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Surgeons pioneer robotic outpatient treatment for prostate cancer

Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area.

Surgeons pioneer robotic outpatient treatment for prostate cancer

Keck Medicine of USC is the first academic medical center in the nation to use new energy-based focal ablative technology in an outpatient procedure for prostate cancer patients.

On Dec. 10 and 11, USC Institute of Urology surgeons used a Food and Drug Administration (FDA)-cleared non-invasive high intensity focused ultrasound (HIFU) surgical ablation system to non-surgically destroy prostate tumors in three patients. The system enables surgeons to introduce the HIFU probe into the patient’s body through the rectum to treat localized tumors in the prostate gland.

Inderbir Gill, MD, founding executive director, USC Institute of Urology, and chairman and professor, Catherine and Joseph Aresty Department of Urology at the Keck School of Medicine of USC, performed the surgery on three patients, two of whom went home the same day. (One patient went home the following day.) This is quicker than what patients typically experience with prostate surgery.

“The goal of focal HIFU is to target and destroy only the significant cancer lesion, thereby preserving the delicate nerves around the prostate, thus protecting both continence and potency,” said Gill. “This is a non-invasive, non-surgical, outpatient procedure that does not involve any radiation. There is no blood loss, the recovery is quick, and typically the patient is back on his feet and discharged home the same day.”

Prostate cancer is the second leading cause of death among American men, behind lung cancer. More than 220,000 American men will be diagnosed in 2015 with prostate cancer, according to the American Cancer Society. Nearly 28,000 men in the United States are expected to die from prostate cancer in 2015.

According to Gill, HIFU surgery is a viable option for patients who have low-to-intermediate risk cancer, with localized lesions within a prostate gland that is no more than 40 grams in volume, and who already possess strong levels of continence and potency. In general, patients should have organ-confined disease and a prostate-specific antigen (PSA) level under 15-20 ng/ml.

For patient Brett Lindsay, 46, a Phoenix, Ariz. resident who is regional vice president with a natural gas fuel company, the decision to undergo surgery with the HIFU technology stemmed from its minimal side effects.

“I was anxious to find a form of treatment that would remove my cancer, but still allow me to get back on the road with minimal down time,” said Lindsay. “With HIFU, I can continue working with my team, and still have the energy to get in a few rounds of golf on the weekends.” Lindsay actually scheduled a business trip to take place five days after his surgery.

With the patient under general anesthetic, the HIFU probe is introduced into the rectum. The ultrasound beam is aimed at the prostate through the rectum, destroying the tumor non-invasively and precisely.

Currently, HIFU systems developed by only two manufacturers, EDAP TMS and SonaCare Medical, have been granted FDA clearance. The USC Institute of Urology is the first and only academic medical center in the United States to offer both these cutting-edge technologies, which collectively cover the entire range of HIFU treatments.

“We are thrilled to have the first installation of Ablatherm Robotic HIFU following FDA clearance at such a prestigious university hospital as Keck Medical Center of USC, the first academic facility to purchase our device in the U.S.,” said Marc  Oczachowski, CEO of EDAP TMS. “It is an honor to be working with the world class urology team led by Dr. Inderbir Gill, one of the top urologists in the world, and to collaborate with them on the establishment of a state-of-the-art training and reference center for Ablatherm Robotic HIFU in the U.S.”

“SonaCare Medical is delighted to strengthen its relationship with Dr. Gill and his excellent research team at Keck Medicine through this first use of focal ablation of the prostate at an academic center in the U.S. using Sonablate,” said Mark Carol, MD, CEO of SonaCare Medical.  “Dr. Gill’s team is recognized around the world as one of the pioneers in ablative therapy.  His expertise in focal ablation of the prostate and other organs, along with the capabilities of the SonaSource system, are suited ideally to partner in developing novel ways to deliver and apply ablative therapy.”

by Mary Dacuma