In the last several decades, the diagnosis of prostate cancer has gone from a dreaded disease to one that is better understood and effectively treated. While prostate cancer is the second leading cause of cancer deaths in men in the U.S., the mortality rate has dropped by more than half from 1993 to 2016. This is in large part thanks to a greater medical understanding of the disease, and of course, better treatment options. The result is that the 5-year survival rate for men with local or regional prostate cancer is nearly 100%.
But prostate cancer treatments haven’t always been this promising or useful. In fact, treating prostate cancer effectively is a fairly recent advancement. At HIFU, we use a highly advanced ultrasound process to target harmful tissues and eliminate them. When compared to the treatment options of the past, and even by the standards of today, it’s akin to science fiction. But to have a great appreciation for our work, it’s important to put it into the context of treatment options in the past. Today, let’s explore the history of identifying and treating prostate cancer in men.
The Exploration of Medicine in the Renaissance
The Renaissance was a time of exploration in every sense of the word. As western societies began to shift away from religious thought, they began to investigate problems using an early form of the scientific method.
It was in this context that the researchers first described the symptoms of prostate cancer. Venetian anatomist Niccolo Massa first described the disease in 1536. An early illustration was completed by the Flemish anatomist Andreas Vesalius in 1538. While these early scientists had identified that there was a complication, they didn’t fully understand what it was.
Prostate Research in the 19th Century
Building on earlier research, it wasn’t until the 1850s that scientists first diagnosed prostate cancer. It was in 1853 during a histological examination that J. Adams described the first case of prostate cancer. The surgery was performed at The London Hospital, and Adams reported that it was a “very rare disease.”
Today, we know that prostate cancer is one of the most commonly diagnosed forms of cancer in men, but in the late 19th century, it was considered rare for a variety of reasons. This is due to a misunderstanding of what this form of cancer truly was, and also the generally shorter lifespans of people living then. Many medical professionals at the time did not distinguish prostate cancer from any other form of urinary obstruction. Since the diagnosis of prostate cancer is more likely in men in old age, shorter lifespans meant that fewer men were diagnosed with the disease.
By the 1890s, surgeons and researchers were beginning to try various treatment options for prostate cancer. These surgeries were largely focused on relieving any urinary obstructions, and in some cases, an orchiectomy, or removal of the testes, was used to treat the disease. While these approaches were innovative for their time, their success was fairly limited.
Medicine in the 20th Century
In the 20th century, the dialogue surrounding prostate cancer, and medicine at large, was rapidly changing. While surgeons in the past had simply removed any masses on the prostate, there was little in the way of guidelines or techniques that were reported to be effective in removing the prostate entirely.
In 1904, Hugh Hampton Young began the process of performing radical perineal prostatectomy. Young, who worked at the John Hopkins Hospital, would pioneer this technique which would quickly become the standard method for prostatectomy for the next several decades.
In addition to surgical interventions, the early 20th century was also remarkable for its early uses of radiation treatments in addressing prostate cancer. In 1913, researchers and specialists began introducing radium sources into the urethra and rectum as a palliative alternative to surgery.
By the 1970s, radiation therapy had become more popular as stronger radiation sources became available. Eventually, external beam radiotherapy became common practice as doctors were able to use precisely focused x-rays.
While radiation therapy was expanding throughout the middle of the 20th century, so too was the option of chemotherapy treatments. Beginning in the 1950s, researchers used alkylating agents, but these tests were not well documented, and the results weren’t terribly useful. In 1972, the National Prostatic Cancer Project began examining the efficacy of chemotherapy in those with prostate cancer. After a three-year randomized study, the NPCP found that chemo could be used to great effect.
Treating Prostate Cancer in the 21st Century
Like all things in medicine, researchers are constantly looking for ways to improve their methods and techniques, finding new ways to treat old conditions that limit their impact on the patient’s quality of life.
Today, those diagnosed with prostate cancer have a variety of treatment options to consider. Based on their diagnosis, stage of cancer, and overall health, an individual might utilize a specific treatment. These treatment options include:
- Active surveillance: For those who have slow-growing cancer, this a way to manage their prostate cancer.
- Surgery: Often, the prostate itself is removed in a process called radical prostatectomy.
- Radiation therapy: Radiation energy is used to shrink or stop the spread and growth of the tumor.
- Cryotherapy: In this treatment option, the harmful tissues are frozen and destroyed.
- Hormone therapy: A systematic therapy option that introduces or removes hormones in order to halt tumor growth.
- HIFU: This is a non-invasive, low-risk surgery that uses ultrasound energy to destroy the harmful tissues. The ultrasound energy is converted into a heat that’s concentrated on specific points in order to destroy the growth or tumor.
As a prostate cancer treatment option, HIFU is one of the most promising out there. The procedure typically takes one to four hours and can be done under general anesthesia, IV sedation, or an epidural. Patients are then placed into recovery at the treatment center for two to four hours and then are released back to their family and caretakers. It’s not uncommon for patients to feel well enough to go for an evening walk the same day of the procedure.
Find a HIFU Doctor Near You
If you’ve been diagnosed with an early stage of prostate cancer, you might be an ideal candidate for a high intensity focused ultrasound treatment. We encourage you to find out more about HIFU, and then find the doctor nearest you who offers this innovative treatment method. HIFU is very excited to have a network of doctors and treatment centers who now offer our cutting-edge service. You can also schedule a phone consultation to find out more.