HJAR Sep/Oct 2023

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2023 61 Robbie Hurtt, MD Arkansas Urology how fast they are proliferating. The test tracks the expression of over 30 genes re- lated to CCP. The result is an extremely ac- curate prediction of whether prostate cancer is likely to spread and whether a patient can safely enroll in active surveillance and avoid traditional treatment. One study found 49.5% fewer surgical interventions after prostate cancer diagnosis when Prolaris was utilized. ExoDx prostate IntelliScore (EPI): ExoDx prostate testing looks for prostate cancer- specific biomarkers expressed in the urine during tumor cell growth. These levels are then calculated into a score that shows the patient’s risk of having clinically signifi- cant or aggressive prostate cancer. If the test indicates low risk, patients can usually avoid traditional treatment in favor of active surveillance. Advanced imaging Multiparametric MRI (mpMRI): When coupled with advanced testing, MRI can be a powerful ally for men on active surveillance. Multiparametric MRI is a newer technique that pairs standard MRI scanning with at least one other type of MRI scan, like DCE- MRI. The technique can reveal precise details about suspected lesions in the prostate, pro- viding insight on whether prostate cancer is likely to spread or is growing slowly enough for active surveillance. PSMA PET-CT: Approved by the FDA in 2020, prostate-specific membrane antigen (PSMA) PET-CT scanning is a special type of positron emission tomography (PET) scan. In studies, PSMA PET-CT has been shown to improve detection of metastatic tumors. PSMA’s usefulness is further enhanced by emerging techniques like adding lutetium to the PSMA-targeting ligand, taking treat- ment directly to cancer cells highlighted in a PET scan. Active surveillance is not right for every patient, but for those with low-risk prostate cancers, today’s tools and imaging make ac- tive surveillance a safe alternative to tradi- tional treatments that can impact function and quality of life. For those patients, living with carefully surveilled prostate cancer can be a much healthier option than going through what it can take to become cancer free. n A native of Salem, Arkansas, Robbie Hurtt, MD, joined Arkansas Urology in 2017. Hurtt received a medical degree from the University of Arkansas for Medical Sciences. He completed a general surgery internship at the University of Mississippi Medical Center inJackson,as well as a urologic residency.He also served as chief resident in his time there. Hurtt is amember of theAmerican Urological Association and is board-certified as a diplomat of theAmerican Board of Urology.He is also amember of theArkansas Urologic Association and Arkansas Medical Society. infection while preserving bowel, sexual, and urinary function. It’s an option that patients are choosing in increasing numbers. A2022 report by the National Cancer Institute noted that while only about 26% of men in the U.S. with low- risk prostate cancer opted for active surveil- lance over traditional treatment in 2014, ac- tive surveillance was being utilized in 59.6% of low-risk cases by 2021. A 21st century toolkit Today, there are non-invasive methods that can accurately and safely diagnose prostate cancer and predict how likely it is to spread. Blood, urine, and tissue testing Prostate health index (PHI) test: Ablood test that can accurately predict the likeli- hood of high-grade cancer, PHI testing can also accurately predict whether prostate cancer is likely to spread during active sur- veillance. A2017 study led by researchers at Johns Hopkins found that PHI could also predict aggressive cancer without a pros- tate biopsy, especially when paired withMRI imaging. Prolaris cell cycle progression test: The Prolaris cell cycle progression (CCP) test is a genomic test that looks at prostate cancer cells collected during biopsy and estimates