Prostate cancer is the second-leading cause of U.S. cancer deaths in men, just after lung cancer. According to the American Cancer Society, about one in eight men will be diagnosed with prostate cancer in their lifetime. Because it is a slow-growing cancer that occurs in men as they age, about one in 41 men will die of the disease.
But as advances in diagnosis and treatment have improved in recent years, so too have survival rates, especially at academic medical systems, including UCI Health, ranked No. 24 in the nation for urology by U.S. News & World Report.
David I. Lee, MD, one of the nation’s foremost prostate cancer surgeons, recently joined UCI Health to direct its new Comprehensive Prostate Cancer Program. He is building on the legacy of the UCI Health Center for Urologic Care as a powerhouse of leading-edge prostate cancer care and innovative research.
Lee, who specializes in robot-assisted prostatectomies, describes his vision for the program and what patients need to know about advances in prostate cancer diagnosis, monitoring and treatment.
What are your plans for the Comprehensive Prostate Cancer Program?
My initial focus is to ensure that our multidisciplinary team of urologists, radiation oncologists, medical oncologists and other highly skilled professionals are working together like a fine-tuned machine. Prostate cancer is a disease that requires teamwork. We have one of the most highly skilled, talented teams in the country. That’s not something a lot of other places have.
I also see a lot of opportunities for innovative research and clinical trials that will advance treatment options even further for patients at UCI Health and the nation.
What is new in prostate cancer care?
Imaging and biopsy techniques have improved significantly in recent years. We were among the first to use Artemis, a revolutionary technology that combines 3D imaging, a robot arm and a needle-guidance system to precisely locate and biopsy prostate cancer cells.
We have long been leaders in performing safe and effective robot-assisted prostate surgeries that dramatically improve survival and preserve urinary continence and sexual function.
We also are pioneers in ablative prostate cancer treatments, including cryotherapy to destroy tumor cells by freezing affected tissue with ultracold gas. And we were the first in the nation to use high-intensity focused ultrasound to target and destroy only cancerous tissue, sparing the rest of the prostate gland.
Advances in radiation therapy more accurately target prostate tumors. And new cancer medications that target cancer cells in different ways offer more options to patients with advanced prostate disease.
We’re also smarter about determining who needs definitive therapy and stepping back from overtreating this condition when it’s unnecessary. Instead, we are able to safely monitor many men with active surveillance for a number of years.
What are the advantages of robot-assisted surgery for prostate cancer?
Open prostatectomy has been associated with a long recovery. Reattachment of the bladder and urethra required using a catheter for up to three weeks after open surgery.
Robot-assisted surgery allows us to remove the catheter within six days after surgery. Because the procedure is minimally invasive, there is less blood loss and less pain. In experienced hands, it can also lessen side effects such as loss of urinary control and sexual function.
Over the last few years, about 80% of the patients I treated have gone home the same day. We are now offering the procedure on an outpatient basis to our UCI Health patients.
What areas of research will your team focus on?
For men with high-risk prostate cancer that can recur after surgery, I’m interested in exploring new combinations of therapies to improve survival outcomes. We’re also looking at genomic markers and using that data to better stratify patients by low, medium and high risk. This helps us refine treatment regimens even further for each patient.
What do patients need to know about UCI Health prostate cancer services?
We realize that a diagnosis of prostate cancer is a very scary thing. Most men have not yet experienced any symptoms when they are diagnosed with this disease. They often become even more frightened when they hear that side effects of prostate surgery can include urine leakage and problems with sexual function.
At UCI Health, we meld education about the disease with our depth of experience to help men understand their options. We want our patients to know that we will give them the best possible care designed to meet their individual needs, and that we will see them through each and every step.