Dr. Gerald Andriole
treats patients at the
Center for Advanced Medicine
4921 Parkview Place,
St. Louis 63110
Barnes-Jewish West County Hospital
Medical Office Building One
1040 N. Mason Road, Creve Coeur, MO 63141
Question: My older brother had a radical prostatectomy 14 years ago. I’m 67 and just found out that I have a small cancer on one side of the prostate. Are there new options?
Answer: Radical prostatectomy (complete removal of the prostate) is considered the gold standard surgical treatment for prostate cancer. However, many men, with a small and suspected slow-growing tumor, are reluctant to undergo this procedure because of the potential side-effects — urinary incontinence and erectile dysfunction.
For men like you, it is now possible to destroy only the cancerous part of the prostate because of an improvement in prostate biopsy.
In the past, biopsies were taken using a two-dimensional ultrasound device. Now, because of the latest advances in technology, I routinely take prostate biopsies using an ultrasound that provides a three-dimensional picture of the prostate. This device, known as a TargetScan™, enables us to identify the precise size and shape of the prostate. It uses a computer algorithm to determine the optimal locations within the prostate to biopsy and in so doing, provides the precise location (or address) of each biopsy.
For a person such as yourself, the TargetScan™ biopsy would provide us with the exact location of the cancer in your prostate — information which we could then use to guide us when we surgically ablate (destroy) only the part of the prostate where the cancer is located.
When we focally destroy prostate cancer in this way, it is done as outpatient surgery and patients have minimal side-effects. Additionally, we could repeat the procedure in later years, should you develop another cancer in a different part of your prostate. Or we have the option of removing the entire prostate at a later date if required from the occurrence of a second cancer.
We are learning more about focal ablation of prostate cancer every day. It is clearly not appropriate for every man, but men like you should discuss this option with their specialist. The key piece of new technology that enables this technique is a precise three-dimensional biopsy of the prostate.