By Molly Dannenmaier

A new nonsurgical prostate cancer treatment offered at the University of Texas Medical Branch virtually eliminates the side effects of impotence and incontinence that can occur when patients receive the traditional treatment for prostate cancer — surgical prostate removal.

UTMB’s chairman of radiology Dr. Eric Walser is one of only a few physicians in the world and the only physician in Texas who performs this groundbreaking procedure.

Using a state-of-the-art, MRI-guided laser ablation instrument developed at UTMB, he zaps away the cancer without removing the prostate.

Recently, the American Urological Association released new prostate cancer screening guidelines, saying men 55 and younger should no longer receive routine prostate screening and that men 80 and older should not receive it if they have a life expectancy less than 10 to 15 years.

The association determined the odds of preventing prostate cancer death with a PSA (prostate specific antigen) blood test for men ages 55-69 amounted to one life spared for every 1,000 men screened over a decade.

This is on the heels of the U.S. Preventive Services Task Force statement last May, saying that more harm than good was being done to men who underwent screening, biopsy and surgical removal of their prostate gland.

The vast majority of prostate cancers are so slow-growing that they will never cause a problem. And the impotence and incontinence that can result when the sensitive nerves surrounding the prostate are damaged or severed during surgery can be devastating.

“The problem is, most men who test positive, even if the risk is one in 1,000 of dying of prostate cancer, still just want to get it out of there,” Walser said. “You never know if you are going to be that one.”

For those patients whose prostate cancer is large, aggressive or has spread outside of the pelvis, ablation therapy might not be the answer.

In those cases, UTMB’s department of urology offers a range of minimally invasive surgical options, including advanced robotically assisted laparoscopic prostate removal.

In addition, UTMB’s department of radiation oncology has numerous methods to treat prostate cancer with focused radiation therapy.

However, for those who want the nonsurgical option, the technology has improved significantly in recent years. In the past, there was no way for doctors to remove prostate cancer without removing the whole prostate gland because the imaging technology was not powerful enough to illuminate the cancer and the laser ablation technology was not focused enough to remove the cancer without damaging surrounding tissue. That’s not the case now.

“Our approach pairs the most advanced MRI imaging to identify cancer-suspicious areas in the prostate and the most advanced laser technology to remove them, with virtually no risk of impotence or incontinence,” said Walser, who has been performing this procedure for three years.

Clinical trials of Walser’s new MRI-guided ablation procedure show that it is safe and effective, with new clinical results just published online in the journal Radiology and an ongoing study being conducted at the University of Chicago’s Pritzker School of Medicine.