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UCSD Health’s alternative approach uses high-intensity sound waves to treat prostate cancer

Bob Damashek, pictured with his wife, Mimi, was treated for prostate cancer at UCSD Health using high-intensity ultrasound.
Bob Damashek, pictured with his wife, Mimi, was treated for prostate cancer at UC San Diego Health using high-intensity, focused ultrasound.
(Courtesy of UC San Diego Health)

Bob Damashek was diagnosed with prostate cancer 15 years ago. Due to the early stage and grade of his condition at the time, he was able to avoid surgery and manage the disease through surveillance by his medical team for any signs of progression.

His cancer remained stable until last year. Testing of Damashek’s prostate-specific antigen (PSA) — a protein produced by normal and malignant cells of the prostate gland — began to rise. A biopsy confirmed his cancer had worsened.

“I have had several family members and friends impacted by prostate cancer,” Damashek said. “I know how horrible this disease can be and that getting treatment early is paramount.”

That’s when the Denver resident, who is in his 70s, went to UC San Diego Health for a treatment approach not available to him at home.

UCSD Health is the only hospital system in San Diego County to use high-intensity, focused ultrasound for treatment of prostate cancer.

HIFU is a minimally invasive outpatient treatment that uses high-frequency sound waves directed at the cancerous tissue through an ultrasound probe. The sound waves target and heat the cancer tissue to temperatures high enough to cause cell death.

HIFU provides an alternative to surgery or radiation for eligible patients.

“As the only academic medical center and National Cancer Institute-designated comprehensive cancer center in the region, we can offer patients leading-edge treatment not always available at other health care systems,” said Dr. Scott Lippman, director of the Moores Cancer Center at UCSD Health.

Through the HIFU system, high-resolution images are combined with biopsy data and real-time ultrasound imaging to provide urologists with a 3D view of cancerous tissue. Physicians can then draw precise contours around the diseased tissue, target only that portion of the affected organ and minimize damage to surrounding structures, which include nerves, blood vessels and muscle tissue. For the patient, the approach minimizes the risk of urinary incontinence and erectile dysfunction.

At the end of the procedure, a temporary urinary catheter is placed to limit the risk of urinary retention (inability to pass urine) due to temporary swelling of the prostatic urethra. The catheter is typically removed three to five days after the procedure.

The treatment results in removing cancerous tumors “with extreme accuracy and quicker recovery times because no incisions are required,” said Dr. E. David Crawford, a urologic oncologist at UCSD Health who is Damashek’s physician.

For Damashek, that meant a trip to Disneyland the day after treatment and feeling fully back to himself a few days later.

“I feel like a big weight has been lifted off my shoulders,” he said. “For the first time in a very long time, I am not consumed by cancer. The [procedure] was effective and so easy to tolerate that it boggled my mind. As a cancer patient, you are always assessing, worrying and sometimes second-guessing the best treatment for your specific case. I am 100 percent confident I made the right decision.”

Prostate cancer is the most common solid organ cancer diagnosed and the second-leading cause of cancer deaths in males in the United States. When found early and treated appropriately, the five-year survival rate is nearly 100 percent.

Despite the serious nature of some prostate cancers, many cases are non-aggressive. Not all men require surgery or radiation, Crawford said.

Ideal candidates for HIFU have early-stage, low- to intermediate-grade cancer that is confined to the prostate. HIFU is used to treat a single tumor.

“It is like the male equivalent of the female lumpectomy used for certain breast cancers,” Crawford said. ◆