One in seven men in the United States will face prostate cancer at some time in their lives, making the disease the second leading cause of cancer death in America. For some of these patients, a new minimally invasive procedure can help them avoid surgery and the side effects that may follow.
Approved by the FDA last year, high intensity focused ultrasound (HIFU) can drastically reduce side effects such as erectile dysfunction and incontinence with the same success as more traditional and invasive options. However, patients must be selected properly says Mark DeGuenther, MD, a urologist with Urology Centers of Alabama, the only practice in Alabama currently offering HIFU.
Any prostate cancer patient with localized cancer is potentially a candidate for HIFU. Using advanced diagnostic technology including multiparametric MRI and targeted biopsy, physicians can more easily identify the location and volume of the cancer and provide a treatment option without the traditional side effects.
HIFU eradicates the cancer through precise focusing of sound waves to the targeted area. The interaction between the sound waves and the cancerous tissue destroys the cells. Several studies have been published on HIFU effectiveness showing men with low to moderate risk disease achieve excellent disease-free rates and excellent negative biopsy rates. The most recent HIFU study shows that overall survival five years following the procedure is 97 percent, which is no different than traditional treatments. In addition to excellent long-term survival, its metastasis-free survival rate is 97 percent.
DeGuenther says what distinguishes HIFU from more traditional therapies is that traditional therapies treat the entire prostate, which can lead to complications like incontinence and erectile dysfunction. "We can almost eliminate all side effects with HIFU," he says. "The thing that prevents a lot of men from having screening or treatment for prostate cancer is their fear of the adverse effects of the surgery. With HIFU, those fears are eliminated, and the procedure is a great advantage for men who are candidates."
DeGuenther says Urology Centers of Alabama wants to offer patients a full range of services, including HIFU. "Right now, HIFU is a niche treatment, but if we administer the entire line of prostate treatment from top to bottom, we think we can help control quality and guide patients to what will be best for them in an individualized manner," he says. "If we do it piecemeal, quality control won't be as good."
The use of HIFU at Urology Centers of Alabama is the result of a partnership with Vituro Health, a Birmingham-based startup company and a comprehensive health care provider that empowers men during all stages of life. In 2015, Vituro Health launched its operations to offer complete prostate management services.
"We offer our patients education, financing, concierge care from dedicated medical professionals, and access to advanced HIFU therapy," says Vituro CEO Clete Walker. "Vituro Health wants to ensure men have a precise and complete diagnosis and that they are given all treatment options."
Walker and Stephen Scionti, MD, created the company as a center for HIFU excellence in the U.S. They also wanted it to be a vehicle for training other urologists to ensure quality outcomes with HIFU. "We saw a need in men's health, and Vituro Health is built on the foundation of men's health, especially prostate cancer and HIFU specifically," Walker says.
Scionti trains physicians in and outside the U.S. to provide HIFU to patients. Through Vituro Health, he teaches urologists both in person and live case proctoring via the internet. "We are pursuing the creation of geographic distribution of this service around the country," Walker says. "Doctors are interested in this new technology, but physician behaviors and insurance companies sometimes move slower than technological development. We want to make sure the men who are interested in innovative care are connected to physicians who can help them take advantage of it."
In addition to Urology Centers of Alabama, Vituro Health also has partnerships with nine other practices in the states of Florida, Georgia, Pennsylvania, New Jersey, Texas, Nevada, Arizona, and Washington D.C. "Our primary objective is training and quality so we can give our patients the best care available. Currently, insurance does not cover HIFU, but we will work with patients who are interested," Walker says. "Helping patients is our key role."
Being able to provide a service that can cure cancer drives Walker's desire to expand the reach of Vituro Health. "Knowing that we can offer these patients the hope for a cure is what makes me passionate about what we are doing," he says.