HJAR Nov/Dec 2023

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2023 55 Keith Mooney, MD Urologist CARTI use the cancer’s microscopic appearance to help ascertain tumor risk. Exciting new re- search and discoveries provide a greater un- derstanding of molecular-level gene muta- tions to inform treatment decision-making, and gene assays help direct specific, targeted therapies. With genetic information as our guide, we can also implement screening for other cancers. At CARTI, we’re fortunate to have the largest cancer genetics and risk management clinic in the state, which allows us to direct appropriate testing for patients and their families. In 2023 alone, Arkansas is expected to see 2,500 new cases of prostate cancer. Accord- ing to the American Cancer Society, it’s the most common cancer for men in the U.S., with 1 in 8 being diagnosed in their lifetimes. We’ve made incredible progress in helping those impacted by prostate cancer treat or manage the disease. But we can do even more. By collaborating across specialties and taking advantage of new tools — from CyberKnife to custom, gene-based thera- pies—we can continue improving patient outcomes and ensure men’s quality of life. n Keith Mooney, MD, is a urologist with CARTI. He graduated from the University of Arkansas for Medical Sciences, where he completed residencies in surgery and urology.He is a fellow of theAmerican College of Surgeons and amember of theAmerican Association of Clinical Urologists, American Boards of Urology, American Urological Association-South Central Section, Arkansas Medical Society, and Arkansas Urological Society. I’ve witnessed how patients benefit — shorter hospital stays, less post-op discomfort, and better long-term outcomes, including pres- ervation of erectile function and continence. Outside the operating room, we’ve also seen positive patient outcomes from focal and pharmacological therapies. Again, with the support of radiation oncologists, pa- tients’ urologists can offer innovative pro- cedures like irreversible electroporation. This image-guided ablation technology uses strong, pulsed electric fields to target and kill a patient’s cancer cells. Surrounding struc- tures are left unaffected, deterring potential adverse side effects. Cryoablation is another minimally invasive procedure that destroys prostate cancer cells through freezing. Moving away from the “cut it out” men- tality of decades past, active surveillance is increasingly recommended for many pa- tients with slower-growing or less aggres- sive prostate cancer. Generally, patients are seen every six months for prostate-specific antigen blood tests, with MRI imaging ob- tained annually. As needed, urologists con- duct prostate biopsies to assess the cancer’s biological activity. MRI imaging is fused with an ultrasound of the prostate to provide a clear, three-dimensional image, ensuring greater accuracy in the sample collection process. Microscopic and biomolecular testing have also created better insight into prostate cancer activity and aggressiveness. Using the Gleason grading system, urologists can This shift can begin immediately post- diagnosis. For many men, finding out they have prostate cancer is a life-altering event. The impact is felt not only in the immedi- ate aftermath of hearing the news but also as they contemplate how the disease may impact their participation in or enjoyment of daily activities. Their emotions may intensify if their treatments affect bodily functions or their self-image. According to a study in Frontiers of Psychology , the “physical and sexual effects [of prostate cancer treatment] can directly affect body image and have negative psychological and social implica- tions,” such as low self-confidence, anxiety, or depression. Fortunately, healthcare providers now have innovative treatments like stereo- tactic radiosurgery (SRS) to help minimize prostate cancer patients’ physical and psy- chological side effects. CyberKnife, a non- invasive robotic radiation therapy, delivers precise, personalized treatments with sub- millimeter accuracy, cutting patients’course of radiation from more than 40 days to an average of just five sessions. Prostate cancer patients can quickly return to everyday life without restrictions post treatment. Medical experts may recommend that patients consider undergoing minimally invasive, laparoscopic robotic surgery, which allows for better visualization, sur- gical precision, and physician control during operations. As one of the state’s most expe- rienced robotic prostate cancer surgeons,