What is Prostate Cancer?

Prostate Cancer Treatment – Prostate cancer (of the prostate gland) is the most common cancer among men, and in its early stages, it is asymptomatic. The prostate, or prostate gland, produces a fluid that helps thin the semen and assists in sperm motility, which is essential for fertilization. Prostate cancer is a cancerous process that develops in the prostate gland. It was once believed that prostate cancer was a disease of older men, however, recent statistical data show a sharp increase in the number of men aged 40-50 who suffer from tumors of this gland.

Prostate cancer represents a serious medical issue and is either the first or second leading cause of male cancer-related mortality. Despite notable progress in public health and better access to medical services, the high incidence and mortality rates of prostate cancer continue to be a major concern for healthcare systems worldwide.

The mechanism behind the development of prostate cancer is unknown, but it is important to understand certain risk factors:

• With increasing age, the likelihood of developing the disease increases.
• Hereditary predisposition – the risk of developing prostate cancer is significantly higher for men whose relatives have had prostate cancer.

Prostate Cancer Screening – Early Diagnosis

In its early stages, prostate cancer is asymptomatic, and this characteristic contributes to its high mortality rate. Given the widespread nature and mortality of prostate cancer, as well as statistically valid facts about the “younger” onset of this disease, prostate cancer screening and early diagnosis have gained particular importance, especially considering that prostate cancer is fully treatable with timely diagnosis.

As mentioned earlier, prostate cancer in its early stages develops without symptoms, so it can only be detected through comprehensive examination. Traditional screening methods require a lot of time and resources. However, this process has become much more reliable, accurate, comfortable, cost-effective, and advanced with the advent of a modern medical achievement – micro-ultrasound! Micro-ultrasound (micro-US) for prostate examination is now a cutting-edge method, rightly regarded as a necessary standard in prostate screening and diagnosis.

With micro-US, targeted and, if desired, fusion biopsy is also performed. Micro-US can fully replace traditional multi-step prostate cancer screening procedures. Its ExactVu micro-ultrasound system was specifically developed for diagnosing prostate diseases and managing targeted and fusion biopsy procedures.

Micro-US is performed with the ExactVu micro-ultrasound device for prostate cancer diagnosis.

Micro-US offers:

• A 300% magnified image compared to traditional ultrasound (US);
• A 300% increase in prostate biopsy effectiveness;
• Precise identification of biopsy sites and maximum research results;
• A 300% increase in the effectiveness of targeted prostate cancer treatment;
• Comparable or even higher accuracy than magnetic resonance imaging (MRI).

Karaznashvili Robotic Center – This is the only urological center in the Black and Caspian Sea region where micro-ultrasound, targeted and fusion prostate biopsies are performed transperineally under micro-ultrasound control. This state-of-the-art method for prostate cancer screening and early diagnosis not only eliminates multi-stage examinations and unnecessary biopsies but also saves the patient time and money. As you may have guessed, early-stage prostate cancer treatment is 30 times cheaper and 95% more effective than late-stage treatment.

To better understand the difference between traditional and micro-ultrasound screening and early diagnosis of prostate cancer, let’s look at the pre-screening procedures for each.

Prostate Cancer Diagnosis Without Micro-Ultrasound:

• Determination of prostate-specific antigen (PSA) in the blood
• Traditional prostate ultrasound
• Digital rectal examination (DRE) of the prostate (examination with a finger through the back of the body)
• Magnetic resonance imaging (MRI) of the prostate
• Systemic (non-targeted) or “fusion” biopsy of the prostate to confirm prostate cancer

Prostate Cancer Diagnosis with Micro-Ultrasound Method:

• Determination of prostate-specific antigen (PSA) in the blood
• Micro-ultrasound of the prostate
• Targeted prostate biopsy under micro-US control

Undoubtedly, the determination of prostate-specific antigen (PSA) remains a crucial tool for screening and early diagnosis of prostate cancer. However, prostate biopsy does not need to be performed for any increase in PSA levels in the blood. Instead, we perform micro-US of the prostate, and a prostate biopsy is only performed if cancer is suspected during the micro-US examination.

Thus, micro-US allows for avoiding unnecessary prostate biopsies, significantly reducing screening costs, and saving time. If needed, the most advanced type of prostate biopsy can be performed under micro-US control: the transperineal targeted/fusion biopsy under micro-US guidance.

At the Karaznashvili Robotic Center – Professor Guram Karaznashvili’s urological center, prostate cancer screening and early diagnosis are carried out using this state-of-the-art method instead of multi-stage, expensive, and traditional examinations. With micro-US prostate cancer screening in our clinic, we identify asymptomatic individuals with precancerous conditions or early-stage cancer, which plays a vital role in initiating early treatment, reducing morbidity, and lowering mortality.

It is important to note that at the patient’s request, a “fusion” biopsy can also be performed. Target Fusion Biopsy is a combination of magnetic resonance imaging (MRI) data and micro-US. Since micro-US is specifically designed for prostate examination and its technology is based on ideal visualization with ExactVu.

Non-Surgical, Robotic Treatment for Prostate Cancer

It is known that accurate diagnosis is the foundation of effective cancer treatment. Prostate cancer, when diagnosed on time, is almost 100% curable. This is especially important for prostate cancer, as the latest technologies allow for the precise destruction of prostate cancer while preserving healthy tissue.

There is a revolutionary innovation in the treatment of prostate cancer – robotic ultrasound therapy “HIFU” (High Frequency Focused Ultrasound), which destroys localized prostate cancer in a single day without the need for surgical intervention.

Focal One HIFU – This is an ultra-modern, non-surgical, non-invasive, radiation-free, and the only robotic method for focal treatment of prostate cancer in the world. It is also known as focal therapy.

Focal One HIFU uses a high-intensity focused ultrasound beam that safely and effectively targets and selectively destroys the damaged tissue in the prostate while leaving the healthy tissue intact.

Prostate Cancer Treatment – Advantages of Focal One “HIFU”:

• No need for incisions
• Not associated with any surgical risks
• The prostate gland of the patient is preserved
• Male potency is preserved
• No complications such as urinary incontinence
• Minimal hospitalization time (1 day)
• Does not use radiation
• Precise targeting of damaged tissue
• Healthy tissue remains unaffected

As mentioned, prostate cancer treatment using the Focal One HIFU technology is suitable for localized cancer/early-stage cancer or in cases of cancer recurrence after radiation therapy. However, Focal One HIFU is not used for metastatic cancer, which further emphasizes the importance of prostate screening and early diagnosis.

Since robotic ultrasound therapy only destroys the areas of the prostate affected by cancer, leaving healthy tissue intact, it minimizes the risk of disease progression, causes fewer side effects, and improves the quality of life compared to radical treatments (radical prostatectomy or radiation therapy).

The Guram Karaznashvili Urological Center has once again adhered to its tradition of implementing innovations and, in 2020, introduced all of the above-mentioned cutting-edge technologies for the first time in Georgia and the region.

Guram Karaznashvili, MD, Professor of Onco-Urology and Pediatric Urology, highest category physician, recipient of the National Prize of Georgia, President of the Georgian Association of Onco-Urologists, and a member of the board of the World Federation of Urological Oncology. Professor Guram Karaznashvili is the only Georgian urologist who presented at the American Urological Association congress with a video description of the innovative technique of retroperitoneal radical cystoprostatectomy with the creation of a retroperitoneal artificial bladder, preserving potency and urinary retention. This surgery is considered one of the most complex surgeries in oncology.

Thanks to Micro-Ultrasound and Focal One HIFU, the path for prostate cancer patients from diagnosis to non-surgical treatment becomes much more effective and cost-efficient.

After determining the prostate-specific antigen (PSA) level, the first step is to perform micro-ultrasound of the prostate and, if necessary, a transperineal targeted biopsy under the guidance of micro-ultrasound. Micro-ultrasound allows for an accurate diagnosis, provides detailed images of the prostate, and shows the localization and structure of the cancer. After making the most accurate diagnosis, prostate cancer is eliminated in just one day using a robotic method, without any surgical or invasive procedures. Along with the patient’s life, their quality of life is preserved – since the prostate is an important aspect of normal sexual and urinary function.

The Karaznashvili Robotic Center, based on the Western education and experience of Guram Karaznashvili, is a urological hub equipped with modern, high-tech, cutting-edge equipment. It rightfully occupies leading positions not only in Georgia and the region but also globally.

If you wish to be cured of prostate cancer through surgery, we are pioneers in this field as well. Karazanashvili’s Robotic Center is the first and only center in the Caucasus where surgeries are performed robotically. The center conducts surgeries in urology, gynecology, and abdominal surgery. Robotic surgery is the highest level of medicine.

How does robotic surgery differ from traditional surgeries? For more information, visit the page.