By Guido Deboeck
In the Detroit Gazette of June 11th I wrote about Green Light Laser therapy to reduce problems related to an enlarged prostate, also called Benign Prostatic Hyperplasia or BPH. While Green Light Laser therapy (www.greenlighthps.com/consumers/) shrinks the prostate, it is not a treatment method for prostate cancer. In this segment I will share my personal experience and review of undergoing treatment after being diagnosed with prostate cancer.
Prostate cancer remains one of the major causes of men dying early, if neglected, or suffering from physical consequences when treatment is rendered. Prostate cancer when detected early can be eliminated if the patient qualifies! PSA is a superior marker that speaks to the health of the prostate. Based on several PSA readings the velocity of PSA results can be determined. If the PSA readings keep increasing the first step would be to go for a 3T MRI-S to identify potential areas in the prostate that are suspect. A “targeted biopsy” (not a conventional random biopsy associated with sampling bias) is the next logical step. If this yields any indication of prostate cancer then various treatment methods need to be considered.
One of the best overviews of the possible treatment options for prostate cancer is provided in the Johns Hopkins White Paper on Prostate Disorders (available on-line at www.johnshopkinshealthalerts.com). Unfortunately, even in the exceedingly well written White Paper there is no mention of the latest medical advances in this area. I got lucky and found a leading edge Urologist (Dr. Ronald E. Wheeler, Medical Director of the Diagnostic Center for Disease in Sarasota, FL, see http://www.mrisusa.com/) who is at the frontier of thinking in his field. Note that less than 200 out of 8,500 urologists in the USA have shown interest in improving the status quo. Dr. Wheeler educated me regarding new technologies, like HIFU during our coaching session. “HIFU, which is short for High Intensity Focused Ultrasound, is a state-of-the-art technology acoustic ablation technique that utilizes the power of ultrasound to destroy deep-seated tissue with pinpoint accuracy for treatment of prostate cancer. HIFU focuses sound waves in a targeted area, which rapidly increases the temperature in the focal zone causing tissue destruction (coagulative necrosis). In most cases, HIFU is a 1-4 hour, one-time procedure performed on an out-patient basis under spinal or general anesthesia. Unlike radiation, HIFU is non-ionizing; this means that HIFU may also be used as a salvage technique if other prostate cancer treatments fail.”
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Among all the treatment options for prostate cancer HIFU is the only one, which is non-invasive (no surgery, no radiation), has the least negative treatment consequences (urinary incontinency and erectile dysfunction are avoided) and is based on the use of ultrasound. It is a treatment method not well known in the USA because the FDA has yet to approve it. In Japan HIFU has been practiced for over ten years; in Europe it was approved in 2000 and in Canada in 2003. FDA recently ordered 40 sites to undertake clinical trials based on which HIFU may be approved in the USA by 2012.
Worldwide more than 20,000 patients have undergone HIFU (and this number increases weekly). Many papers have been written about it and its effectiveness has been established through many studies. The approach entails applying 400-600 pulses of high intensity focused ultrasound on the prostate with a result that all cancerous cells are destroyed.
After being diagnosed with prostate cancer with a 3T MRI-S scan and confirmed with a targeted biopsy, Dr. R. Wheeler suggested to me to contact HIFU International (see insert) to schedule my procedure in accordance with his schedule. HIFU International has various sites outside the USA where HIFU can be applied (Canada, Mexico, Bahamas, Dominican Republic, Costa Rica, India). I chose the Bahamas because it was a shorter distance (less flying time) from Arlington, the available dates fit my schedule, and because my wife and I had never been to the Bahamas. Additionally, Dr. Wheeler, a trained HIFU expert was willing to treat me there.
International HIFU is a subsidiary of US HIFU, LLC which makes HIFU technology available outside of the United States where the procedure is approved, authorized or otherwise permitted for the treatment of localized prostate cancer. US HIFU, LLC is a privately held health care company focused on treating primary and recurrent prostate cancer using HIFU, a minimally invasive outpatient procedure which significantly improves patients’ quality of life. US HIFU was founded in 2004 and is headquartered in Charlotte, N.C. For more info see http://www.internationalhifu.com/
After scheduling an appointment I received via e-mail a complete guide and instruction kit. Before going for HIFU I had to go for a blood and urine tests, provide a recent X-ray and EKG, and make payment for the procedure.
On June 18th my wife and I flew to the Bahamas for a pre-op appointment at 6 PM that same day. Four other couples attended the pre-op meeting that included three doctors and two nurses all associated with HIFU International. Robert Johnson, one of the male nurses, told us what to expect the next day as well as what would follow after the procedure. Most of the time was spend on signing consent forms...
On Friday, June 19th my wife and I were picked-up from the hotel at 12 noon and taken to the treatment facility. We were brought to Doctors Hospital in Nassau where for the next two hours I was prepped before I met with Dr .Wheeler, my Urologist who had flown in from Sarasota. After a short talk, two lovely nurses escorted me to the operating room where the anesthetic was given to me. That's all that I can remember. Five hours later I awoke, albeit a bit dazed from the anesthesia. My wife Hennie had discussed the entire procedure with Dr. Wheeler who believes the cancer was totally ablated. After a while I got up and got dressed and was brought back to the hotel room. As I could not walk without help because of the anesthesia my wife arranged for a wheelchair to assist me to our hotel room.
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On the next day we got up and took a taxi to Nassau center where we visited on Bay Street, touring a nice history museum about the abolishment of slavery, the straw market and several brand name jewelry shops. Nassau is a duty free port where many luxury ships dock for a few hours, each bringing thousands of tourists eager to buy "duty free”. We also visited the Bacardi rum store where we learned about Bahamian rum business. Two days later we returned to Arlington. For the next two weeks I am supposed to take some antibiotics, take it easy (no biking, no heavy lifting...) and I am depending on a small catheter, a minor annoyance, to drain my Bladder until I am emptying normally through the Urethra. Otherwise I feel great and am very glad that I chose HIFU under Dr. Wheeler’s expert guidance and skill as opposed to any other treatment methods, which all have more significant negative consequences.
If all men were to live equally long, they would all die of the same cause, prostate cancer. More than 200,000 men are annually diagnosed with prostate cancer in this country and about one in ten of those diagnosed die annually from it. Many more men do not know (or do not realize) that the inconveniences they suffer from could be from BPH, prostatitis or prostate cancer; hence, the importance of taking annual PSA screenings. Prostate cancer is the most common cause of cancer deaths in men over 75 years old. Additionally, upwards of 30% of men aged 30 to 40 often have prostate cancer without knowing it. This is confirmed by research from Memorial Sloan-Kettering and Weil Sakr, M.D. in Detroit. When detected early prostate cancer can however in many cases be prevented or eliminated. The fact that the FDA has not yet approved HIFU in the USA should not deter anyone from learning about the use of ultrasound to eliminate prostate cancer and the vast experiences with it from all sources.
Guido J. Deboeck is the author of Flemish DNA & Ancestry: history of three families over five centuries using conventional and genetic genealogy, DokusPublishing, Arlington, VA, 2007 (http://www.FlemishDNA.com). He is also a regular contributor to the Gazette of Detroit.