Counter-intuitive though it might seem, a prostate cancer diagnosis shouldn't always lead to immediate prostate cancer treatment.
Although prostate cancer is the second-leading cancer killer of men, behind lung cancer, and causes more than 29,000 deaths in the U.S. each year, in many cases, the tumors are small, slow-growing and confined. That means that most prostate cancer tumors might not automatically warrant medical intervention.
“Active surveillance,” in which physicians closely monitor patients so they can identify early signs of disease progression, is emerging as the best course of action for many men with prostate cancer. The strategy enables doctors to treat cancer before it becomes a serious threat, while avoiding unnecessary risk by treating tumors unlikely to spread.
Because aggressive treatment can impact a man’s quality of life, increasing the chance of impotence and incontinence, prostate cancer experts stress the importance of choosing the right course of action. At City of Hope, prostate cancer researchers have been working to improve active surveillance through the use of MRI assessments and biomarkers.
One study used a nanodevice to detect and bind to biomarkers in cells surrounding prostate cancer tumors. Another study found that biomarkers within prostatic secretions could help determine whether men with prostate cancer are good candidates for active surveillance, or if they need more aggressive treatment.
Both papers suggest that non-invasive approaches could help determine the best treatment regimen for a prostate cancer patient.
"Most of the biomarkers in use today originate in the cancer," said Steven Smith, Ph.D., a professor in the Division of Urology and Urologic Oncology. "However, we're looking at biomarkers that do not originate within the cancer cells themselves, but are a consequence of the cancer or a response to its presence."
A new option when treatment is necessary
But the research doesn't stop there. City of Hope’s commitment to research of many types ultimately gives men access to options they might not otherwise.
City of Hope, for example, was the first center in the nation to perform a new procedure using a focused beam of ultrasound energy to “ablate” the prostate cancer. In this ultrasound ablation technique, the ultrasound is guided by magnetic resonance imaging, or MRI, technology, allowing the ultrasound to be delivered very precisely to the site of the cancer.
The imaging provides real-time thermal feedback, which helps surgeons determine at the time of the procedure if enough ultrasound was delivered to the targeted area.
“The potential is that if we could provide a focal therapy that has a much lower risk profile compared to standard therapies, this may potentially be an option for men who choose not to ‘watch and wait,’” said Jeffrey Wong, M.D., chair of radiation oncology at City of Hope and a primary investigator on the trial. “At this time, the treatment is under trial and still being evaluated.”
The research-based, specialized and comprehensive cancer care at a center like City of Hope means patients have access to the most advanced techniques available, ensuring the best outcomes with the highest quality of life possible.
Learn more about getting a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.