HIFU - Latest News » General

Prostatic Specific Antigen (PSA)

admin — Mon, 06 Sep 2010 18:30:17 +0000

The PSA is a protein produced by epithelial cells of the prostate and can be measured in the blood and used as a tumor marker.
The total PSA (tPSA) is considered normal if less than 4ng/ml but it is not a reliable indicator of presence or absence of prostate cancer.
An abnormal tPSA should always be confirmed to exclude spurious laboratory results before embarking upon a possible prostate biopsy.
About 30% of men who have a tPSA between 4-10 ng/ml will have a prostate cancer but about 70% will not.
Also,about 15% or more of men with a tPSA less than 4ng/ml will have a clinically significant but localized prostate cancer. About 2% of these men will have a very aggressive prostate cancer.
The use of the %free PSA (calculated from the tPSA and the free PSA) may improve the accuracy of this blood test in prostate cancer screening. The PCa3 test may also prove to be a useful marker.
The level of the tPSA in the blood can be lowered by various medicines such as Statins,NSAIDS,Thiazides and 5 alpha reductase inhibitors such as proscar and avodart. This lowering of the tPSA by these medicines does not necessarily lower the risk for prostate cancer.
In contrast,the tPSA can be elevated in men with a large prostate,by inflammation in the prostate, a urine infection, after a digital rectal examination, a prostate biopsy or after ejaculation, without the presence of an underlying prostate cancer.
Despite the limitations of the tPSA as a reliable test for prostate cancer screening the test is still useful especially when the
%free component is also measured. The more prostate cancers are detected when still localized,the greater the likelihood that treatment options such as HIFU can afford a cure. After total treatment of the prostate cancer, follow up monitoring of his PSA is very reliable.

September is PROSTATE CANCER AWARENESS MONTH.

admin — Mon, 30 Aug 2010 18:35:11 +0000

Dr. Bert Vorstman is joining other organizations nationwide to promote prostate cancer awareness during September.
Dr Vorstman has developed his website, www.HIFUrx.com as a resource to empower a man and his spouse with knowledge on prostate cancer and treatment options.
Prostate cancer is a silent disease and although most common in men after age 65, some men in their 30′s may also have the disease.
Men with a family history of prostate cancer and men of African American heritage are also at risk.
Prostate cancer is the second leading cause of death in men after lung cancer.
The goal of prostate cancer awareness is to make men and their spouses knowledgeable about the benefits of prostate screening as well as the benefits of early non surgical treatment. Although screening with a DRE and PSA and %free PSA are not perfect,this process will detect a significant number of prostate cancers when they are still localized to the prostate.

Cure and Survival in Localized Prostate Cancer

admin — Mon, 23 Aug 2010 15:28:56 +0000

Cure means complete disappearance of disease and restoration of health.
For prostate cancer,many of the data points used to assess the stage of a man’s prostate cancer and his risk for progression of the disease are affected by physician subjectivity for interpreting scale of disorder. If the data points can be so affected by subjectivity then they lack accuracy and therefore the cure rates generated by these data points lack reliability. Because of these concerns for lack of reliability and lack of reproducibility in generating cure rates for prostate cancer,the use of the term survival seems more appropriate as it is less limiting when applied to prostate cancer treatment success.
T1c stage prostate cancer is the most common presentation for prostate cancer currently and is detected because of an abnormal PSA.
This T1c stage defines a localized prostate cancer and the survival benefits between the four different treatment categories for localized prostate cancer are similar. However,of these treatment options for localized prostate cancer,only HIFU is the most precise as well as affording a superior post treatment quality of life (QOL). The continued evolution of this state of the art technology should result in even greater prostate cancer survival benefits in the future.

Recurrent Localized Prostate Cancer Treatment Options

admin — Wed, 04 Aug 2010 15:57:14 +0000

The same four definitive treatment options available initially for localized prostate cancer are also available for treating a possible recurrence of localized prostate cancer.. These treatment options are High Intensity Focused Ultrasound (HIFU),Cryoablation (freezing),Radiation (various forms) and surgery (various types). The four categories of treatments have similar survival benefits but the first three have less complications than surgery which also has the biggest negative impact on Quality of Life (QOL) issues.

After definitive therapy for for localized prostate cancer your PSA (prostatic specific antigen) should nadir to about 0.1-0.2ng/ml but about 1/3 of treated men will develop a rise in their PSA at some time.

A rising PSA may not always mean a recurrence of the prostate cancer or an incomplete treatment of the cancer as a temporary “bump” or “bounce” in your PSA after radiation is common.

However,all persistent PSA rises should be evaluated early with a trans-rectal prostate biopsy. After any prostate biopsy you should demand to have your slides sent to a reference laboratory for validation. This is very important as the majority of the prostate biopsies are read by general pathologists and because there is a certain degree of subjectivity involved in determining the presence of prostate cancer,the amount of cancer, as well as the Gleason score,validation is important.

If a man is diagnosed with a recurrence after radiation he is usually offered only active surveillance (AS) or androgen deprivation therapy (ADT) or so called “hormone shots”. Unfortunately,long term ADT has significant downsides with side effects as well as bone wasting and metabolic syndrome events bringing about a negative impact on QOL. HIFU and Cryo are ideal definitive treatment options in men with an early localized prostate cancer recurrence after radiation or in those men where the treatment was incomplete after radiation.

Recurrent prostate cancer after surgical removal is not uncommon either and a man and his spouse are quite mistaken to think that after surgical removal that they can forget about a cancer recurrence because the prostate is gone. Not so. In fact,after surgery (which includes robotics),somewhere between 20-40% of men will have positive margins to their specimens which means that prostate cancer was left behind. Some of these men will be offered AS. Others will be offered radiation,either adjunctive or salvage, to the prostatic bed.

However,if there is a nodule palpable in the prostatic bed and it is proven to be a cancerous recurrence then HIFU may be used to treat this definitively.

The treatment of recurrent cancer in the prostate after radiation or surgery is possible once more using HIFU or Cryo.

Unfortunately,few urologists or radiation oncologists are familiar with or have had the training in the minimally invasive therapies of HIFU or Cryoablation. HIFU is the most precise of these options,as well as being non surgical and non radiation and performed as an outpatient. Furthermore,unlike Cryo or radiation where the treated prostatic cancer tissue remains within the prostatic capsule, after HIFU treatment the treated cancerous tissue is expelled over time during urination. This particular feature of HIFU treatment for prostate cancer may help minimize the chances of a recurrent cancer developing.

Treatment Choices for Localized Prostate Cancer

admin — Thu, 08 Jul 2010 15:08:08 +0000

There are four DEFINITIVE TREATMENT options for localized prostate cancer, HIFU,cryoablation,various radiation therapies and various surgical options.

Unfortunately,many urologists and cancer support groups have little or no experience with all four definitive treatment groups so men are usually counseled with one, or possibly two options that their physician is familiar with.

In the appropriately selected man with localized prostate cancer,all four treatment groups have SIMILAR SURVIVAL BENEFITS.

If the survival benefits for localized prostate cancer with these four treatment groups are similar,what other factors can we examine in order to separate these four definitive therapy groups and make a more informed choice for treatment?

I recommend that the patient and his spouse examine the various complications associated with each of the four definitive treatment options for localized prostate cancer and determine how these different complications will impact their quality of life (QOL). The incidence of these complications is profoundly different between the four different treatment groups.

Because prostate cancer is one of the few diseases where the treatment complications affect not only the man but directly impact also the spouse and their partnership,both man and wife should spend considerable time and effort in reviewing QOL issues associated with the treatment option they have chosen or has been proposed for them.

Surgical options, (including robotic removal) have the highest incidence of complications as well as the biggest negative impact on QOL for both the man and his partner. Since the survival benefits between the four treatment groups for localized prostate cancer are similar whether the prostate has been surgically removed or not and the three definitive non surgical treatment groups have less complications and a better QOL,we encourage men to consider these definitive non surgical options of HIFU,cryo or radiation.

Of these three treatment groups HIFU is most precise and appears uniquely positioned to afford cure and with a superior QOL as well as being non radiation and accomplished in one outpatient treatment.

QUALITY OF LIFE (QOL) ISSUES FROM PROSTATE CANCER TREATMENT

admin — Tue, 22 Jun 2010 21:11:28 +0000

The reason it is important for men to study their treatment options for localized prostate cancer is that generally, for properly selected patients, there are no clear survival benefits between the different treatment categories. The complications,however, are very different between the options. This has been outlined at http://www.hifurx.com/cancer/quality-of-life.html . Therefore, if generally the survival benefits are similar for all of the treatment options surely you would want to focus on options that are associated with minimal complications and superior quality of life (qol) issues. Especially since the complications associated with the treatment of a man’s prostate cancer also indirectly affect the spouse and the partnership lifelong.

HIFU,as a minimally invasive,out patient,non surgical, non radiation treatment for localized prostate cancer is uniquely positioned to accomplish both survival benefits and superior quality of life after treatment.

It is very important for men and their wives to do their homework when considering treatment options for their localized prostate cancer. This is especially so since most urologists and prostate cancer support groups are not totally conversant with all of the 6 broad groups of treatment options for prostate cancer and will be unlikely to apprise you of them. These 6 categories of treatment options include HIFU,cryoablation,radiation,surgery,androgen deprivation therapy (adt) and active surveillance.
The reason it is important for men to study their treatment options for localized prostate cancer is that generally, for properly selected patients, there are no clear survival benefits between the different treatment categories. The complications,however, are very different between the options. This has been outlined at http://www.hifurx.com/cancer/quality-of-life.html . Therefore, if generally the survival benefits are similar for all of the treatment options surely you would want to focus on options that are associated with minimal complications and superior quality of life (qol) issues. Especially since the complications associated with the treatment of a man’s prostate cancer also indirectly affect the spouse and the partnership lifelong.
HIFU,as a minimally invasive,out patient,non surgical, non radiation treatment for localized prostate cancer is uniquely positioned to accomplish both survival benefits and superior quality of life after treatment.

HIFU for Prostate Cancer

admin — Tue, 26 Jan 2010 14:03:26 +0000

HIFU as you are aware by now from my site, is an alternative to traditional prostate cancer treatments. Over the past several years HIFU has gained popularity across the seas in countries like China and the UK. Its already approved in other countries which makes HIFU a safe alternative over there. However in the US, HIFU treatments are moving a bit slower.

Its currently being investigated by the FDA and is in Phase III of clinical trials. The trials offer prostate cancer patients free HIFU treatments for study. (To find out if you qualify simply fill out our form online and I’ll call you back as soon as possible).

Please bookmark this site as I’ll be updating the blog regularly to discuss prostate cancer and HIFU.