Myths about Prostate Cancer and HIFU
Prostate cancer is the most common cancer found in men, with over 230,000 men diagnosed in the United States every year. Although it is common, it is still one of the least well-known cancers and there are several myths circulating about PSA testing, symptoms, treatments such as HIFU and life after treatment. In this blog, I will address 5 common prostate cancer myths.
Myth 1: Only old men get prostate cancer
While the percentage of diagnosed men is significantly higher after the age of 65, more than 76,000 men are diagnosed at an earlier age, particularly between the ages of 40 to 59. Although 1 in 10,000 men under the age of 40 are diagnosed, the number increases significantly to 1 in 38 for ages 40 to 59 and 1 in 15 for ages 60 to 69.
Risk factors should always be considered when understanding your likelihood for developing prostate cancer. Race, genetics, physical health and lifestyle are all factors that can increase chances. If your father or bother has had prostate cancer , you are at higher risk to be diagnosed with it.
Myth 2: A high PSA level = prostate cancer. A low PSA level = no prostate cancer
This is not entirely true. While prostate cancer is a common cause of elevated PSA levels, men can also have prostate cancer with low PSA levels. High PSA levels could also be the cause of other noncancerous health-related conditions such as a urinary tract infection, medical procedures, enlargement of the prostate gland and more. “Normal” PSA depends on your age and your prostate size. Although the use of PSA screening has become controversial, as it can lead to the over diagnosis and possible over treatment of prostate cancer, men between the ages of 55 - 69 will benefit the most from an early diagnosis of prostate cancer. If there is a family history or in African American men, I believe that PSA screening should begin before age 50
Myth 3: All prostate cancer needs treatment
Many doctors treat all prostate cancers as if they are the same. This makes no sense at all! One man’s cancer may be very small and slow-growing. These men can usually be very safely placed on active surveillance. Another man may have a large cancer that involves the majority of his prostate, with a high Gleason score and poor genetic profile, a faster growing type of cancer requiring more aggressive treatment. These men require treatment. Accurate diagnosis is essential to determine what type of cancer is present. How much cancer is present? What is the Gleason score? What are the genetic or genomic characteristics? Where is the cancer located within the prostate? What is the man's estimated overall health and life expectancy? Surgery, radiation, seeds, cryotherapy, HIFU and hormonal therapy are all acceptable and available treatments. An experienced prostate cancer physician can determine which treatments types fit a particular type of prostate cancer. A man's preferences are also very important as some men really just want their prostate out ( whether they need surgery or not) and other men will refuse surgery. HIFU, for instance, is ideal for a patient who desires a high-quality of life , minimal side effects, and a minimally invasive non surgical treatment.
4. Prostate cancer treatment always causes impotence or incontinence.
Erectile dysfunction may occur in more than 50 percent of patients and urinary leakage may occur in more than 20 percent of men after surgery to remove the prostate. Radiation techniques are also associated with a high risk of sexual and urinary side effects. However, HIFU technology is a minimally invasive treatment that targets specific tissue in the prostate, eliminating harm to other critical structures such as the bladder, rectum, external urinary sphincter and neurovascular bundles. In highly experienced hands, HIFU offers an excellent chance for a man to maintain normal sexual and urinary function. Every patient is different, but MRI Fusion Guided targeted HIFU has been shown in published studies to maintain function in the vast majority of men. Thorough evaluation and discussion with a HIFU expert physician can help a patient decide if they are great candidates for HIFU treatment.
5. HIFU is experimental and is not FDA approved.
HIFU was approved in the United States by the FDA in October 2015 for prostate tissue ablation.The FDA reviewed published data from around the world regarding the safety of HIFU and the ability of HIFU to kill prostate tissue before granting this approval. The most common use of HIFU worldwide has been to treat prostate cancer with patients undergoing HIFU treatment in Europe as early as1995, over 20 years ago. There are several published studies that report outcomes over 10 years that document that prostate cancer survival, metastasis free survival and need for secondary or salvage treatment , is similar to results from surgery and radiation. To learn more, click here to access the published studies library . However, even to this day, patients are told by usually well meaning, but uninformed physicians and insurance companies that the HIFU procedure cannot be done in the United States. The Scionti Prostate Center is association with Vituro Health, has been offering HIFU at the Vituro Sarasota HIFU Center of Excellence in Sarasota, Florida since December 2015. If you have been diagnosed with prostate cancer, HIFU may be an excellent treatment solution. HIFU is not ideal for all patients, therefore careful evaluation of a patient's prostate cancer history by a physician highly experienced in HIFU is required to determine if HIFU ideal .