Minimally invasive diagnostic investigation complements atraumatic prostate therapy / Heidelberg clinic largely foregoes problematic biopsies / low-risk and accurate diagnosis of prostate cancer
HEIDELBERG, Germany, August 08, 2011
The Heidelberg Clinic for Prostate Therapy is the only clinic in all of Germany that specialises exclusively in atraumatic prostate treatment methods. With new, more accurate forms of diagnosis, by which the risk of cell and bacteria seeding in the body is minimised, urologists Dr. Thomas Dill and Dr. Martin Löhr made another great stride towards a comprehensive and atraumatic prostate treatment.
A patient is diagnosed with cancer every minute in Germany. There are 436,000 new cases and 208,000 deaths every year in Germany. With nearly 60,000 cases, the most common cancer in men is prostate cancer (PCa). For men over age 45, doctors recommend receiving an annual physical with tactile examination of the prostate, a urine analysis, a sonography of the bladder and kidneys, as well as determination of the PSA value. PSA stands for "prostate specific antigen" and has become the most important identifier in urology. An elevated PSA value can be, but is not necessarily, a sign of a prostate tumour. For this reason, an even slightly elevated PSA value will often prompt a prostate biopsy of the rectum.
However, the accuracy of the ultrasound-guided prostate biopsy of the rectum is relatively low and is also associated with significant risks. Often three or more procedures, for each of which up to 30 samples are taken from the prostate, are necessary to diagnose prostate cancer. These procedures can lead to bacterial influx in the bloodstream, which can also cause life-threatening blood poisoning (septicaemia). There is also the risk of cell seeding. This clinic for prostate therapy uses special non-invasive investigative methods, which make a prostate biopsy unnecessary in many cases. In doing so, the negative effects of a biopsy can be avoided on the one hand, and false negative results can be avoided on the other.
Using the most modern laboratory methods, tumour activity in the blood can be detected from a simple blood sample. Statements regarding treatment options can be made in advance from the thus determined tumour status. Furthermore, with the help of special urine analysis, certain gene sequences in prostate cells can be detected that are typical for cancer. A high-resolution magnetic resonance imaging (MRI) of the prostate can also accurately locate small prostate carcinomas to enable a precise treatment, in which healthy prostate tissue can be preserved. The best-proven technology at the Heidelberg Clinic for Prostate Therapy is the ultrasound elastography, which is an ultra-modern diagnostic procedure for prostate cancer. If the diagnosis of prostate cancer is made, this can be gently treated using the method of high-intensity ultrasound (HIFU) without invasive surgery. The method has a high chance of recovery.
Founded nearly twenty years ago by the urologist Dr. Joachim-Ernst Deuster, the clinic for prostate therapy has been passed on to the two urologists Dr. Thomas Dill and Dr. Martin Löhr.
Focussed ultrasound
(HIFU) recognised in Europe as a therapy for prostate carcinoma
(PCa):
The Heidelberg-based
Clinic for Prostate Therapy places its confidence in a gentle
form of cancer treatment
HEIDELBERG
(3 MARCH 2010) - In Germany the Heidelberg-based Clinic for Prostate
Therapy counts as a pioneer when it comes to introducing new,
gentle methods for the treatment of prostate disorders. For over
eight years now, the team of urologists headed by Dr. med. Joachim-Ernst
Deuster have been treating carcinomas of the prostate with high-focussed
ultrasound (HIFU), a procedure that meanwhile has been recognised
throughout Europe as a promising form of therapy.
Cancer of
the prostate is the most common form of cancer in men. Each year,
some 40,000 men are diagnosed as having a malignant enlargement
of the prostate gland. Conventional forms of therapy that are
offered include radical surgery, radiation therapy - in some cases
involving implanted seeds -, and therapy with hormones. Radical
surgery is generally associated with considerable side-effects,
the most common ones being incontinence and impotence.
Now, however, the Sonablate 500 system, an ultrasound device manufactured
by the American Focus Surgery company, has made it possible to
perform therapy within a very short time of treatment, which furthermore
goes easy on the patient's general well-being and is virtually
free from side-effects.
Abroad, too, experts have recognised the advantages offered by
the noninvasive and gentle treatment of PCa by means of ultrasound:
the French Urology Society (AFU), for instance, has just recently
issued recommendation guidelines for the treatment of uro-oncological
disorders. After a systematic evaluation of the available literature,
the HIFU method is now recommended as the primary form of therapy
of prostate carcinoma in patients over 70 years of age and with
a remaining life expectancy of at least seven years, as well as
for younger patients with a comparable morbidity or with a tumour
stage of T1 to T2. The Gleason score should be at most 7, and
the PSA value should be lower than 15 ng/ml. HIFU is meanwhile
also a standard therapeutical procedure in England and Italy.
"Depending on the individual patient's diagnosis, it may
be appropriate to treat the prostate by laser three to four weeks
before the HIFU procedure as a measure to reduce the volume of
the prostate and to prevent urine retention", adds Dr. Thomas
Dill, co-director of the Heidelberg-based Clinic for Prostate
Therapy.
In the HIFU therapy method, an ultrasound probe is inserted into
the rectum of the lightly anaesthetised patient; this probe then
emits ultrasonic waves of four megahertz in an impulse-like manner.
This ultrasound penetrates the surrounding tissue without causing
any injury whatsoever. Since several ultrasound waves are emitted
at one and the same time to converge on a focal point much in
the same way as light is focussed by a concave mirror, the result
is that the local tissue is heated to as high a temperature as
100° Celsius. The tumour tissue is destroyed. Controlled by
a computer, the focal point of the ultrasound waves then travels
through the entire cancer tumor.
This form of therapy lasts just a few hours, and the patient can
leave the clinic after just a short stay, usually on the day after
the procedure. "The great advantage of our method of treatment
is that most patients retain their sexual potency", reports
Dr. med. Joachim-Ernst Deuster, HIFU pioneer in Germany and founder
of the special clinic in Heidelberg, who goes on to say that over
500 PCa patients have been treated with the HIFU method and the
Sonablate 500 system since August 2002.
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Clinic contact data:
Klinik für
Prostata-Therapie GmbH im :medZ
Bergheimer Straße 56a
D-69115 Heidelberg, Germany
Phone (+49) (0)6221 / 65085-0
Fax (+49) (0)6221 / 65085-11
E-mail: info@prostata-therapie.de
Internet: www.prostata-therapie.de / www.prostate-therapy.eu
Heidelberg-based
Clinic for Prostate Therapy extends its range of therapy options:
Pelvic-floor
therapy with magnetic field stimulation / Extracorporeal Magnetic
Innervation (ExMI) stimulates nerves and muscles / Men and women
benefit from NeoControl therapy in fighting incontinence
HEIDELBERG ( 9 FEBRUARY 2010) - For over 15 years
now, the Heidelberg-based Klinik Clinic for Prostate Therapy in
the Heidelberg-Bergheim Medical Centre (:medZ) has been specialised
in providing gentle diagnostic and therapeutic procedures for
the treatment of prostate disorders. A recent addition to the
spectrum of therapy has been made, namely the so-called extracorporeal
magnetic innervation method (ExMI). This procedure is used to
manage disorders in the region of the pelvic floor and specifically
to treat forms of muscular weakness that may result in incontinence
and sexual dysfunctions.
The director of the clinic, Dr. Joachim-Ernst Deuster, counts
as a pioneer in the area of gentle prostate diagnosis, and names
the most important advantages of this method: "The patient
simply sits comfortably in a sort of armchair, wearing his or
her normal clothes, and is treated with magnetic impulses transmitted
through the seat of the chair ". The only sensation felt
by the patient is a slight, rhythmic tingling in the pelvic region
- a sign that the nerves are absorbing the electromagnetic impulses
and reacting by stimulating mild contractions of the muscles.
"This results in a passive exercising effect in the pelvic
floor", explains urologist Dr. Thomas Dill, co-director of
the Clinic for Prostate Therapy. The muscles are strengthened
and their function is gradually restored on a session-by-session
basis.
The treatment
generally lasts just a few weeks, with two to three sessions each
week. Each session lasts about 30 minutes, including a ten-minute
break. The therapy can be enhanced by concurrent conventional
physiotherapeutic training of the pelvic floor.
This method is also an effective form of treatment of urinary
and faecal incontinence as well as of a series of sexual dysfunctions
with their origins in disorders affecting the pelvic floor. Since
this may also be a major problem for women, for instance those
who suffer from urinary incontinence after pregnancy, the Clinic
for Prostate Therapy is also becoming an interesting address for
female patients.
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Clinic contact data:
Klinik für
Prostata-Therapie GmbH im :medZ
Bergheimer Straße 56a
D-69115 Heidelberg, Germany
Phone (+49) (0)6221 / 65085-0
Fax (+49) (0)6221 / 65085-11
E-mail: info@prostata-therapie.de
Internet: www.prostata-therapie.de / www.prostate-therapy.eu
Heidelberg Working
Group for biopsy-free diagnosis established:
Decreasing
the risks of prostate diagnosis
Punch biopsies associated with a high risk / New task force
established as an interdisciplinary podium / Network of German
specialists in Heidelberg
HEIDELBERG
( 6 MAY 2009) - Last week saw the foundation of a working group
in Heidelberg by renowned experts from the field of urology and
diagnostics, whose aim is to network various medical specialties
in promoting the development of new methods and the exchange of
experiences in the biopsy-free diagnosis of prostate disorders.
Prostate carcinoma (PCa) is a malignant form of cancer occurring
in the glandular tissue of the prostate. In Germany, nearly three
of every one hundred men die of prostate cancer. The early diagnosis
of the disease reduces the risk of dying of such a tumour. As
a measure to gain conclusive proof as to whether the prostate
has been afflicted by a carcinoma, as a rule blood investigations
are performed and the area is screened ultrasonically, after which
a biopsy specimen is taken. This involves the invasive removal
of tissue; while it is a standard procedure, it is nevertheless
subject to controversial medical debate. In many cases three or
even more punch biopsy specimens, selected from as many as 30
specimens punched from the prostate, are necessary to securely
diagnose prostate carcinoma. "This may lead to the influx
of bacteria into the bloodstream, which in worst-case circumstances
can result in life-endangering septicaemia", Dr. Joachim-Ernst
Deuster, the Heidelberg-based urologist, warns. "And if the
biopsy needle hits a prostate carcinoma, this bears the risk of
spreading tumour cells in the body. What's more, so-called cytokines
may be released that are capable of enhancing the growth and metastasis
of the prostate carcinoma." The urologist is director of
the private Clinic for Prostate Therapy and has specialised in
the gentle treatment of prostate disorders.
"Gentle treatment of the prostate should also be accompanied
by just-as-gentle diagnostic procedures", says Deuster. He
sees an enormous deficit of information in the branch. For this
reason, in Heidelberg last week he established the "Arbeitskreis
biopsiefreie Diagnostik" (Biopsy-free Diagnosis Working Group),
that was attended by renowned experts from the areas of cytodiagnosis,
molecular pathology, and magnetic resonance spectroscopy from
throughout Germany. Together with experts from the area of laboratory
medicine, they discussed the options available to reduce the risks
associated with biopsy-taking procedures - for example by using
entirely new and promising methods. These include so-called real-time
choline PET/CT (choline positron-emission tomography / computer
tomography) of the prostate - a novel, combined imaging method
made possible by nuclear medicine - and MR spectroscopy.
"Our wish is to offer experienced practising specialists
an informational podium", is how Dr. Joachim-Ernst Deuster
explains one of his major aims. "By creating a closely meshed
network, urologists and specialists from the cytoanalysis field
and in the proven imaging techniques, such as computer tomography,
want to join forces to identify ways to improve the accuracy in
diagnosing prostate carcinomas or, as the case may be, of being
able to exclude a carcinoma with a high degree of probability",
adds Dr. Thomas Dill, a urologist from Heidelberg. The principal
aim is centred on the ability to avoid having to take biopsy specimens
wherever possible as a measure to minimise the risk for the patient.
The Working Group will be meeting regularly in the future, and
warmly invites specialists from other areas to take part.
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Clinic contact data:
Klinik für
Prostata-Therapie GmbH im :medZ
Bergheimer Straße 56a
D-69115 Heidelberg, Germany
Phone (+49) (0)6221 / 65085-0
Fax (+49) (0)6221 / 65085-11
E-mail: info@prostata-therapie.de
Internet: www.prostata-therapie.de / www.prostate-therapy.eu
Gentle diagnostic
method may replace prostate biopsy in future:
Clinic
for Prostate Therapy puts its trust in real-time elastography
HEIDELBERG (22 DECEMBER 2008 ) - For over 15 years now, the
Heidelberg-based Klinik Clinic for Prostate Therapy has been specialised
in providing gentle therapeutic procedures for the treatment of
prostate disorders. Now, following the launch of the treatment
of prostate carcinoma by ultrasound using the HIFU method and
the so-called greenlight power-laser radiation of the benign variant
of tumours, the gentle diagnostic method of real-time elastography
is being added to the spectrum of methods for the therapy of prostate
cancer.
In Germany, the urologist Dr. Joachim-Ernst-Deuster counts as
a pioneer in the area of gentle prostate diagnosis and therapy.
Regarding the malignant growth of the gland - prostate carcinoma
- Deuster was the first expert in Germany to place his trust in
the use of high-focussed ultrasound according to the HIFU principle.
Here the prostate is treated with ultrasound waves emitted by
a probe inserted into the patient's rectum; these waves targetedly
heat and hence destroy the tumour tissue. "But gentle therapy
of the prostate should also involve just-as-gentle diagnostic
procedures", says the Heidelberg-based urologist. While generally
a tissue specimen is taken from the prostate for diagnosis - urologists
here speak of a biopsy - tumour cells can also be detected in
the patient's blood. What's more: ultrasound can be used to define
the region of the tumour entirely noninvasively and without having
to take any tissue specimens, since these regions are harder and
denser than the surrounding, healthy tissue. In this method, the
urologist inserts a special probe into the patient's rectum and
in doing so exerts a slight manual pressure on the prostate. Slight
compression and decompression and the parallel sonication with
ultrasound yields a specific echo pattern, in which the tumour
shows up as a dark or dark-blue area. "We were the very first
in this metropolitan region to use the promising method of real-time
elastography in the urology field", Dr. Joachim-Ernst Deuster
explains, going on to state that more than 300 patients have been
successfully treated with the Hitachi system at the Clinic for
Prostate Therapy since last February. The device computes the
relative elasticity of the tissue and superimposes this information
on the conventional ultrasonic image as a coloured mask. Rigid
structures such as tumour areas show up blue, while the more elastic,
healthy structures show up red.
In cases where the elastographic finding is remarkable and the
blood investigations indicate that further examinations are necessary,
Deuster cooperates closely with radiological institutes in Stuttgart
and Offenbach to have the prostates subjected to further diagnostic
procedures there by means of magnetic resonance spectroscopy (MR
spectroscopy ). The initial results, says Dr. Thomas Dill of the
Prostate Clinic of the recently opened Heidelberg-Bergheim Medical
Centre, show a good agreement of the findings yielded by elastography
with the MR results. It will probably not be all that long, he
says, until the unpleasant and in many cases high-risk procedure
of biopsy taking can be dispensed with altogether.
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of charge. Please send a proof copy.
Clinic contact data:
Klinik für
Prostata-Therapie GmbH im :medZ
Bergheimer Straße 56a
D-69115 Heidelberg, Germany
Phone (+49) (0)6221 / 65085-0
Fax (+49) (0)6221 / 65085-11
E-mail: info@prostata-therapie.de
Internet: www.prostata-therapie.de / www.prostate-therapy.eu
