Professor Nathan Lawrentschuk
A breakthrough treatment for prostate cancer has already helped 100 men in Victoria.
Epworth Freemasons was the first hospital in the state to introduce the minimally invasive treatment, called focal therapy, in 2019.
Using NanoKnife technology, it only treats the cancerous part of the prostate, leaving the rest of the prostate tissue intact, thus minimizing side effects.
Prof Nathan Lawrentschuk, a urologist at Epworth, said the NanoKnife was an alternative to radical surgery or radiation therapy for patients with prostate cancer.
“Unfortunately, radical surgery for prostate cancer or radiation therapy causes side effects in some men, including erectile dysfunction and impaired bladder control,” he said.
“Killing cancer cells using the NanoKnife does not affect surrounding structures, such as nerves and the bladder – it is life changing for men.”
The process uses irreversible electroporation (IRE), where a surgeon implants several small electrodes called NanoKnife around the cancerous tumor.
The electric ones are used to punch nano-sized holes in the tumor causing the cancer cells to die.
Treatment using the NanoKnife is a one-day procedure. Patients are then followed over time to make sure new tumors do not appear.
Melbourne man George Alexander was diagnosed with low-grade prostate cancer in 2016.
Since then, he has had regular biopsies and surveillance scans, and was told in late 2021 that prostate cancer had developed.
Mr Alexander said Prof Lawrentschuk had given him three options: a complete removal of the prostate; wait another six months and get MRI and PET scans; or, between these extremes, undergo IRE NanoKnife surgery.
“I spoke with my GP about Men’s Health Clinic at Epworth Freemasons and spoke with men from a prostate cancer support group about their past experiences,” he said.
“My decision to receive the NanoKnife procedure was based on convenience and lifestyle choice.”
Mr Alexander said he was aware of the side effects of a radical prostatectomy, and even the small possibility of being incontinent at 67 “didn’t suit him”.
“Putting things off for another six months wasn’t an option either. The cancer was there, it could only get worse and I didn’t want to take any chances,” he said.
“The NanoKnife option made sense because it would address the immediate problem of cancer and still allow for other types of treatment if needed.”
Thilakavathi Chengodu, research program manager at Epworth HealthCare’s EJ Whitten Prostate Cancer Research Center, said the 100th milestone achieved by patients in the past three years coincided with an effort to become a center major training center for the IRE in Australia, as well as a center for education and research.
A doctoral candidate examines IRE “in all aspects”, while six Epworth urologists are trained in the use of the technique.
“We believe the outcome of this PhD will guide practice in this area of treatment and care, so that our center will become a premier destination for IRE training and education in Australia in the future,” said Ms. Chengodu.
“We are building our own first-hand knowledge on the effectiveness and impact of this technology and, more importantly, the difference it makes in the lives of our patients now and in the future.”
Along with the Epworth Medical Foundation, the EJ Whitten Center is also funding a study to determine if a PET/CT scanner is more effective than traditional MRIs in tracking the spread of prostate cancer.
A combination of a prostate-specific antigen (PSA) blood test, an MRI, and a biopsy is currently used to confirm a diagnosis of cancer.
Those with large or aggressive tumors then undergo additional treatment such as surgery or radiation therapy.
If low-grade cancer is detected, active surveillance involving regular MRIs and biopsies is used to track the cancer, reducing the need for more aggressive treatment.
Laurence Harewood, associate professor of urology at Epworth, said while most men on active surveillance did well, some cancers were still missed.
“Once in a while, someone may show up in six or 12 months with a nasty cancer that was obviously there at the time, but didn’t show up on the MRI or the biopsies,” he said. he declares.
During the CONFIRM study, men will be injected with a tracer that targets prostate-specific membrane antigen (PSMA) in prostate cancer.
Study is enrolling 223 men with prostate cancer who will undergo PSMA PET/CT among the Epworth Freemasons as part of their active oversight.
The patient will then undergo a type of x-ray known as a PSMA PET/CT scan, in which the prostate cancer will shine brightly.
“We hope that by using the PSMA PET/CT scanner during the study, we will have the ability to detect areas of cancer that may be missed and we can go back and do biopsies,” Professor Harewood said.
“That will then give us the ability to advise the patient to undergo further treatment, rather than just monitoring.”
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