Prostate cancer affects during their lifetime, making it the most prevalent form of cancer for males. For many, the standard of care means facing aggressive treatments that include radiation and the freezing or removal of the entire prostate, which often result in incontinence and erectile dysfunction. But at RUSH, a new treatment for some types of prostate cancer offers hope for those looking to avoid punishing side effects.
鈥淲e were about 50 years behind breast malignancy treatment,鈥 said , a urologist at 脱衣直播. 鈥淚n breast cancer, you often excise the cancer while leaving the healthy tissue, but we weren鈥檛 able to do that.鈥
Men with early-stage or lower-risk prostate cancer could take a 鈥渨atch and wait鈥 strategy, in which the cancer is monitored regularly but no immediate interventions are made to avoid more aggressive methods. This leaves patients with the choice between waiting and taking aggressive steps.
鈥淎 lot of guys want a middle ground between those two options,鈥 Vourganti said. 鈥淲e鈥檙e really excited that we potentially have another option for some cases.鈥
New NanoKnife technique
That 鈥渕iddle ground鈥 is a new treatment at RUSH using the NanoKnife, a tool for use in irreversible electroporation, or IRE. The technique uses electricity to destroy cancer cells while leaving surrounding healthy tissue and nerves unharmed, making it a good option for patients with low or intermediate-risk prostate cancer.
Vourganti recently used the technique with one of his patients, John, who was diagnosed with prostate cancer in February 2021. John, who asked to be referred to only by his first name, said that when he was diagnosed, Vourganti explained all of his options, including using the NanoKnife. Though the method is still considered experimental, John thought this was preferable, since he wanted to prevent the side effects that often come with other types of prostate cancer treatment.
鈥淚t seemed like a good option primarily because of the collateral damage that the other things could do,鈥 John said. 鈥淗e said it鈥檚 a new field, it鈥檚 experimental, but to prevent damage to the nerves, it was a good way to start.鈥
How it works
The NanoKnife has four small probes that are inserted into the tumor and guided by ultrasound and magnetic resonance imaging (MRI). The probes pass electricity in a manner that targets only the cancer cells, leaving nearby healthy tissue and cells alone. The technique also spares harm to the nerves within the prostate related to erections and bladder control, potentially preserving urinary and erectile function.
The procedure takes place under general anesthesia to ensure patients remain immobile. Patients recover at home, where they need to use a urinary catheter for three days after the procedure.
鈥淧eople can go home the same day,鈥 Vourganti said. 鈥淧atients still go through a lot, but it鈥檚 definitely an easier recovery period than full gland removal.鈥
John underwent the procedure in July 2021, and it successfully destroyed the cancer in his prostate. Both the IRE and recovery, he said, were uneventful, aside from three days of discomfort with the catheter. John had an MRI and biopsy in October, which showed no evidence of any cancer recurrence. He will receive another MRI, as well as a blood test, in May to check on his recovery, and thus far he reports that he has experienced no urinary or sexual side effects from the procedure.
鈥淏ecause there were no side effects, I鈥檓 already back in a normal routine,鈥 John said. 鈥淪o that鈥檚 the whole point. It鈥檚 status quo. I asked Dr. Vourganti after the surgery, 鈥楢re there any restrictions?鈥 And he laughed. He said, 鈥楾here鈥檚 no restrictions.鈥欌
NanoKnife outcomes
It鈥檚 important to note that 15% to 20% of prostate cancers return after initial treatment, Vourganti said. If the cancer does return after the IRE procedure, he added, patients still have more aggressive forms of treatment available to them.
鈥淲e don鈥檛 know if it鈥檚 going to work for everybody,鈥 Vourganti said. 鈥淏ut it could give many men an appropriate form of control. And if it comes back, we have more options. So, we鈥檙e really excited about that.鈥
A clinical trial to study the use of the NanoKnife procedure for prostate cancer is enrolling patients at Rush and the Mayo Clinic. Other clinical studies are underway to evaluate the effectiveness of NanoKnife in treating advanced pancreatic cancer.
John said he鈥檚 happy with the choice he made after consulting with Vourganti, and he highlighted Vourganti鈥檚 commitment to finding more options for people with prostate cancer.
鈥淗e鈥檚 passionate about what he鈥檚 trying to do here,鈥 John said. 鈥淗e believes it鈥檚 a good option to try before some of the more extreme measures, to help people. It doesn鈥檛 mean it鈥檚 not going to come back. But it鈥檚 all relative, you know? I just move with the flow. We鈥檝e got to get something done. Let鈥檚 make the best decisions we can with the options we have.鈥
