On Oct. 9, the U.S. Food and Drug Administration approved a new treatment for prostate cancer, but doctors have been performing the same procedure, called High Intensity Focused Ultrasound, in the Cayman Islands since the beginning of this year.
Dr. George Suarez and Dr. Stephen Scionti, who are both licensed to practice medicine in the U.S. and in the Cayman Islands, have been treating overseas patients with the non-invasive prostate cancer treatment since January 2015 at the Chrissie Tomlinson Memorial Hospital.
Recently, the doctors say, they performed the HIFU treatment on a Caymanian patient for the first time. Dr. Suarez said he has met several Caymanians with prostate cancer who have had to have surgery or radiation treatment in the U.S., which can be costly and time-consuming, and often requires patients to be away from their support system while they undergo treatment.
High Intensity Focused Ultrasound is a non-invasive treatment option for prostate cancer. It destroys cancerous tissue by using sound waves to heat up the tissue at a focal point.
Dr. Suarez compares the process to starting a fire with a magnifying glass. Just as a sunbeam can be focused to direct heat and start a fire at a specific spot, the sound waves can be focused so that nothing outside of the treatment area is affected.
“HIFU does not emit energy beyond that treatment zone,” Dr. Suarez said. “That’s very important because it means that this is very precise and it’s impossible to hurt surrounding tissue.
“The goal of treating any cancer is treating unhealthy tissue but not [hurting] the surrounding tissue, and that’s what we’ve been able to do with HIFU,” he added.
Another benefit of HIFU compared to traditional treatment options like surgery, radiation, or chemotherapy, is that it is fast, he said. It is a one-time, outpatient procedure that takes, on average, two hours to complete. Comparatively, radiation therapy lasts for six weeks.
Patients treated with HIFU go home on the same day as the procedure, and, according to Dr. Suarez, most patients return to their normal activities the same day.
Dr. Suarez said that HIFU is as effective as other standard therapies, with the added benefit of causing fewer side effects.
He said that surgery and radiation have a 60 to 80 percent chance of leaving men impotent and a 10 to 20 percent chance of leaving men incontinent. He said, based on cases he has seen, HIFU has a 2 percent chance of causing impotence and a 4 percent chance of causing incontinence.
“Every potential complication is decreased by a very large percentage,” Dr. Suarez said. “Given all the information and all the alternatives, I think that most men that have done their research will find that this prostate cancer treatment is the way to go.”
HIFU has been approved in Europe since 1996, and more than 50,000 patients have received the treatment to date. The U.S. Food and Drug Administration was hesitant to approve the technology, indicating that data about its efficacy was incomplete, but has now cleared the treatment for use in the U.S.
Prostate cancer is the next most common cancer to affect men after skin cancer. It is more common in men with African ancestry, with an average onset age of 10 years earlier than in white or Asian men.
It is currently impossible to know how many men in the Cayman Islands have been diagnosed with prostate cancer, as there is no national cancer registry, but according to Cayman Islands Cancer Society operations manager Jennifer Weber, there has been a “dramatic” increase over the last few years in the number of men being diagnosed with prostate cancer in the Cayman Islands. That does not necessarily mean that prostate cancer is becoming more common, just that more men are now getting tested for it.
“We can contribute that to our community awareness efforts, to get men to turn up to learn more about their health and the number of PSA [Prostate-Specific Antigen] vouchers that we have been giving out,” Ms. Weber said.
Prostate cancer is very treatable, and the prognosis is especially good if it is caught early, doctors say.
“Sadly, by the time men come to us, it’s often at a later stage,” Ms. Weber said. “Early detection is key and so if it’s there, we want to catch it, get it treated, and let people go on with their lives.”
On Nov. 13, the public is invited to attend a health information night at the Lions Community Centre where men can learn more about men’s cancers and receive a free PSA test, which involves a simple blood draw that is then sent to a lab for analysis.
The event is part of “Movember,” an annual event which involves growing mustaches during the month of November to raise awareness for men’s health issues, including prostate cancer.