Dr. Herb Riemenschneider is a board certified urologist treating patients in Columbus, Ohio. He is the HIFU Program Director at Riverside Urology and has personally seen hundreds of men conquer their battle with prostate cancer.
Below, we put the spotlight on Dr. Riemenschneider and learn more about his expertise in choosing specific treatment plans for his patients diagnosed with prostate cancer.
- What was your main motivation in becoming a doctor? When did you decide on this path?
I came from a medical family, physicians and dentists. In that process, I became interested in anatomy, and that ultimately led to my becoming an M.D. and urologist.
- How did you decide on your particular specialty? Why urology?
Originally I chose a general surgery specialty, but I became interested in urology when I realized I had the technical skills to make a contribution. My diagnostic skills came naturally.
- What is your favorite part about being a physician?
The patient-physician relationship. Medicine is an evolving field and I have been in the forefront of the development of urology.
- When did you first learn about HIFU as a treatment for prostate cancer?
I learned about HIFU as I started to realize that whole gland therapy was not right for everyone. I became knowledgeable about cryoablation, and learned about HIFU, which was reported to be precise and allow less damage to surrounding tissue allowing patients to maintain important functions. This was in 2009 in Atlanta at the annual meeting of the AUA where I met Dr. Mark Emberton who was about to speak. I kept track of his belongings while he made a necessary call and we have been friends ever since.
- When did you become involved in treating patients using HIFU technology?
I became involved treating patients in late 2013.
- Why did you initially become interested in HIFU as a treatment for prostate cancer?
I became interested in HIFU from my prior experience with cryosurgical ablation, and my understanding that HIFU was more precise and that it had decided benefits.
- What do you tell a patient when they are first diagnosed with cancer?
The cancer usually appears in abnormal lab tests. We repeat the tests, take a careful history, and understand the stage and grade of the disease. If appropriate, and the patient is motivated to receive precise therapy and preservation of function, we will move toward HIFU. In some cases my opinion is more appropriate and of course, radical prostatectomy is available.
- What different types of treatments do you offer men with localized prostate cancer?
Radical surgery, cryoablation, HIFU, and most commonly in recent times based on individual patients, active surveillance. The big benefit of course with HIFU is the ability to eliminate complications of patient prostate cancers with appropriate selection and preserved functions.
- How do you decide if HIFU is right for a patient?
I understand the disease, understand the patient, explain the advantages and risks, and if the patient can afford the treatment, in other words, pay for the precision that is available, we will then use HIFU.
- In general, how quickly do your patients recover after HIFU?
Most, but not all, patients are back at their job within a week. Many times, they’re having dinner at a restaurant the night of treatment.
- There are obviously a lot of different treatments for prostate cancer; where do you think HIFU best fits in the prostate cancer landscape?
I believe that HIFU is the best treatment option for a patient with an early diagnosis, small volume size prostate with Gleason score 6-7-8 range, particularly if the disease is modest.
- 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 PSA is a valuable study, but we have to take into consideration the grade and stage of disease and patient attitudes. Adding MRI to this process makes the equation relatively easy. If volume is modest, and greatest not higher than 8, and the patient is interested in preservation of function, we have an answer that does not represent overtreatment.
- When not practicing medicine, what do you like to do?
I enjoy running, photography, being a part of my grandchildren’s lives, writing and researching ideas, understanding business and finance, and going back my fundamental interest in biology.