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By implanting tiny radioactive capsules, Monmouth Medical Center
pioneers are helping men wage a tough new war against prostate
cancer.
They resemble grains of rice, so small that dozens can be cupped
in the palm of your hand. But when these radioactive capsules
are placed directly into the prostate gland, they deliver a powerful
punch against the second-leading cause of cancer death among American
men: prostate cancer. This innovative, low-dose procedure, which
is performed by a team of highly skilled urologist, radiation oncologists
and physicists, dramatically limits the radiation dose to surrounding
healthy tissue.
Since 1998, this pioneering radiation implant therapy, also called
permanent seed brachytherapy (PSB), has been performed at Monmouth
Medical Center in Long Branch, the region's top provider of state-of-the-art
cancer and urological services.
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In its earliest stages, prostate cancer generally
progresses slowly. Watch for these symptoms:
- Frequent urination or inability
to urinate
- Trouble starting or holding
back urination
- Weak or interrupted urine
flow
- Frequent pain or stiffness
in the lower back, hips or upper thighs
- Impotence
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Two simple test can yield an answer: a rectal
exam to feel for abnormalities of the prostate
gland and a blood test that measures prostate-specific
antigen (PSA), an enzyme produced by the gland.
"When performed together, these test are
the most effective tools to detect prostate cancer
early," says
Arnold Grebler, M.D., chief of urology.
Beginning at age 50, men are encouraged to undergo
annual checkups that include both tests. Men at
high risk for the disease, including African Americans
and those with a family history of the disease,
should begin routine testing at age 40.
If the PSA finding is abnormal, DR. Grebler recommends
men undergo an advanced blood test known as percent-free
PSA testing, which measures the normal fraction
of prostate-specific antigen in the specimen. Monmouth
Medical Center was the first hospital in the region
to offer this diagnosis tool.
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And last year, Monmouth became the first hospital in central New
Jersey to offer real-time, dynamic, computer-assisted planning
for men with early-stage prostate cancer undergoing PSB.
The new VariSeed system produces
3-d images of the prostate while the procedure is under way. The
images are transmitted to a planning computer in the operating
room. A sophisticated software program then calculates the number
of seeds needed --- and their precise placement --- to deliver
the most effective dose.
"The intraoperative
planning program is critical for identifying the approach to be
followed in placing the seeds," says Arnold Grebler, M.D., chief
of urology at Monmouth. "It also provides 'real-time' dose calculation
and dynamic feedback during the procedure."
"This significant advance allows us to immediately gauge
the dose to the prostate from the seeds as we are implanting them,"
says Adam Raben, M.D., chairman of the Institute fro Advanced Radiation
Oncology at Monmouth. "It gives us a tremendous advantage in minimizing
the dose the urethra and the rectum while delivering the proper
dose to the gland itself."
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Urological Surgery
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