Fighting Prostate Cancer: Part 2 | Medical Watch | WGNTV.com | WGN TV

Fighting Prostate Cancer: Part 2

Learn about some of the other choices men have so they can tailor their treatment to their needs.

By Robert Jordan, Reporter

June 19, 2006

Prostate cancer is the third leading cause of cancer deaths in men. Last night on WGN news we showed you the new "da Vinci Robotic Surgery" that may have saved my life.

Tonight, I'm going to show you some of the other choices men have so they can tailor their treatment to their needs. With new technology, having your prostate removed is light years ahead of what it used to be. But the key is early detection -- through a simple blood test and digital rectal exam.

The prostate is a walnut-sized gland located just beneath the bladder, deep in a crowded, hard-to-reach area in the pelvis. It is surrounded by a mesh of blood vessels and important nerves that help maintain bladder control and stimulate erections. So, for decades, doctors have been trying to find a way to successfully remove a cancerous prostate without injuring those critical nerves.

Charles Hoyt, Asst. VP of Radiation Medicine -- "Sterotactic radiosurgery: it allows us to precisely treat tumors using radiation."

Radiation is a popular form of treatment for prostate cancer. Men - 65 or 70 years and older, can select from many forms of treatment - some target the gland by shaping the radiation beam to surround and only hit the prostate - not the surrounding healthy tissue.

"This machine's accuracy is within a half millimeter. So as this machine moves around - which it does 180 degrees - it doesn't move off our isocenter more than half a millimeter," said Hoyt.

Because of the position of the prostate in the body, it is often difficult to treat. Here it is right here - located just beneath the bladder and just above the bowel but with radiation like tomotherphy which is very precise, it often produces fewer side effects.

"We can, very precisely, put in seeds just around the prostate," said Dr. William Bloomer of Evanston Northwestern Healthcare.

Brachitheraphy or radioactive seed implantation has been successfully used for many years. But even this, popular and reliable procedure has been improved upon.

Dr. Bloomer said, "And we can push a seed in - pull back a little more - put in another seed. And we do this until we have the distribution we're looking for then we pull the needle out."

This procedure is repeated over and over until anywhere from 90 to just over 100 seeds are permanently implanted in the prostate where they emit radiation killing the cancer cells.

"And it has a very high preservation of sexual potency rate. So, this another reason that men like this," said Dr. Bloomer.

Another form of radiation is tomotheraphy, again, where the radiation beam is contoured or shaped to fit the prostate.

"The fact that it's built on a cat-scan system that helps us image the prostate everyday and deliver it the same way we take the cat-scan images … that's what revolutionary about this machine. More precise? More precise. And that's important when you're dealing around an area where there're critical nerves. Correct. Correct," said Dr. Michael Stutz, a Radiation Oncologist at Advocate Good Samaritan Hospital.

Another option more and more men are selecting is robotic laparoscopic surgery using a machine called the da Vinci robot.

"The da Vinci and the camera system we use are the main benefits. It has magnification and it has a camera that can go in as close or as far out as you want," said William K. Johnston III, a Laparoscopic surgeon at Evanston Northwestern.

The 3-D camera gives a splendid view of the inside of the body - plus the images are magnified 10-times larger or more. To the surgeon the scissors look like hedge clippers. Look at this dime; next to some modeling clay objects used for practice. To the surgeon, it looks like a manhole cover. If these were body parts he could see the tiny, nearly microscopic nerves that he wants to avoid and protect.

"So, if I had to sew something … I'm right there, I could sew on his ear, in fact - look at the ear on that...I'm scratching behind his ear," said Dr. Johnston.

This spectacular, close-up view is what gives the surgeon the indispensable ability to dissect closely to the prostate without damaging the crucial nerves that have power over bladder control and sexual potency.

But the cancer needs to be caught early, with a PSA test - a simple blood test -- before it spreads to the lymph nodes or other organs. Thanks to PSA testing the number of prostate cancer deaths is dropping.

Dr. Johnston said, "For the majority of cancers nowadays - over 60 to 70% -- we pick up because of an abnormal PSA. And this has resulted in us catching cancer at an earlier stage than we ever have before."

Again, men at age 50 should begin having a PSA test combined with a digital rectal exam: or at age 40 if they have a family history of prostate cancer or are African American. Remember, caught early prostate cancer can almost always be cured.

"The worst thing that can happen to someone is that they develop metestatic prostate cancer, for which there is no good cure, and they have to live through that. When your time comes you want to die of a heart attack. You don't want to die of prostate cancer," said Dr. Bloomer.

I also want to mention another procedure that was not covered during our story. It's called proton therapy and was pioneered and has been carried out by Loma Linda University Medical Center in California, for the past 16 years. More and more centers across the country are offering this treatment, as well.

Now that we've seen some of the options men have for selecting the type of treatment that fits their individual cases... we want to give you additional information on our website -- wgntv.com. There we also have links to some area hospitals and the American Cancer Society.

So the key here is early detection.

RESOURCES
da Vinci Robot Prostatectomy
Evanston Hospital
Advocate Good Samaterian Hospital - Downers Grove
American Cancer Society