Meet Frank Tortora, MD, a board certified urologist treating patients near Raleigh, NC. He is sought after nationally by developers of new urological techniques and treatments and is considered an expert for panel discussion in his field.
Learn more as we put the spotlight on him and his experience with HIFU and other minimally invasive treatments.
1.What was your main motivation in becoming a doctor? When did you decide on this path?
I was involved in genetic research at Yale University. My Dad was a Urologist in New Haven. Seeing him everyday enjoy his work and witnessing him make a difference in people’s lives influenced me to change course.
2. How did you decide on your particular specialty? Why urology?
Urology is the only field of medicine that deals with men, women and children. It incorporates interesting surgery, endocrinology, nephrology, oncology and infectious disease. You can do all these things for both the genital and urologic systems.
3. What is your favorite part about being a physician?
Being allowed to enter people’s lives, understand them and attempt to be a force for good.
4. When did you first learn about HIFU as a treatment for prostate cancer?
About ten years ago. I was the innovator in my area. The first to introduce Dr. Walsh’s nerve-sparing retropubic prostatectomy, the first to perform brachytherapy and the first to do robotic prostatectomies in our area with the DaVinci Robot.
5. When did you become involved in treating patients using HIFU technology?
I first became involved about 8 years ago observing cases in Cancun.
6. What do you typically tell a patient when they are first diagnosed with prostate cancer?
I tell them there is a spectrum to the disease. Not all prostate cancer is lethal but not all prostate cancer is a slow actor either. The treatment is extremely individual depending on the person and the type and extent of disease he has.
7. What different types of treatments do you offer men with localized prostate cancer?
Active surveillance, robotic prostatectomy, brachytherapy, IMRT radiation and HIFU.
8. In your professional opinion, what are the benefits of HIFU as a treatment for prostate cancer?
As I see it, there are two major advantages to the HIFU treatment for prostate cancer: 1. Minimal change to a person’s lifestyle; i.e. very little erectile dysfunction and no urinary incontinence and 2. It leaves all options on the table if recurrence should occur.
9. How do you decide if HIFU is right for a patient?
There are three things I look at to determine if a patient qualifies for HIFU. The first thing I determine is if the cancer is localized to the prostate gland. Next, I look at the Gleason score; to make sure it is less than grade 8. Finally, I look at the size the prostate to verify if it is small enough (under 45 grams) to be effectively treated with HIFU.
10. In general, how quickly do your patients recover after HIFU? What do you tell men to expect?
Have it on Friday go to work Monday.
11. There are obviously a lot of different treatments for prostate cancer; where do you think HIFU best fits in the prostate cancer landscape?
HIFU is a treatment option that fits best between active surveillance and radical prostatectomy.
12. In recent years there has been some discussion about over treating prostate cancer and even changing guidelines on when men should start getting regular screening for prostate cancer. What do you tell men?
I believe the pendulum has swung excessively in the wrong direction. Reports are now surfacing of an increasing number of men with metastatic disease at diagnosis. One of the conditions, which probably influenced the task force to recommend against PSA screening, was the large number of patients undergoing prostate biopsies. This increased cost as well as led to a certain percentage of adverse reactions in patients. Now we have much more sophisticated means of limiting biopsies with various blood and urine tests as well as minimally altering lifestyle with treatments such as HIFU. I believe the task force’s recommendations are out of date and harmful to patients.
13. When you aren’t practicing medicine what do you like to do?
The number one thing I love to do is be with my family, which includes, 3 children, two little grandchildren, my adorable labs and last but never least, my best friend, my wife. We cook together, go on trips and spend time at the beach and mountains.
Read other Physician Spotlights here!