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Dayton Physicians Network

Dr, Anderson Attends Ohio Urologic Society Annual Meeting in Columbus

Dayton Physicians Network

In mid-April was the Ohio Urologic Society Annual Meeting in Columbus. At this meeting, Dayton Physicians Network’s Blake Anderson, MD took part of a panel about Management of Complex Stone Disease. The moderator for the discussion was Sri Sivalingam and other panelists were Mantu Gupta, MD, Smita De, MD, PhD, Michael Sourial, MD.

Dr. Anderson said “I really enjoyed being on the moderator panel for management of complex stone disease.” In the discussion several cases were presented and the panelists all weighed in on different approaches. One case discussed was, how to treat 10 cm of bladder stones in a man with BPH (enlarged prostate). Also discussed, was a case of a septic woman with recent chemotherapy for breast cancer with bilateral obstructing stones.

All the Panelists noted that there were multiple options for treatment but many factors had to be considered. Below is Dr. Anderson take on the discussion, treatment options, and considerable factors.

“How to treat 10 cm of bladder stones in a man with BPH (enlarged prostate. Options are: shockpulse and laser lithotripsy, then holmium laser enucleation of the prostate.
For the bladder stone cases in general, I am in favor a of combination approach to obstructive prostate tissue under the same anesthetic when feasible as bladder stones typically only form in the setting of obstruction. KUB should be done or can check scout film of CT if that has already been done to see if bladder stones are visible, if not may contain uric acid and preoperative medical therapy with potassium citrate could significantly decrease stone burden.

Kidney stone cases were numerous, incomplete left duplex kidney with large upper pole stone burden, difficult renal access and discussed special techniques to do this and accomplish PCNL.
Another case was of a septic woman with recent chemotherapy for breast cancer with bilateral obstructing stones, discussed ureteral stents or bilateral nephrostomy tubes as options, each with own advantages but both effective in prior studies. This decision involves a lot of patient specific variables, stone size, stone location, anticoagulation status and other anatomic considerations. In patients with low urine pH and low stone Hounsfield units on CT, especially in setting of recent chemotherapy, suspicion for uric acid stones should be high and stone dissolution therapy should be considered (medication, potassium citrate, raises urine pH and can dissolve uric acid stones).”

Cancer 101: Understanding the basics

“You have cancer.”

Dayton Physicians NetworkThose are the words that no one wants to hear from their doctor. Unfortunately, far too many do.

According to The American Cancer Society, an estimated 1,685,210 new cases of cancer were expected to be diagnosed in the United States in the last year alone.

The good news is that, with early diagnosis and treatment, the number of people living beyond a cancer diagnosis is expected to rise to almost 19 million by 2024 (up from nearly 14.5 million in 2014).

Dayton Physicians NetworkKnowledge is power
One of the scariest things about being diagnosed with cancer is all the unknowns. Gaining some understanding about the various stages of cancer and how it’s generally treated can go a long way toward alleviating some of the fear and anxiety.

Cancer staging
“Staging helps doctors to know where a cancer is located, if and where it has spread, and whether it is affecting other parts of the body,” explained Mark Marinella, MD, FACP, a specialist in the hematology and medical oncology department of the Dayton Physicians Network. “With this information, doctors can plan a course of treatment, including the type of surgery and whether chemotherapy or radiation are needed.”

Most cancers have four stages: stage I (one) to IV (four), with four being the most advanced.

  • Stage I: Often called early-stage, Stage I is usually a small cancer or tumor that has not grown too deeply into nearby tissue and also has not spread to the lymph nodes or other parts of the body.
  • Stage II and III: These stages indicate larger cancers or tumors that have grown more deeply into nearby tissue and may have also spread to lymph nodes but not to other parts of the body.
  • Stage IV: Also called advanced or metastatic cancer, this stage indicates that the cancer has spread to other organs or parts of the body

Treatment
“Treatments for cancer vary greatly, with the most common being surgery, chemotherapy and radiation. The stage of the cancer will help to determine the best course of treatment,” said Dr. Marinella.

  • Surgery can be used to take out the cancer (tumor) and occasionally to remove some or all of the body part(s) affected by the cancer.
  • Chemotherapy (also called “chemo”) is the use of drugs to kill cancer cells or slow down their growth. It can be given intravenously or as pills to swallow. Chemotherapy treatment is useful in treating cancers that have spread.
  • Radiation also is used to kill or slow the growth of cancer cells and can be used alone or with surgery or chemo. Having radiation treatment is similar to getting an x-ray.
  • Immunotherapy: Newer drugs, called “checkpoint inhibitors,” are now available that stimulate the immune system to fight cancers such as melanoma, lung cancer, kidney cancer, bladder cancer, and head and neck cancers.
  • Targeted therapies are antibody treatments and other oral drugs that attack a certain abnormality in the cancer cell.

Dayton Physicians Network

During diagnosis, Dayton Physicians Network routinely checks genomic profiling on many patient tumors. This procedure looks for genetic changes and abnormalities that may help determine a course of treatment and allows DPN to find trials in which a patient can participate.

Should I get a second opinion?
“Unless a patient really wants one, I generally don’t recommend it,” said Dr. Marinella. “Where I might recommend a second opinion is more of a physician-driven thing. For example, if I see something that is very rare or if a patient has received all the treatment I can give, I might consult with another physician on a possible clinical trial.”

The diverse areas of expertise and specialties in cancer care that exist among the doctors, as well as the access they have to cutting-edge technology and clinical trials, allows Dayton Physicians Network to provide patients with timely and comprehensive, patient-centered care. In addition, with 13 practice locations from Greenville to Middletown, patients can receive cutting-edge cancer care while remaining close to home.

Click here to learn more about Dayton Physicians Network cancer care, or call 937-293-1622937-293-1622.

Dayton Physicians Network’s Jhansi Koduri, MD has been nominated for Leukemia and Lymphoma society Woman of The Year

 
Dear Friends,

As an oncologist of 15 years, my work has been transforming. I have been a part of many cancer journeys, the fright and the fight, the hurt and the healing, the stress of finances and the journey of hope. I often succeed in the fight for my patients, but sadly even in this era of modern medicine and advanced research, I have to idly stand by and watch a few succumb.
Dayton Physicians Network
I have humbly accepted the nomination to be a candidate for The Leukemia & Lymphoma Society’s (LLS) Man & Woman of the Year, 2019 fundraising campaign. The generous funding of LLS to my own patients has enabled them to receive the latest treatments without the stress of losing their homes. A young patient of mine is now undergoing CAR-T-cell immunotherapy, and due to the innovative therapies of LLS research, will survive in spite of recurrent aggressive Non-Hodgkin’s lymphoma. Since 2000, over 40% of all U.S. Food & Drug Administration (FDA) approved cancer drugs were for blood cancer, some even used to treat other forms of cancer and non-malignant diseases.  A “win” for blood cancers, therefore, is a win for the cancer community overall.  I run this campaign along with my patients Cynthia, Betty, Jeff, Ken, Chalonda, John, Edward, Tatyana, Bobbie, Toni, Jowana, Minnie, Patricia, Essie, Joan & many more; I run in honor of Tim, Anita & Donna.

I dream to erase the connotation of death from the word cancer one day. Every dollar raised in this campaign funds the work of LLS.  Cancer research has come a long way. In the 60s, a blood cancer patient’s survival rate was 3%; today, it is 90%. Although 90% is remarkable, someday that 10% must be accounted for. With your support we are well on our way to making that someday today.

Please join the team and help us to cure every cancer patient. Donations can be made starting on February 28, 2019 through May 11, 2019 via credit card at https://pages.mwoy.org/soh/dayton19/jkoduri

 or by mailing a check made out to  LLS with Team Koduri in the memo and send it to 1029 Whispering Pine Lane, Dayton Oh 45458.  Click here to know the impact of your donations. Thank you in advance for helping save lives through your generosity.

 

Sincerely,

Jhansi Koduri, MD

Hematology/Oncology,

Associate Professor, Wright State University

Cancer survivorship program provides continued support after treatment

Dayton Physicians NetworkDealing with cancer can be difficult enough, but often the aftermath can be just as troubling. Survivors not only have to deal with the disease, but also may struggle with lasting physical and emotional effects of treatment. Patients who felt they had a great deal of support throughout treatment often find it hard to adjust to a new way of life and the challenges they may face in the recovery phase.

Dayton Physicians Network offers a survivorship program to help patients navigate these difficulties and continue supporting them after treatment. Elizabeth Delaney, DNP, APN, FNP-BC, is a nurse practitioner with the program.

“We have had the opportunity to witness people experiencing the long-term effects of therapy, as well as impacts to their quality of life from their treatments,” Delaney said. “Cancer survivorship is about addressing the impact of cancer and treatment for the individual, particularly after those initial therapies are completed.”

Rotating through four Dayton Physicians Network locations, Delaney sees patients who are in stages 0 through 3 with curative therapy at the Survivorship Clinic. Right now, that includes only patients of breast and colon cancer, but DPN hopes to expand to include lung and prostate cancer patients in the near future.

Once curative therapy is completed, patients have the opportunity to complete a National Comprehensive Cancer Network (NCCN) survivorship assessment to determine what issues may need to be addressed post-treatment. Dayton Physicians screens for a variety of issues including anxiety, depression, distress, changes in cognitive and memory, hormonal or sexual problems, even financial concerns.

For example, some treatments have delayed impacts to the heart and lungs, so patients may need to be aware of the potential for shortness of breath or swelling in the arms. And breast cancer patients might experience lymphedema, a swelling in one of the legs or arms. The patient may not even be aware of these conditions, but they all affect long-term recovery.

The next part of the visit is to create a tailored Survivorship Care Plan, a summary document about everything regarding the patient’s cancer diagnosis and treatment. A copy is given to the patient and all of their care providers, such as the surgeon or other specialists.

Finally, staffers review the current national recommendations for healthy lifestyle choices and ways to reduce the potential for recurrence of the patient’s original cancer or development of other types. For example, helping them to stop smoking, integration of a healthier diet and exercise, mental health counseling, and regular spirituality practice. Research has shown that all of these practices improve quality of life, reduce anxiety and depression, and in some cases, reduce recurrence of cancer.

Delaney says that patient response to the Survivorship Clinic has been overwhelmingly positive, and they are grateful to have the plan review. “I articulate common concerns for cancer patients, like emotional and mental health, weight gain, smoking cessation, fertility issues, and so on,” she explained. “We go through all of those and, often, just showing people that these are common concerns can help reduce the ‘suffering in silence.’ It feels good to them to know they’re not uncommon.”

“Being able to articulate their story and have someone listen to them can make a big difference,” Delaney said. “Sex, for example, is a big topic that comes up. Women who have had mastectomy may suffer with body image changes, and the effects of chemotherapy and hormonal drugs can lead to other related complications.”

The most common concerns and questions from patients tend to depend on the stage of cancer and the age of the patients. Understanding the common concerns, however, is helpful across the board. Many are interested in the impact of healthy lifestyle and want input from the providers on those choices.

The greatest barrier to helping survivors through the challenging time following treatment is that they often do not schedule the visit. Patients have expressed the value of the service, from the information provided and the overall support offered, to keeping office visits to a minimum. When a provider says you may be eligible for a survivorship visit, take advantage of it.

For more information about the Dayton Physicians Network Cancer Survivorship Clinic, call 937-293-1622.

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Local Physician Group Investing Millions In Potentially Life-Saving Equipment

Dr. Gregory Rasp Dr. Gregory Rasp is medical director and radiation oncologist for Dayton Physicians Network.

A local health care company is investing $22 million in facility upgrades and new equipment, including “game-changing” technology that could help save lives.

Dayton Physicians Network, a multi-specialty medical group that provides cancer treatment and urological services, is expanding one of its facilities and renovating two others to make room for new radiation equipment. The expansions also will lead to new hires, with up to 30 employees added in the next year as a result of the project. The group currently employs 400 people at its Dayton-area facilities.

The upcoming expansion also could provide work for area builders and suppliers.

The physician network recently purchased imaging machines and linear accelerators, which can be used as radiation treatments for patients with cancer. The equipment will touch nearly every facility the network operates — seven locations from Greenville to Middletown — but the bulk of investment will occur at the Greater Dayton Cancer Center in Kettering, Atrium Medical Center in Middletown and Upper Valley Medical Center in Troy.

The equipment purchase was a joint venture with Dayton Physicians and Dayton-based Premier Health. The physician network leases space from Premier in a few of its hospitals, including Atrium and Upper Valley, but it is an independent group.

Dayton Physicians Network Greater Dayton Cancer Center in Kettering is Set for Expansion.

Dr. Gregory Rasp, medical director and radiation oncologist at DPN, said the new equipment will turn “good treatment into great treatment.”

“It’s going to allow for more accurate treatment, and more accurate treatment means better cure rates and lower complication rates,” Rasp said. “Basically, it will help us diagnose cancers better and treat them better.”

The imaging component will include new software called Smart Metal Artifact Reduction, which eliminates what medical professionals call “streaking.” Streaking is common in patients with fillings, artificial hips or other procedures involving the insertion of metal, which makes it difficult to visualize where a tumor starts and stops.

In addition, the equipment will allow physicians to more accurately position patients for treatment. This will cut down on errors that can occur if a patient moves during treatment, and helps doctors pinpoint the exact area needed for radiation therapy.

“With the newer equipment, the computer automatically adjusts for those shifts and rotations, and puts us right on the money with treatment,” Rasp said. “It’s kind of a game-changer because it allows us to treat a smaller area. Small areas mean less complications.”

The hope is enhanced treatment will decrease side effects and increase cure rates by 3 percent to 4 percent. Rasp said even if cure rates improve by just a few percentage points, it will save lives.

“Even if the cure rate stays the same, which we don’t anticipate, we can reduce the number of people having complications from the radiation,” he said. “It’s going to make it a lot easier on them and their families.”

The new equipment is expected to be installed in the first and second quarter of 2019, but before it is up-and-running, DPN must make some upgrades to its facilities.

At the Greater Dayton Cancer Center in Kettering, a new addition will be constructed onto the existing facility, and “significant remodeling” will occur at Upper Valley and Atrium, Rasp said. Wayne Cancer Center in Greenville also will be remodeled, though he said it will be less significant.

Each facility is likely to see an increase of 900 to 1,000 square feet, which include seven-foot-thick concrete walls needed to shield the radiation. Most of these walls are already constructed, though another “vault,” as Rasp described it, may need to be added at the Kettering center.

DPN has contracted with Dayton-based Sharp Conway Architects to design the project. Once the drawings are finalized, construction bids will be released. Rasp said the hope is one construction company will work on each facility.

Construction on each location will be staggered, and the first facility is expected to be completed in four to six months. Rasp said they’ll likely start in Middletown.

The facility upgrades and new equipment add to millions of dollars in investment DPN has been making in the last few years. Rasp said they’ve reinvested $18 million in the practice since 2012, and the latest project will bring them up to $40 million over a six-and-a-half year period.

“In a lot of groups, that money would just funnel to shareholders,” he said. “But we’ve always known that we need to reinvest it to be at the cutting edge of things, and in turn the practice grows. The other thing is we always put patients first over profits. I know that sounds like something every doctor says, but we’ve always had this belief that we need to have the highest quality standards for our patients.”

Technological advancements lead to more effective radiation treatments

Dayton Physicians NetworkThe field of radiation oncology is a high-tech world, where medical science and physics are orchestrated together to provide the best possible outcome for cancer patients. At Dayton Physicians Network, our radiation oncology staff is working to keep all of our clinics equipped with state-of-the-art technology and expertise. The goal is personalized treatments for our patients, making sure that every patient receives the best possible care and is able to maintain his/her quality of life.

Madhup Gupta, MS, DABR is the Director of Medical Physics and Chief Medical Physicist at Dayton Physicians Network. It might seem unusual to have a physicist working in a medical field, but in the world of radiation oncology, his position is vital.

As a medical physicist, board-certified by American Board of Radiology, Mr. Gupta calibrates the linear accelerator, which delivers a radiation dose to a highly specific location.

Dayton Physicians Network“A physicist is in a cancer clinic because of the presence of highly sophisticated radiation-producing machines,” Mr. Gupta explained. “Our main job is to calibrate and quantify the radiation that the physician wants delivered to the patients. We cannot see, hear or feel radiation, however, we use it daily to stop the spread of cancer and kill cancer cells anywhere inside the body.”

Another aspect of the job is radiation safety – a team of seven board-certified medical physicists make sure that all treatments are safe and effective. They ensure that our patients and staff stay safe during the complex high-energy radiation delivery to the tumor.

Some of the newest technology coming to Dayton Physicians Network is called RapidArc® with robotic couch. Compared to Cyberknife® technology, the RapidArc® conforms the radiation to the shape of the tumor and “paints” the radiation with a beam in an arc over the tumor with different entry points around the body. This allows a highly modulated dose delivery precisely concentrated to the tumor location in rapid beam sequence within a minute for a full arc. So, what would take an hour to accomplish with Cyberknife can be done in about ten minutes (including the setup time) with RapidArc®.

That level of precision also requires the patient to be positioned exactly right, and the newer technology has provided a solution to that, as well. The patient is CT imaged (CBCT to view 3D anatomy) just prior to their treatment, and the robotic treatment couch (with 6 degrees of freedom) can position the patient to under one degree or one millimeter. This precision in tumor localization allows for accurate tumor dose delivery while sparing the surrounding normal organs. Radiation doses are planned and calculated by a medical dosimetrist, who is certified by the American Association of Medical Dosimetry.

Dayton Physicians Network is the first in Ohio to receive a third-party accreditation from the American Society of Radiation Oncology for all six radiation clinics in and around Dayton.

During a year-long process, DPN gave access to ASTRO APEx® radiation oncologists and medical physicists to review all procedures and processes, treatment planning and delivery. They looked at everything, from cancer diagnosis and staging, to machine quality control and staff certifications. A team consisting of radiation oncologists and radiation physicists visited our six radiation clinics and interviewed our experts. Accreditation was awarded at the end of 2016 and is good until 2020.

We are also a Certified Member of MD Anderson Cancer Network for Oncology Program. MD Anderson is the nation’s premier cancer treatment and research clinic, based in Houston, Texas. All our radiation and medical oncologists have also received certification by the M.D. Anderson Cancer Network, giving physicians access to the latest cancer care options.

With six outpatient radiation sites, Dayton Physicians Network is making it easier for patients to get the best possible treatment closer to home. “It’s good to have our treatment centers spread out where patients don’t have to drive too far for their treatments,” said Mr. Gupta. “They can get the top-notch cancer care closer to home.”

For more information or to schedule a consultation, contact Dayton Physicians Network Radiation Oncology and Imaging at 937-771-2422937-771-2422.

(All images courtesy of Varian Medical Systems, Palo Alto, CA)

Hydrogel Spacer Helps Protect Healthy Tissue During Radiation Therapy

Dayton Physicians NetworkAccording to the American Cancer Society, urological cancers, which include cancers of the bladder, kidney, prostate and testicles, are relatively common. In the United States, bladder cancer is the fourth most common cancer among men and ninth with women. More than 50,000 new cases of bladder cancer are diagnosed each year.

In younger men, ages 15 to 44, testicular cancer is most prevalent. But one out of every 10 men, most over the age of 50, will develop prostate cancer at some point, making it the most common cancer experienced by American men.

Treating urological cancer involves therapy using heavy doses of precisely administered radiation. Some of the major challenges to the success of the treatment include complications caused by the high concentration of radiation needed in order for the therapy to be effective. The challenge is to deposit a large enough amount of radiation at the proper location without doing harm to the other areas, including the bladder and rectum.

Since the ultimate goal of radiation therapy is to maximize the dose of radiation administered in order to gain the greatest benefit in the shortest amount of time, that also means more potential damage to the tissues surrounding the treatment area.

In order to deal with localized disease such as prostate cancer, it’s important to put as much space as possible between the organ being treated and other areas, in particular the rectum. Now, a new injectable material can artificially and temporarily increase that space, to help protect the rectum from the harmful radiation so vitally needed to treat localized prostate cancer.

SpaceOAR is the name of an absorbable hydrogel used to create a space between a diseased prostate undergoing radiotherapy and the rectum. The barrier provides protection of the rectum during the radiation treatment, minimizing complications resulting from damaging otherwise healthy tissue. The “OAR” in SpaceOAR stands for “organ at risk” – in this case, that organ would be the rectum.

Using ultrasound, the doctor locates the area where the SpaceOAR is to be injected. The hydrogel is made up of two liquids that combine to form a soft gel mostly made of water, so it can be safely used without injury or allergic reaction. In clinical trials, patients who were given the hydrogel spacer reported significantly reduced rectal pain and less severe, long-term rectal complications.

Patients may be awake or under general anesthesia during the procedure. This minimally invasive hydrogel stays intact during the radiation therapy, but over time, it is gradually absorbed by the body, once the therapy is completed.

“Giving more distance between rectal wall and prostate enables the use of a high dose of radiation to treat cancer in the prostate, but with a much lower dose going to the rectal area. This provides a significant benefit to the patient by preserving the healthy tissue in the surrounding area,” explained Douglas Ditzel, D.O., radiation oncologist with Dayton Physicians Network.

A special needle is fed by two syringes, which merge into one applicator. The hydrogel is injected and solidifies in about 15 seconds within the space, spreading out the affected tissue. The gel will remain there from three-to-six months, providing a space of about one-and-a-half centimeters, expanded from the original area of approximately three millimeters.

“So far, the procedure has been very effective,” Dr. Ditzel said. “It takes about 20-to-30 minutes, and patients are home and resuming normal activity right away.”

SpaceOAR helps to preserve healthy tissue and maintain rectal, urinary and sexual health and quality of life. Because of this preservation, the procedure also minimizes side effects associated with prostate cancer radiation therapy, such as rectal pain, bleeding, and discomfort.

Not all patients and situations are right for SpaceOAR. If the cancer has spread to the surrounding tissue or moved somewhere else within the body, the hydrogel will be of little use. In this situation, the radiation oncologist must examine the case and determine the best course of action, based on the specific patient’s needs.

If you are undergoing radiation therapy for prostate cancer and would like to learn more about how SpaceOAR can become part of your treatment plan, call Dayton Physicians Network at 937-293-1622937-293-1622 or click here.

Ask The Expert

Michael Yu, MD Dayton Physicians Urology

Michael Yu, MD
Dayton Physicians Urology

Think You Have an Enlarged Prostate?
Urologist Michael Yu of Dayton Physicians Urology Answers Questions about Symptoms and Discusses
a Minimally Invasive Breakthrough Treatment Option

What Are the Symptoms of Enlarged Prostate and When Should Men See a Urologist?
Over 70% of men in their 60s have symptoms of enlarged prostate1. This can cause loss of productivity, interrupted sleep and, in some cases, can cause depression.2

Common symptoms include:

  • Frequent need to urinate both day and night
  • Weak or slow urinary stream
  • A sense that you cannot completely empty your bladder
  • Difficulty or delay in starting urination
  • Urgent feeling of needing to urinate
  • A urinary stream that stops and starts

UroliftEnlarged prostate can wreak havoc on a man’s quality of life, so it’s important to see a physician if these problems persist.

What Treatment Options Do You Recommend to Your Patients?
Treatment options for enlarged prostate range from medications to surgery, with minimally invasive options in between.

Medications can be helpful in relieving symptoms for some men, but patients must continue taking them long-term to maintain the effects. Some patients may suffer side effects including dizziness, headaches, or sexual dysfunction. And some may not get adequate relief of their symptoms.

Dayton Physicians NetworkSurgical options, such as transurethral resection of the prostate (TURP) or photovaporization of the prostate (PVP), are very effective. However, these typically require general anesthesia, overnight hospitalization, and post-operative catheterization. Surgery can also increase the risk of erectile dysfunction or loss of ejaculation.

Can You Describe What Minimally Invasive Treatments are Available?
I’m very excited to offer my patients a revolutionary treatment option called the UroLift® System treatment. The UroLift System treatment is a breakthrough, minimally invasive option to treat enlarged prostate. It does not require any cutting, heating, or removal of prostate tissue.

Here’s how it works: a urologist uses the UroLift System device to lift and move the enlarged prostate tissue out of the way so it no longer blocks the urethra (the passageway that urine flows through). Tiny implants are placed to hold the tissue in place, like tiebacks on a window curtain, leaving an unobstructed pathway for urine to flow normally again.

Dayton Physicians NetworkWhat are the Benefits of the UroLift® System?
I perform the UroLift System treatment in the hospital, which patients like. The treatment typically takes under an hour, preserves sexual function, doesn’t require cutting, heating or removal of tissue. Compared to other BPH surgeries, the UroLift System treatment has a strong safety profile with minimal side effects.3

Most common side effects are mild to moderate and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge. Most symptoms resolved within two to four weeks after the procedure.

References
1. Berry, et al., J Urol 1984
2. Speakman et al., 2014 BJUI International
3. Roehrborn, et al., J Urology 2013

New minimally invasive procedure provides relief from BPH

Dayton Physicians NetworkOne of the most common health problems for men over 50 is benign prostatic hyperplasia (BPH). Put simply, the condition is the result of prostate gland enlargement. It can cause a number of varying symptoms, including uncomfortable urinary issues, blocking the flow of urine out of the bladder, and urinary tract and kidney problems.

The prostate grows continually in most men throughout life. Often, this ongoing enlargement of the prostate is enough to cause urinary difficulties or significantly block the flow of urine. It is not clear exactly what causes the prostate to enlarge, but most experts agree it happens because of changes in the balance of sex hormones as men age.

Diagnosis of BPH is achieved through a number of tests, including a digital rectal exam, urinalysis to check for infections that cause similar symptoms, blood test to rule out kidney problems, and the prostate-specific antigen (PSA) blood test. Other tests also might be needed to check urine flow and voiding volumes, in order to determine how constricted the urinary tract might be.

Untreated, BPH could lead to urinary tract infections, bladder stones and damage, kidney damage, and urinary retention (the inability to urinate). When not emptied completely, the bladder weakens over time, and the muscular wall may no longer contract properly. Fortunately, there are new, less-invasive procedures available right now at Dayton Physicians Network that can ease these symptoms without major surgery.

The size of the prostate does not necessarily dictate the severity of the symptoms — some men experience severe problems, while others may have few issues at all. Although in some cases symptoms gradually diminish over time, it’s usually a good time to see the doctor as soon as the symptoms become troublesome. If unchecked, symptoms can become more severe and other serious issues arise, like blockage of the urinary tract.

Most men, about one-third, experience some type of enlarged prostate symptoms by age 60, but very few under 40 have problems from it. Family history, obesity, and those with diabetes or heart disease can have a higher risk of BPH. However, proper diet and exercise can help lower the risk of BPH.

Dayton Physicians Network

Treatment options for BPH

There are a number of treatments for BPH including medication, minimally invasive therapies, and surgery. One procedure now being used at Dayton Physicians Network to treat BPH is called the “UroLift System,” a new, minimally invasive approach for patients who want an alternative to drug therapy or invasive surgery.

According to clinical data, the UroLift System is safe and effective and can improve BPH symptoms three-to-four times better than medication alone. The goal of the procedure is simple: to relieve urinary symptoms and help patients resume daily activities. The less-invasive method of UroLift also helps reduce the likelihood of infection or other complications from surgery.

Michael Yu, MD, FACS, is a urologist with DPN who recommends the procedure to his qualifying patients. “UroLift, a prostatic urethral lift, is a great alternative to invasive surgical procedures where appropriate,” he said. “Good candidates are men over 45 who are experiencing BPH. We begin with a series of tests, including a cancer screening to rule out anything more serious, then determine the best options for treatment.”

The procedure uses tiny, highly specialized implants to lift and hold the enlarged prostate tissue so that it no longer blocks the urethra. This allows for the resumption of normal urine flow without cutting, heating or removal of the prostate tissue.

“When medications are not effective, and surgery is determined too invasive, UroLift is an option for some patients that will improve symptoms and recovery time,” said Dr. Yu. “The average recovery for a surgical patient is six-to-eight weeks, but because there is no cutting involved, UroLift recovery is as little as two or three days.”

For more information on treatment for BPH and the UroLift System at Dayton Physicians Network, call 937-293-1622937-293-1622 or click here. If you are experiencing severe symptoms, such as blood in the urine, you should see your doctor immediately or go to the emergency room.