Prostate Cancer

We work in collaboration with oncologists at the Brown University Health Cancer Institute and its Genitourinary Multidisciplinary Clinic, with the goal of precisely diagnosing and treating prostate, kidney, and bladder cancers as soon as possible.

Expertise with High-Risk Patients

We have extensive experience caring for high-risk prostate cancer patients. High-risk prostate cancer includes men with a Gleason score of 8-10 or PSA greater than 20. These types of aggressive prostate cancers often require multiple modalities of treatment and a team-based approach to treatment. 

Medical Imaging

We utilize various imaging technologies to give you the best care:

• PET scans
• Prostate MRI scans
• High-resolution CT scans
• Ultrasound

Diagnostics

We use diagnostic tests to help identify prostate, kidney, and bladder cancers.

Fluciclovine PET

Fluciclovine PET is an advanced diagnostic imaging agent, or radiotracer, that’s used with a positron emission tomography (PET)/computed tomography (CT) scan for men who have had prior treatment for prostate cancer and now have elevated prostate specific antigen (PSA) levels. 

PSMA PET

PSMA stands for prostate specific membrane antigen, a protein found on the surface of prostate cancer cells. Positron emission tomography (PET) is a type of medical imaging that detects if prostate cancer has spread anywhere in the body. PSMA PET imaging allows for more precise detection of prostate cancer in the body, for better treatment planning, and targeted care. This exam uses a new imaging agent that is far superior to earlier agents to detect prostate cancer that may have spread to other parts of the body.

Transperineal Biopsy

Transperineal biopsy is the gold standard for diagnosing prostate cancer. A transperineal biopsy is a newer approach for detecting prostate cancer that has benefits for both patient and surgeon, the transperineal prostate biopsy targets the perineum, the area between the testicles and anus. It has decreased risk for infection compared to the more traditional prostate biopsy, is a more comfortable procedure for the patient, and is appropriate for men who have an elevated PSA or are at increased risk for prostate cancer.

Fusion MRI

Fusion MRI is one of the newest and most advanced technologies available to diagnose and monitor prostate cancer is the MRI/Ultrasound Fusion-Guided Prostate Biopsy. MRI images of the prostate are fused or blended with real-time ultrasound images using special computer software known as computer-aided detection (CAD). This allows the provider to target the biopsy of the suspicious areas much more accurately than the standard TRUS (transrectal ultrasound) biopsy. This is performed as an outpatient service.

Promaxo

Brown Urology is the first location in the region to offer this revolutionary MRI procedure, available to Minimally Invasive Urology Institute patients. Promaxo is a fast, outpatient procedure that is conveniently quiet, open, and non-invasive. It can precisely target areas of interest, eliminating the need for a transrectal ultrasound, which reduces the risk of infection and ensures more accurate results.

Treatment Options for Prostate Cancer

Our prostate cancer therapies include:

• Robot-assisted laparoscopic radical prostatectomy, using minimally invasive, robot-assisted surgery.
• Robot-assisted laparoscopic pelvic lymph node dissection, in which a pelvic lymph node is removed and sent for pathology analysis.
• Brachytherapy, an internal radiation therapy delivered by implant of small radioactive seeds at the site of the tumor.
• Salvage prostatectomy, a procedure for patients who have previously had radioation therapy.
• The NanoKnife outpatient procedure is a minimally invasive, ablation therapy for prostate cancer that destroys targeted cancerous cells while preserving healthy, non-cancerous areas, providing a fast recovery time, and allowing men to quickly return to their normal activities. Learn more about the NanoKnife outpatient procedure.

For certain patients, additional therapies may also be used.

Minimally Invasive Surgery for Prostate Cancer

At the institute, we use minimally invasive, robot-assisted surgery to treat prostate cancer. The da Vinci Surgical System is a state-of-the-art surgical robot that gives surgeons more precise views of the prostate and surrounding tissue, as well as greater dexterity. Benefits of surgery with the system could include preservation of the nerves located along the prostate. The goal for the nerve-sparing, robotic prostatectomy is to enable the patient to retain sexual function. Additional benefits may include:

• Smaller surgical incisions of one inch or less
• Less intraoperative blood loss and need for blood transfusion
• Reduced postoperative pain and discomfort
• Shorter hospital stay (one day)
• Shorter catheter duration (seven to 10 days)
• Faster overall recovery

With the da Vinci Surgical System the surgeon controls the robot from a remote console that precisely translates hand, wrist and finger movements to the robotic arms that manipulate miniature surgical instruments within the patient. The video screen provides a three-dimensional, magnified view of those movements. Using the robot, the surgeon makes small keyhole openings rather than a single large incision. The surgeon then completes the surgery through the small openings.

What are the differences between Benign Prostatic Hyperplasia (BPH) and Prostate Cancer?