VUMC First in State to Test New, Less Invasive Prostate Cancer Therapy

August 20, 2007

Sam Chang, M.D.by John Howser

Urologic surgeons at Vanderbilt University Medical Center will be the first in Tennessee to test a new, minimally invasive, surgical procedure to treat prostate cancer.

The Ablatherm procedure uses high intensity focused ultrasound (HIFU) to destroy cancerous prostate tissue without any incision.

HIFU has been used in Europe for more than a decade as an accepted therapy to treat localized prostate cancer in select groups of patients.

Ablatherm works by delivering precisely focused beams of high intensity ultrasound to prostate tissue through a series of targeted shots. At the point where ultrasound is focused, the sudden and intense absorption of the ultrasound’s beam creates a rapid temperature increase in the tissue, which destroys cells in a targeted zone.

HIFU is delivered to the prostate transrectally under spinal or general anesthesia. By precisely moving the focal point of each beam it is possible to destroy a volume of tissue that can include an entire prostate, without damaging surrounding tissue.

VUMC has been selected to participate in a national clinical trial of 410 men to evaluate the safety and effectiveness of HIFU to treat prostate cancer.

Sam Chang, M.D., associate professor of Urologic Surgery and VUMC’s principal investigator, along with co-investigators Michael Cookson, M.D., and Peter Clark, M.D., seek to enroll 15 patients for treatment at VUMC.

Eventually, there will be 18 clinical trial sites in the U.S. for the HIFU study, with 12 sites offering Ablatherm, and the other six sites offering cryotherapy for the study’s control group. Some of the other clinical trial sites include: Duke University, Georgetown Medical Center, Baylor College of Medicine, the Cleveland Clinic and the New York Prostate Institute.

“This is the first FDA-approved study with this device for the treatment of primary, localized prostate cancer. In Europe HIFU is the fastest growing treatment for localized prostate cancer,” said Chang. “Right now, through this study, this is the only way in the U.S. for patients to receive this type of therapy in a controlled and safely regulated manner.”

According to the Centers for Disease Control and Prevention, prostate cancer is the second leading cause of cancer deaths among U.S. men, second only to lung cancer. Prostate cancer is the fifth leading cause of death overall for American men. Collectively, U.S. men face a 16 percent chance of developing prostate cancer during their lifetime.

As one of the Southeast’s leaders in the treatment of prostate cancer and prostate disease, Chang said VUMC’s involvement with the Ablatherm trial keeps the institution at the forefront of new therapies to treat prostate cancer.

“This procedure carries with it the buzz words of ‘minimally invasive,’ and in many instances this is what patients are seeking,” he said.

In addition to being minimally invasive, another potential advantage of Ablatherm is that the procedure can be repeated, if necessary. However, patients selected for this study will be allowed only one treatment with HIFU.

Other FDA-approved, non-surgical treatments for prostate cancer, such as brachytherapy and cryotherapy, are not repeatable procedures for prolonged disease management.

Brachytherapy, commonly called ‘radioactive seeds,’ uses tiny radioactive implants inserted directly into the prostate to irradiate and destroy cancer cells. During cryotherapy, the prostate is frozen solid under ultrasound guidance. If these therapies fail to halt disease progression, alternatives are limited. However, with Ablatherm, if new cancer is detected the patient can undergo a second round of treatment.

Ablatherm is recommended for patients 60 and older with localized, early-stage prostate cancer, who because of their age, general condition, or having another disease, may not be surgical candidates, or may be suggested for those patients who want an alternative to radical prostatectomy.

For more information about the clinical trial, contact the Department of Urologic Surgery at 343-2120.

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