Advances in Prostate Cancer Diagnostics and Treatments

About Prostate Cancer

Prostate cancer is a cancerous tumor that usually begins in the prostate’s outer area. It is the most common solid tumor cancer in men globally. It is usually a very slow growing cancer and men can live for many years without problems.

If found early, prostate cancer is often confined to the prostate gland – called stage T1 and T2. Stage T3 has advanced to tissue outside the prostate gland and stage T4 is an advanced form of the disease which has spread to other parts of the body.

Traditional Prostate Cancer Diagnostics and Treatment

Traditionally, prostate cancer is diagnosed by a physical examination and prostate-specific antigen (PSA) blood test. This may be followed by a transrectal ultrasound (TRUS) guided biopsy.

Treatment for prostate cancer typically involves a prostatectomy – surgery to remove the prostate. A radical prostatectomy may be performed to remove the prostate and seminal vesicles if the cancer has spread. External radiation therapy may also be offered.

In recent years, the way prostate cancer is diagnosed and treated has dramatically changed. Advances in imaging, which have allowed for more targeted biopsies, have been a significant contributor to evolving diagnostics, and new treatments have emerged including advanced radiotherapy, radionucleotide therapy and next-generation hormone therapy.

Advanced Therapies at Cleveland Clinic Abu Dhabi

Innovational treatment options are available at Cleveland Clinic Abu Dhabi, with prostate cancer patients benefiting from advanced therapies offered in conjunction with the center’s Oncology Institute and Surgical Subspecialties Institute. The advances in treatment are improving the prognosis for patients with advanced prostate cancer.

Advances in Prostate Cancer Diagnostics

MRI fusion guided biopsy

Cleveland Clinic Abu Dhabi is one of only a handful of centers in the region to offer MRI fusion guided biopsy. The advanced diagnostic technique combines a specialized type of MRI scan with images from an ultrasound in real time. When these images are blended, they create a very clear image of the area which allows doctors to accurately target the area for biopsy, supporting more accurate diagnosis.

Advances in Prostate Cancer Treatment

Minimally Invasive Radical Prostatectomy

The minimally invasive radical prostatectomy is an advanced surgery to remove the prostate gland. Unlike conventional prostatectomy, minimally invasive procedures require only a few small incisions, through which a surgeon uses a camera and surgical instruments to remove the prostate.

The procedure can be performed in several ways:

• Laparoscopic radical prostatectomy: A minimally invasive procedure that removes the prostate gland.
• Robotic radical prostatectomy: Surgeons use robotic arms to guide the laparoscope through small incisions and remove the cancerous prostate and affected tissue.
• Cryotherapy. Small needle-shaped probes can be inserted into the prostate to freeze the gland and kill the prostate cancer. This minimally invasive approach is incision-free and can be performed either on an outpatient basis or with a one-night hospital admission. Patients recover in a matter of days and usually experience minimal aftereffects.

Advantages of performing a minimally invasive radical prostatectomy include:

• Less pain
• Less blood loss
• Smaller scars
• Shorter recovery time
• Reduced risk of infection
• Fewer complications
• Better clinical outcomes.

Intensity-modulated radiation therapy (IMRT)

Radiation therapy is a treatment which targets cancer cells with radiation, so their DNA is damaged, and they are destroyed. IMRT is a type of radiation therapy and a very precise technology used to treat prostate cancer. A machine is used which sends multiple energy beams of varying strengths to the tumor. This kills cancer cells and shrinks the tumor but spares nearby healthy tissue from harmful radiation exposure. This reduces side effects associated with radiation therapy.

Volumetric modulated arc therapy (VMAT)

VMAT is a type of radiation therapy that delivers customized doses of radiation. During treatment, a machine rotates around the body once or twice. The machine delivers multiple energy beams, each of varying strength, which kill cancer cells and destroy tumors.

VMAT is very precise and focuses radiation onto the tumor meaning healthy tissue is spared. The treatment is very quick (only a couple of minutes) meaning improved accuracy and shorter treatment durations.

Radionuclide therapy

This is an advanced technology which uses targeted radiation therapy for certain advanced prostate cancers. The therapy uses radioactive substances which are injected into the patient. The treatment is systemic, meaning it reaches all cells via the bloodstream. However, unlike other systemic treatments such as chemotherapy, the radioactive substances only target cancer cells, sparing healthy cells and reducing potential side effects.

High-intensity focused ultrasound (HIFU)

HIFU is a minimally invasive procedure that is used to treat prostate cancer and other conditions. The treatment involves highly focused, high-intensity ultrasound waves.

Ultrasound scans are regularly used by doctors to obtain images of the inside of the body. They involve using high-frequency sound waves which produce images of soft tissues or organs in real time.

HIFU directs sound waves at specific parts of the body. Instead of producing images, the high-intensity sound waves cause the temperature of the tissue to increase, which destroys it (called ablation).

Learn more about the ground breaking HIFU procedure here.