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New prostate cancer treatments lead way at Logansport Hospital
Pharos-Tribune - 9/27/2022
Sep. 27—Logansport Memorial Hospital is home to modern prostate cancer treatments that are rarely seen in the United States.
The treatments, MRI Fusion Biopsy and High Intensity Focused Ultrasound (HIFU), are popular options throughout Europe but have not been widely adopted by doctors in the U.S.
The advantage of HIFU, said Logansport Memorial Hospital's urologist Stephen Beck, M.D., is that it offers the same early detection cure rates as surgery and radiation but there is less possibilities of the side effects.
Side effects for prostate cancer surgery include a 25-30% chance of persistent urinary incontinence or erectile dysfunction (ED). Radiation side effects can also include ED but also involves urgent and frequent urination.
When it comes to HIFU, the chance of side effects is less than 2%.
Beck said those who undergo HIFU receive the same cure rates as other treatments but have a better quality of life.
"It's a no brainer in my opinion," he said.
Beck is a board-certified urologist in the Logansport Memorial Cancer Care Center. He completed his urology oncology fellowship at New York City'sSloan Kettering Cancer Center. He completed his degree at Southern Illinois' School of Medicine and his residency at the IU School of Medicine.
Beck said the treatment has brought Logansport to the forefront in terms of prostate cancer care compared to other areas of the state and even nation.
One of the challenges that prostate cancer presents is that there are no symptoms until the cancer spreads to other areas of the body.
That makes early detection so important. Unfortunately, the evasive nature of a rectal exam often scares men away.
The standard screening age for prostate cancer is 50-year-old men and over and 40 to 45 yea- old-men if they are at risk. Primary risk factors include African American men or men with a family history of prostate cancer.
PSA counts (Prostate Specific Antigen) also help determine prostate cancer and this can be done through bloodwork.
Beck said every male has a PSA count, but the number increases with age. The danger area is when the PSA count hits four. However, the difficulty comes in because a man in seventies may have a natural level of four. A man in his 50's or younger with a PSA count of four is at risk of prostate cancer, though.
In the past a biopsy would be performed on the prostate to determine cancer. Beck said biopsies can sometimes miss the cancer, however. That is why he prefers the MRI Fusion Biopsy.
"An MRI detects higher risk disease," he said. "With prostate cancer the first is diagnosis. When you are diagnosed by biopsy what initiates the biopsy is the PSA for the most part—you have an elevated PSA. What we have brought to Logansport is an MRI fusion biopsy which increases the accuracy of the biopsy detection rate. There are less false negatives. False positives are rare."
He said the first thing is to determine if the cancer is local or if it has spread.
"For organ confined prostate cancer, if none of it has spread—so the assumption is all of the disease is in the prostate—that is curable," Beck said.
The two primary treatments for prostate cancer have been radiation and surgery. Both have equal cure rates, he said.
HIFU, which the Food and Drug Administration approved in 2015, has equal cure rates to surgery and radiation for low to intermediate prostate cancer with less chance of long term side effects.
HIFU is an approximately two hour procedure. The process involves an ultrasound probe inserted into the rectum while the patient is anesthetized. The probe provides the surgeon an image while also treating the area of the prostate. The actual treatment takes mere seconds and the process is repeated over the course of several sessions.
The goal in urology is to cure, prevent incontinence and preserve sexual function," said Beck.
"When you say the word cancer people are so focused on treatment they don't care what it is going to cost them physically or emotionally, they just want to get it out of their body," he said. "And then all of a sudden reality hits six months later—'I'm cured by I'm in a diaper. That's tough when it didn't have to happen.'"
Beck approached the hospital administration about bringing the technology to Logansport and they were supportive.
"It's new technology and (the hospital is) willing to do it because they want to advance urology treatments in the community," he said. "To do that you have to have a community that is willing, a doctor who is willing and capable administration willing to do it."
Prostate cancer is the second leading cause of cancer death in men behind lung cancer. It's estimated that 1 in 6 Black men will be diagnosed with prostate cancer in their lifetime.
"(Logansport has) the cutting edge of prostate cancer care in the United States if not the world," Beck said. "We really do. MRI Fusion biopsy and HIFU are the cutting edge of urological oncology as it relates to prostate cancer."
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