HJAR Sep/Oct 2020

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2020 51 Dr. Matthew Kincade practices general urol- ogy out of Arkansas Urology’s Bentonville office. He is a graduate of the University of Arkansas, and obtained his M.D. from the Uni- versity of Arkansas for Medical Sciences. He completed a urology residency at the Univer- sity of Tennessee Health Science Center, and went on to obtain a Master of Health Adminis- tration from Missouri State University. • ExoDx Prostate (IntelliScore), or EPI, gauges levels of three biomarkers in urine to help determine a man’s risk of having aggressive prostate cancer. • ConfirmMDx is a test that looks at certain genes in the cells from a pros- tate biopsy sample. These tests can further clarify a patient’s prognosis following a slightly elevated PSA, or help determine whether he should have a prostate biopsy. Some of these tests might be more helpful in determining if men who have already had a prostate biopsy that didn’t find cancer should have another biopsy. Treatment In many cases of moderate- to high-risk prostate cancer, a proper course of treat- ment will involve a prostatectomy, which is the removal of the prostate gland. Current standard of care for prostate cancer surgery in the United States typically involves lapa- roscopic or Da Vinci robot-assisted prosta- tectomy, as opposed to the open surgery of the past. These procedures are intended to remove all cancerous tissue to cure cancer, and are typically performed during the early stages of the disease. The side effects may include nerve damage that results in urinary incontinence, and erectile dysfunction, but these are typically mild and self-limiting, and often do not affect patients’ quality of life. Today there are also many non-surgical alternatives. We have the ability to apply many different treatment modalities in order to deliver an effective course of treatment, as appropriate to a particular patient’s in- dividual needs: • Hormone therapy to control the sup- ply of hormones, such as testosterone, that cancer cells need to grow. • Chemotherapy to slow or reverse the spread of prostate cancer in advanced stages. • Intensity-modulated radiation thera- py (IMRT) to deliver precise radiation to malignant tumors. This treatment is typically recommended when the cancer is confined to the immediate prostate area, and is often combined with hormone therapy for greatest ef- ficacy. • Cryosurgery to destroy cancerous tissue, which is a minimally invasive outpatient procedure that destroys cancerous cells with ice. Everyone is unique, and every man should begin getting regular checkups from a urologist beginning at age 50. Matthew Kincade, MD Arkansas Urology Gene Therapy No area of cancer research has come far- ther than genetics, and thanks to new drug approvals and effective intervention follow- ing early detection, targeted gene therapies promise to refine treatments at the molec- ular level to personalize patients’ prostate cancer recoveries. Today, we understand the damage cancer does at the human DNA level. We can prescribe a regimen of drug treat- ments suited for the particular genetic pro- file of each patient’s cancer. If you are facing a prostate cancer diag- nosis yourself, speak to your urologist about the best treatment options for you. More than anything, don’t wait. Don’t hes- itate. Patients who communicate symptoms in real time fare better because problems are addressed before they become more serious. Be your own advocate, because if you don’t speak up for yourself, no one will. n “No area of cancer research has come farther than genetics, and thanks to new drug approvals and effective intervention following early detection, targeted gene therapies promise to refine treatments at the molecular level to personalize patients’ prostate cancer recoveries.”