HJAR Sep/Oct 2021

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2021 43 Keith Mooney, MD Arkansas Urology • Brachytherapy, which is a type of in- ternal radiation in which radioactive pellets (or “seeds”) are placed into or near a tumor in the prostate gland. With this procedure, high doses of radiation can be delivered to the immediate area of the tumor, minimizing damage to nearby tissues. • Hormone therapy, which controls the supply of hormones, such as testos- terone, that cancer cells need to grow. • PROVENGE, which is a personalized immunotherapy that activates the im- mune system to fight advanced pros- tate cancer immune cells, and it works like a vaccine in that it boosts the im- mune system’s ability to target and at- tack prostate cancer cells immediately. • Xofigo (radium Ra 223 dichloride), which is an injection used to treat pros- tate cancer that no longer responds to hormonal or surgical treatment. It is for men whose prostate cancer has spread to the bone but not to other parts of the body. • Chemotherapy, which slows or revers- es the spread of prostate cancer in ad- vanced stages. Chemotherapy drugs are injected into the bloodstream to poison the rapidly dividing cancer cells. How- ever, the drugs also impact healthy, di- viding cells in the blood, intestine and hair. Common side effects include nau- sea, hair loss and anemia, whichmay be helped with other medications. • Intensity-modulated radiation thera- py (IMRT), which delivers precise radi- ation to malignant (cancerous) tumors. This treatment is typically recommend- ed when the cancer is confined to the immediate prostate area and is often combined with hormone therapy for greatest efficacy. • Cryosurgery, which destroys cancer- ous tissue with ice during a minimally invasive outpatient procedure. Cryo- surgery is less invasive than traditional surgery, involving only a small incision or insertion through the skin, and uses liquid argon gas to destroy cancerous tissue. Researchers have determined that cryosurgery is a good alternative to surgery or radiation therapy, both of which can have severe side effects. • Gene therapy. No area of cancer re- search has come farther than genet- ics, and thanks to new drug approvals and effective intervention following early detection, targeted gene thera- pies promise to refine treatments at the molecular level to personalize patients’ prostate cancer recoveries. Everyone is unique, and everyman should begin getting regular checkups from a urolo- gist beginning at age 50, or even sooner if they are at higher risk or have a family histo- ry. We hope you will encourage your patients and the men in your lives to get screened. Men who communicate symptoms in real time fare better, because problems are ad- dressed before they become more serious. While a prostate cancer diagnosis can be scary, the treatment options have come a long way, and men are living a longer, health- ier life after a prostate cancer diagnosis. n Keith Mooney, MD, has been with Arkansas Urology since 1987. He received a medical degree from the University of Arkansas for Medical Sciences after earning a bachelor’s degree from Hendrix College in Conway. He was a urology and surgery resident at UAMS. Treatment In many practices — including Arkansas Urology — there is a clinical pathway to help determine the best treatment for patients. Our specialized prostate cancer team treats the patient holistically, not only treats the cancer. It’s best when treatment teams make patients a part of the healthcare team to take an active role in their healthcare and to know more what to expect with each treatment option. In many cases of moderate- to high-risk prostate cancer, a proper course of treatment will involve a prostatectomy. The good news is that this is typically done laparoscopically as a da Vinci robot-assisted prostatectomy, as opposed to the open surgery of the past. The prostatectomy procedure is intended to remove all cancerous tissue to cure cancer and is 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 will not diminish quality of life. Today, many non-surgical alternatives are also available. At Arkansas Urology, we have the ability to apply many different treatment methods to deliver an effective course of treatment as appropriate to a particular patient’s individual needs. Those treatment options include: • Radiation therapy, which works by damaging tumor cells that divide quickly. It is usually used for patients whose cancer is confined to the im- mediate prostate area, but it can also be used in advanced cases to control pain. Radiation therapy can be deliv- ered from outside the body or by using a catheter inside the prostate.