Dr. David Konstandt of Carolina Urology Partners near Charlotte, North Carolina has been practicing HIFU since 2007. He is a urologist who loves developing relationships with his patients and helping them maintain a high quality of life.
1. What was your main motivation in becoming a doctor? When did you decide on this path?
My main motivation for becoming a physician was my love for problem solving and my passion for working intimately with people. I found this desire during my grade school years and realized medicine was the only avenue that would help me fulfill my dreams.
2. How did you decide on your particular specialty? Why urology?
I chose urology for 2 main reasons, the ability to have long term relationships with people while still allowing me to work with my hands in a surgical subspecialty.
3. What is your favorite part about being a physician?
My favorite part about being a physician is hearing from satisfied patients who may either be cured from cancer or have their quality of life improved from urological initiatives.
4. When did you first learn about HIFU as a treatment for prostate cancer?
I first learned of HIFU around 2007.
5. When did you become involved in treating patients using HIFU technology?
I first began implementing HIFU into my armamentarium for treating prostate cancer around 2007-2008.
6. Why did you initially become interested in HIFU as a treatment for prostate cancer?I initially became intrigued by HIFU as a treatment alternative due to its highly curative probability while minimizing collateral damage often plaguing other prostate cancer treatment modalities.
7. What do you typically tell a patient when they are first diagnosed with prostate cancer?
When a patient is initially diagnosed with prostate cancer I spend 60-plus minutes outlining the specifics of their disease, reviewing relevant treatment options, and then comparing and contrasting the potential cure rates and risk profiles. Each conversation is tailored to the individual and their pathology.
8. What different types of treatments do you offer men with localized prostate cancer?
My consultation for localized prostate cancer is a thorough and exhaustive review of all relevant and accepted treatment options including active surveillance, proton beam, cryosurgery, brachytherapy, external beam radiation, robotic and open surgical extirpation, and of course HIFU.
9. In your professional opinion, what are the benefits of HIFU as a treatment for prostate cancer?
HIFU offers patients the desired risk/benefit ratio of outstanding cancer cure rates while minimizing the risks and debilitating side effects often associated with other prostate cancer treatments. In addition, unlike other treatments, if HIFU should not be completely successful it is the only option that can be repeated and does not eliminate other treatment modalities.
10. How do you decide if HIFU is right for a patient?
My HIFU patients usually decide for themselves if HIFU is right for them. I do not mention it as a potential treatment for their disease if it is not appropriate, so the decision usually is patient driven. Most people appreciate the ability to choose for themselves and I am not a physician who dictates which path they should pursue, all factors being equal.
11. In general, how quickly do your patients recover after HIFU? What do you tell men to expect?
HIFU has very minimal to none recovery time. I tell my men to minimize activity for about a week, but other than that I do not place any specific limitations on their lifestyle.
12. 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 best for patients who have low to intermediate grade prostate cancer and early stage disease. It is usually most appealing to men with these disease characteristics who prioritize sexual and urinary function.
13. 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 follow my governing society, the AUA, guidelines in screening and treating prostate cancer. I firmly believe this can avoid over and under treatment and recognition of prostate cancer. Informed shared consent with patients is vitally important during the diagnostic and treatment phases of the disease in order to accomplish these goals.