Did you know that approximately one out of nine men will be diagnosed with prostate cancer in their lifetimes, and that prostate cancer is second only to skin cancer as the most common cancer affecting men in the U.S. today? Even more, prostate cancer does not typically present with symptoms, a fact that makes awareness about risk factors and screening even more critical.
Each September during Prostate Cancer Awareness Month, men’s health specialists share important information about this common and sometimes deadly disease. Below, the Co-Chairs of the Memorial Hermann Prostate Cancer Center of Excellence, Dr. Nathaniel Barnes, MD, a urological surgeon with Memorial Hermann Medical Group, and Dr. Steven Canfield, MD, professor and chair of the Division of Urology at McGovern Medical School at UTHealth Houston and chief of Urology at Memorial Hermann-Texas Medical Center, discuss the importance of screening, risk factors and the latest research underway on new treatments at UTHealth Houston.
Q: Why is regular screening so important when it comes to prostate cancer?
Dr. Canfield: Routine screening is important because it has been proven to make an impact on men’s quality of life as well as overall survival. If caught early, many forms of prostate cancer can be treated effectively. We have numerous screening tools available to us, including the prostate-specific antigen (PSA) blood test, and imaging tools like MRI. Typically, prostate cancer does not present with any symptoms. If a man experiences bothersome urinary symptoms, he may go to see his doctor, but that really has nothing to do with prostate cancer, so we cannot just rely on symptoms. There are men at higher risk, including African American males and anyone who has a first-degree, male relative with history of prostate cancer. Anyone who falls into those categories should certainly follow the latest screening guidelines, which recommend discussions about screening with your doctor beginning at age 50-55 for men at average risk and at age 45 for men at high risk. Men who have more than one first-degree relative who had prostate cancer at an early age should begin screening even earlier, at age 40.
Dr. Barnes: Prostate cancer is such a prevalent cancer and our ability to screen is simple and straightforward and allows us to identify those who need treatment, so the importance of screening cannot be understated. I also think as we move into the future, we’re going to be increasingly focused on other risk factors, including men in high-risk groups who have one or two relatives who have had cancer related to the BRCA2 gene. We have historically looked at men whose fathers had prostate cancer, but now there is significant data showing that if their mothers or sisters have had ovarian or breast cancer, they may be at an increased risk for prostate cancer.
Q: What is the Memorial Hermann Prostate Cancer Center of Excellence and how is it working to develop new treatments for prostate cancer?
Dr. Barnes: The Center of Excellence is a multidisciplinary collaborative effort between a number of specialists within Memorial Hermann Health System and our partners at UTHealth Houston. This includes urologists, radiation oncologists, medical oncologists, uropathologists and radiologists who specialize in MRI who are all affiliated with Memorial Hermann. Our multidisciplinary group works together to standardize how we diagnose, manage and treat prostate cancer across the board. Some places will label themselves a center of excellence without any qualifying criteria to define them as such, but we followed a list of criteria focused on quality metrics that we have established at Memorial Hermann hospitals. Our aim is for the quality of care to be cutting edge and state-of-the-art while ensuring consistency of care with every encounter and with every patient. Oftentimes when we say medicine is a science and an art, the art part is how we subjectively interpret diagnoses and treatment, but that is all based on a strong foundation of the science. Our goal at the Center of Excellence is to use late-breaking, cutting-edge science as the foundation of how we evaluate and manage these patients, and to do it on a multidisciplinary level versus from office to office or campus to campus. In short, we are a collaborative group made up of multiple specialties, all with the same goal in mind and all with the same quality metrics as our standard.
Q: Tell us about the latest research taking place at McGovern Medical School at UTHealth Houston, which uses gold nanoparticles to help localize treatment for prostate cancer.
Dr. Canfield: We are working to make focal therapy even more precise. A few modalities to ablate the area of a prostate affected by cancer currently exist, but we are trying to make this technique smarter by targeting the actual cancer cells in the prostate with nanoparticle technology. We infuse the prostate with special-property gold nanoparticles that were invented in a physics lab at Rice University. Once the nanoparticles are in the prostate, we place a unique laser using MR fusion localization technology, and we then activate those nanoparticles, just where the cancer is. So, it is a much more precise, smarter and ultra-focal way of getting rid of the cancer. Through this increased precision, our goal is to not only ensure we are getting all of the cancer, but also to minimize the other side effects that are common with radical treatments. Our next steps are to gather more data and then submit to the FDA with the hope that eventually, this can become a new standard treatment option for men with prostate cancer.