Guest: Dr. Dan Sperling
Presenter: Neal Howard
Guest Bio: Dan Sperling, MD, DABR, is the Medical Director of the Sperling Prostate Center and the Sperling Diagnostic Center based in Florida and New York. He is certified as a radiologist by the American Board of Radiology, and licensed in New York, New Jersey and Florida, and co-author of the new patient book Redefining Prostate Cancer.
Segment overview: Dr. Dan Sperling, Medical Director of the Sperling Prostate Center discusses Focal Laser Ablation (FLA) using the BlueLaser™ protocol for the treatment of prostate cancer.
Health Professional Radio – Focal Laser Ablation
Neal Howard: Hello and welcome to Health Professional Radio, I’m your host Neal Howard. Thank you for joining us today. Our guest in studio is Dr. Dan Sperling, Medical Director of the Sperling Prostate Center and he’s here today to discuss focal laser ablation using the Blue Laser Protocol for the treatment of prostate cancer. Welcome to the program Dr. Sperling.
Dr. Dan Sperling: Thank you very much Neal, it’s a pleasure to be here today.
N: Thank you. Medical Director of the Sperling Prostate Center, how long has it been in existence?
S: So we’ve been in existence since 2009. I had gone into Europe to learn about some of the basic technology and we’ve continued to grow and evolve to not just diagnosing prostate tumors with MRI and biopsy but to doing treatment as well.
N: Now are you talking all types of treatment?
N: So we’re actually working on mostly right now with prostate cancer, we’re going into other areas. We specialize in treatment done inside the MRI machine which means the nice thing about an MRI is when you’re doing treatment particularly with laser which I use to treat prostate tumors and without causing erectile dysfunction or incontinence, it’s a very safe procedure. We do that inside the MRI so we can actually measure temperature change in real time, it’s called MRI Thermometry. So treatments in the MRI, the beauty of it is you can really gauge and protect sensitive structures and we’re starting to apply it to other organ systems as well and different devices, this MRI Thermometry technology.
N: You mentioned some erectile dysfunction and possibly incontinence issues, is this something that is common with current technology that’s in use for detecting prostate cancer?
N: Yes. Unfortunately most men who undergo surgery, radical prostatectomy, other done with the robotic da Vinci device, or done with the open suffer some degree of incontinence and significant erectile dysfunction. And then people who undergo radiation whether it be proton beam, cyber-knife or many different types of radiation, most of those patients also suffer from erectile dysfunction and incontinence. In addition men undergoing radiation may suffer from secondary cancers caused by the radiation of the rectum and bladder later in their lives.
N: I’m assuming that maybe those are some of the reasons that PSA has come under fire.
N: Yes, because what’s happening is men are being diagnosed with these less evolved technologies to finding lower grade cancers that really can be followed or treated with less aggressive therapies and are taking this sledge-hammer approach is really doing a lot of damage to the quality of men’s lives, having radical impact on them. The nice thing about the focal laser ablation is we’ve never had a case of someone developed an erectile dysfunction or incontinence, it’s very safe, it takes about an hour and a half to do and people can go home the same day and go about and maintain their quality of life.
N: Now is this a service that is unique to the Sperling Prostate Center?
N: So I’ve done the most of these procedures in the world. There some other sites that started after me, they were just a handful of them mostly doing clinical trials and also investigating different versions of this but it is exciting and it is a very promising new technology and replacement of actually for the more aggressive therapies here have been or still wildly used today unfortunately.
N: Now you mentioned being able to detect conditions that can simply be monitored and avoiding that as you say sledgehammer approach. Are you finding that this technique can also prevent the misdiagnosis in the first place in addition to the over treatment or unnecessary treatment?
S: Yes. Using our Blue Laser approach, we can help people decide whether or not they should pursuit treatment to telling them if they have a tumor, how accurately how aggressive the tumor is and then helping to pick out the best type of treatment. Now if they wanted to go on to surgery or radiation, still you have your MRI still has a lot of utility for that to improve nerve sparring, to do a better surgery, to do a better radiation by utilizing the MRI. And then ideally if they’re a candidate for something like focal laser ablation we can eradicate their tumor to accurately see where it is, do it all inside the MRI and destroy with the laser fiber and maintain afterwards the quality of life. And their erections will be intact, they won’t have any trouble with urination, in fact we’re also using it for men who just have enlarged prostates and problems with urinating, we’re able to use laser to help those men urinate normally, yeah.
N: What type of I guess of evaluation process is in place to determine whether or not the treatment was successful in both the short and the long term?
S: So what we do is we do our procedure of the laser, we ablate or heat up the tumor cells until they’re destroyed and we can see these all visually with the MRI. While the patient is still in the MRI exam we inject a specialized contrast medium and that we look for vascularity or blood flow. If there’s no more blood flow to the area that we treated we can confirm that we’re successful. Of course we do careful follow ups that’s usually 3-6 months, we look at the PSA and we do another MRI, we make sure that there’s no residual tumor tissue at that time but actually immediately after the procedure’s completed we can have a very good idea if we’ve been successful.
N: And as far as being a cost-effective procedure, do you find any significant savings in doing this procedure as opposed to the old methodology?
S: Yeah, I mean if you look at surgery and radiation they’re extremely costly procedures to the health care system. The devices for proton beam therapy and millions of dollars, eventually robot radical prostatectomy also millions of dollars of cost, operative costs, personnel costs are very, very high and the problem with those treatments is about morbidity that there’s a very high risk for side effects and then we have to treat the side effects and that’s a real burden on the health care system. Here we have a treatment that’s not as expensive, it’s done inside the MRI, they can do it in their out-patient center, you want to do it in a hospital. I use just local anesthetic so you don’t have to put the patient under general anesthesia and they don’t suffer all those side effects and then they need to follow up treatment so it’s for their health care system it’s a no-brainer. It really can benefit from a dollar standpoint.
N: Let’s talk about some of the psychological aspects as it pertains to the patient. You’ve talked about counseling with them in several short and long sessions. When it comes to the education of the patient of this new technology, do you find an immediate level of trust and understanding? Or do you find that it’s sometimes a challenge getting someone who may have been misdiagnosed and going through some problems once they do find your door to be completely jump on board with this new technology?
S: Yeah, look when a person’s first diagnosed with cancer, any type of cancer including prostate cancer it’s a very, very scary time for them. They are in tremendous amount of stress and then prostate cancer in particular has a tremendous amount of information out there and available treatments that are aggressively marketed by these very big companies and people get very, very scared and are afraid of course of losing their ability to be intimate with their loved ones. And it’s a scary time so I’m able to sit down with them and show them real very, very good avenues they can take to maintain their quality of life keep their life as it was, be able to have sexual, maintain sexual activity and maintain their integrity in terms of not feeling concerned about losing their control of their urine flow, these are all major concerns and really just talking to them and listening to them is one of the things I really do to which is very stressful time and they end up walking away from there relaxed and comforted and knowing that there’s a lot of hope and there’s a lot of good options for them out there including what we do and some other people that I worked with as well.
N: And where can our listeners go and get some information about the Sperling Prostate Center?
S: I encourage them to go to www.sperlingprostatecenter.com we’ve got hundreds of articles on there that are written and many other resources as well and really it’s a wealth of information and we should be very helpful for most people looking into this.
N: You’ve been listening to Health Professional Radio, I’m your host Neal Howard in studio with Dr. Dan Sperling, Medical Director of the Sperling Prostate Center in studio discussing focal laser ablation using the Blue Laser Protocol for treatment of prostate cancer. It’s been great having you here with us today Dan.
S: Thank you very much Neal, very happy to be here. Thank you.
N: Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to this podcast on iTunes.