Welcome to the Next Wave in
Best Care for Prostate cancer and Prostate Patients

Prostate Health

About prostate cancer information, prostate cancer symptoms and prostate cancer treatments. In medicine, pioneering treatments begin with dedicated research. From small ripples of careful inquiry emerge the next wave of life-saving care—sweeping aside prior assumptions and providing hope to those who need it most. Such is the case now with Cryosurgery—as pioneered by Dr. Herbert Riemenschneider of Riverside Urology.

Prostate Cancer Treatments - Video

At Riverside Urology, a particular strength of our practice is the use of Cryosurgery, an effective new alternative to traditional prostate cancer treatments. It is a procedure that Dr. Riemenschneider has pioneered from clinical research into clinical practice.

About Cryosurgery for Prostate cancer 
Cryosurgery is the precise use of super-cooled gas to destroy cancer cells. It is less invasive than traditional surgery and offers fewer complications and reduced side effects. In layman’s terms, focal cryoablation is a targeted use of a super-cooled gas to kill cancer cells, as opposed to a more general surgical or radiation approach. It represents a significant advance in the treatment of prostate cancer, with an emphasis on maintaining quality of life for the patient, with the fewest possible side effects.

A problem with previous surgical and radiation approaches has been the side effects. General surgical and radiation approaches often result in life-damaging effects, such as erectile dysfunction and incontinence. With focal cryoablation, focus is the key. Focal cryoablation begins with precisely localizing the index tumor using a technique knwon as saturation biopsy mapping. In this mapping method, 40-50 tiny biopsy cores are removed, compared with 10 in a standard biopsy. Each biopsy core is correlated to its site of origin in the prostate, creating an intricate map of the prostate. That map allows for very precise application of the cryo treatment, thus largely avoiding the unwanted, general side effects.

Prostate Cancer: An Overview
Prostate cancer is a serious health risk for American men. Prostatic-specific antigen (PSA) was initially discovered in 1971, but it took until the late 1980’s for it to be accepted as a diagnostic standard. Its early application was for men who were already suspected of having prostate cancer—meaning that the cancer had already attained a significant size. PSA used in this situation was more of a confirmation tool than an early diagnostic test. Ultimately,  it was applied as a screening tool for early diagnosis.

Screening is a technique in which a random group of individuals are tested—in this case, men over the age of fifty. This application led to the early diagnosis of disease, and as it was used more aggressively, particularly in younger patients (beginning at age 40), it often achieved very early diagnosis.  Some experts believed that this diagnosed insignificant disease; the concern was that early diagnosis of prostate cancer could be more problematic than beneficial.

However, during the decade of the 1990’s it became apparent that early-diagnosed disease can become clinically-significant prostate cancer. Knowing this, it became possible to treat the disease when the volume of cancer cells is quite small. This treatment results in fewer complications, better long-term survival rates and decreased mortality.

Prostate cancer Treatment History
In a longer historical view, prostate cancer treatment began at Johns Hopkins University in the very early 1900’s, when Dr. Hugh Young developed the treatment of radical perineal prostatectomy. The treatment initially applied was beneficial, but was associated with side effects such as urinary control problems and erectile dysfunction. However, over time, radical prostatectomy was modified. Complications were significantly reduced and cure expected.

External beam radiation therapy became a major treatment option in the mid-twentieth century, and was modified near the close of the century. Ultimately, it evolved to a minimal procedure of placing radioactive seeds into the prostate. This treatment is known as Brachytherapy.

Over time, these advances resulted in an increased cure rate and a significant decrease in complications.

A Careful Approach
Riverside Urology offers advanced treatments for conditions affecting the bladder, kidneys and urogenital system, with special emphasis in the treatment of urologic oncology, primarily prostate cancer. Our practice features leading methods and state-of-the-art equipment, but more importantly, Dr. Riemenschneider’s 25 years of leadership in the development of effective new treatments.

At Riverside Urology, we have been at the forefront of new treatments for prostate cancer, incuding Radical Prostatectomy, External Beam, Brachytherapy, Radiation Therapy and, beginning in 1993, Standard Cryoablation of prostate. By 2001, we began using third-generation Cryoablation as treatment for primary prostate cancer. We have treated over a hundred such patients and currently have five years of follow-up data on our patients. This analysis has demonstrated excellent outcomes as measured by lack of  post-ablation symptoms, negative ultrasound guided needle biopsies and very low PSA. In 2005, we initiated our experience with Focal Cryoablation—becoming the first urologic practice in this area to apply this effective new technique.

The application of the technique of saturation biopsy, with many biopsies taken from geographic identifiable areas in the prostate, has made it possible to find a highly select group of primary prostate cancer patients. These patients have requested information about focal treatment, and after being fully informed about all the treatment options, have chosen Focal Cryoablation. Careful monitoring over the past twenty-four months, which  has included biopsies at six, twelve and eighteen months, as well as interval PSA determination at three-month intervals, has demonstrated good outcomes measured by lack of symptoms, negative biopsies and very low PSA levels.

Preliminary results have shown that progression of disease in these select patients (as measured by PSA and ultrasound guided prostate biopsy) is very infrequent. The side effects of treatment, such as erectile dysfunction and urinary control problems, have largely been avoided. No treatment-induced incontinence has occurred; impotence has not been a significant problem; and the very few cases that have occurred have been satisfactorily treated with oral agents. Thus, quality of life has been greatly enhanced for these patients.

In effect, this cure leaves the man whole and able to resume and enjoy life as before. Such outcomes represent the fulfillment of our years of pioneering research and clinical practice, giving our patients the quality of life for which we all endeavor.

At Riverside Urology, our mission is appying the latest advances in treatment for prostate cancer toward restoring and maintaining the good health of our patients. Our participation in the development of the emerging technique of Focal Oblation puts us at the forefront of clinical treatment—and brings our patients in line for the very best, state-of-the-art care, with the very best outcomes for long, productive and fulfilling lives. 

We are here to provide you with the best choices in care, under the most advanced clinical conditions, using unsurpassed methods with the best overall outcomes—not just treating the disease, but giving total quality of life back to you, the patient.  
 

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