, called focal therapy, in 2019.

Using NanoKnife technology, it treats only the cancerous part of the prostate, leaving the rest of the prostate tissue undisturbed, minimizing side effects.

Epworth urologist Professor Nathan Lawrentschuk said the NanoKnife was an alternative to radical surgery or radiation for prostate cancer patients.

“Unfortunately, radical surgery or radiation for prostate cancer has side effects in some men, including erectile dysfunction and altered bladder control,” he said.

“Killing the cancer cells using the NanoKnife doesn’t affect surrounding structures, such as nerves and the bladder — it’s life-changing for men.”

The process uses Irreversible Electroporation (IRE), in which a surgeon implants several small electrodes called NanoKnife around the cancerous tumor.

With electrical pluses, holes the size of nanometers are pierced in the tumor, causing the cancer cells to die.

The treatment with the NanoKnife is a day treatment. Patients are then monitored over time to make sure no new tumors are developing.

Melbourne man George Alexander was diagnosed with low-level prostate cancer in 2016.

Since then, he has had regular surveillance biopsies and scans and was told in late 2021 that the prostate cancer had grown.

Mr Alexander said Prof Lawrentschuk gave him three options: a complete removal of the prostate; wait another six months and have the MRI and PET scans done; or, in between those extremes, undergo IRE NanoKnife surgery.

“I spoke to my GP from the Men’s Health Clinic at Epworth Freemasons and have spoken to men in a prostate cancer group about their past experiences,” he said.

“My decision to undergo the NanoKnife procedure was based on practicality and lifestyle choice.”

Alexander said he was aware of the side effects of radical prostatectomy, and even the small possibility of being incontinent at age 67 “didn’t suit him.”

“Postponing the case for another six months was also not an option. The cancer was there, it could only get worse, and I didn’t want to take the risk,” he said.

“The NanoKnife option made sense because it would treat the immediate cancer problem and still allow for other types of treatments if needed.”

Thilakavathi Chengodu, Research Program Manager at Epworth HealthCare’s EJ Whitten Prostate Cancer Research Center, said the patient’s 100th milestone in the past three years has coincided with an effort to become a major training center for IRE in Australia, as well as an center for education and research.

A PhD student assesses IRE “from all sides” while six Epworth urologists are trained to use the technique.

“We believe the outcome of this PhD will guide practice in this area of ​​treatment and care, so our center will become a premier destination for IRE training and education in Australia in the future,” said Mr Chengodu.

“We are building our own first-hand knowledge about the efficacy and impact of this technology and, most importantly, the difference it makes to the lives of our patients, today and in the future.”

The EJ Whitten Prostate Cancer Research Center in Epworth studies the effectiveness of PET/CT scanners in tracking the spread of prostate cancer

Together with the Epworth Medical Foundation, the EJ Whitten center is also funding a study to investigate whether a PET/CT scanner is more effective than traditional MRI scans in tracking the spread of prostate cancer.

A combination of a prostate-specific antigen (PSA) blood test, MRI, and biopsy is currently used to confirm a cancer diagnosis.

Those with significant or aggressive tumors then undergo further treatment, such as surgery or radiotherapy.

If a low-grade cancer is found, active surveillance with regular MRI scans and biopsies is used to detect the cancer, reducing the need for more aggressive treatment.

Epworth urologist associate professor Laurence Harewood said that while most of the men were doing well under active surveillance, some cancers were still missed.

“Occasionally, someone may show up within six or 12 months with a nasty cancer that was obvious at the time, but it didn’t show up on the MRI or biopsies,” he said.

During the CONFIRM study, men will be injected with a tracer that targets the prostate-specific membrane antigen (PSMA) in prostate cancer.

The study enrolls 223 men with prostate cancer who will undergo a PSMA PET/CT scan at Epworth Freemasons as part of their active surveillance.

The patient will then undergo a type of X-ray known as a PSMA PET/CT scan, in which the prostate cancer will glow brightly.

“We hope that by using the PSMA PET/CT scanner during the study we will be able to pick up areas of cancer that may be missed and that we can go back and do biopsies,” Prof Harewood said.

“That then gives us the opportunity to advise the patient to undergo further treatment, rather than just supervision.”

/public release. This material from the original organisation/author(s) may be of a point in time, edited for clarity, style and length. The views and opinions are those of the author(s). View full here

#Milestone #lifechanging #prostate #option

Leave a Comment

Your email address will not be published. Required fields are marked *