VA offers successful and cost-effective seed implant as their better choice of prostate cancer treatment

Posted on: April 6th, 2017

A recent radio program highlighted how a Veterans Administration facility, located in Richmond, Virginia, successfully uses LDR brachytherapy (also known as seed implant) to treat vets with aggressive prostate cancer.  McGuire VA Medical Center is reaching out to veterans with prostate cancer from across the country.

Brachytherapy: cost effective, successful treatment model

Brachytherapy, a  minimally invasive procedure, provides excellent prostate cancer outcomes, is cost-effective and convenient,  especially when compared to other treatment options. Radiation sources smaller than a grain of rice are placed inside the prostate, near cancer cells that are then disrupted and destroyed.  At approximately 1/3 the cost of either surgical removal of the prostate or external beam radiation therapy, brachytherapy should serve as a model for other government sponsored healthcare programs, such as Medicare and Medicaid.  Why would government sponsored programs pay more for treatments that do not provide better outcomes or fewer side effects?

Brachytherapy saves VA funds

Radiation oncologist and McGuire VA physician Dr. Drew Moghanaki described the current financial climate of prostate cancer treatment :

“The U.S. healthcare system is really a fee-for-service healthcare system. The more expensive procedures that can be done, the more revenue can be made. And brachytherapy just doesn’t make a lot of money for, you know, practitioners out in the real world. When you put together the convenience of a one-day procedure that is more effective and more cost effective, it really is a win, win, win.”

Seed implant is equally attractive to men who are self-insured or have large deductibles and/or co-payment requirements.  Furthermore, with minimal side-effects and a short recovery period, brachytherapy allows men to return more quickly to their normal activities and work, a benefit to employers and productivity.

Seed implant treatment option preferred by many men

Brachtherapy’s convenience and comfort draws contrasts with external beam radiation therapy (EBRT) and surgery.  EBRT can require six-to-eight weeks of daily treatment which, while cumbersome to the average patient, may be impossible for men who live in remote areas.  Surgical removal of the prostate (also called radical prostatectomy) requires a much longer recovery time and is no more effective than seed implants. Like EBRT, surgery can cause greater side effects.   A veteran from Puerto Rico, highlighted in the radio program, was offered the surgery option.  Instead, he travelled to the VA facility in Virginia where he could chose minimally invasive brachytherapy.

CPCC also serves veterans with prostate cancer

McGuire VA physicians have used LDR brachytherapy to treat over 1,000 military living in areas of the country that may only offer surgery or EBRT.  Similarly, Chicago Prostate Cancer Center (CPCC) has served over 600 men who have travelled from far beyond the Chicago area for consultation on seed implant.  Many of these men are included among over 14,000 brachytherapy procedures completed by CPCC to date, more than any other prostate center in the world.

The Veterans Health Care Administration has a responsibility to offer quality medical treatment within 30 days and pay for treatment at an alternative location if it is not available within 40 miles of the veteran’s home.  Dr. Moghanaki recently visited Chicago Prostate Cancer Center, and is now collaborating with us to treat their overabundance of prostate cancer patients choosing LDR brachytherapy.

One veteran’s treatment journey

Kenny, a veteran from Georgia, served in the Army’s 4th Infantry Division in the early 1980’s after graduation from North Georgia College—a highly regarded military school in Dahlonega, GA.  Last year at age 57, Kenny received a prostate cancer diagnosis that required several types of treatment, which is not uncommon for men with certain higher-risk prostate cancers.

Kenny’s son in the Chicago suburbs knew about the unique expertise of CPCC—a leader in the field of LDR brachytherapy.  They were both grateful Kenny was eligible to receive the seed implant portion of his treatment at CPCC, in coordination with the excellent additional required treatment he received at Hines VA Hospital — all while being with family.

Vet recommends services, support he received at CPCC

“In addition to access to the modern facilities at CPCC and the professional expertise of Dr. Moran and the entire staff, I was received as an individual rather than the next patient and provided the emotional confidence which is key to successful treatment.”

While in town for his seed implant, Kenny showed his support at our annual community 5k event.  He is planning to visit again to reconnect and join other survivors at our next Run and Walk for Prostate Cancer Awareness Month, September 10, 2017.

An avid outdoorsman, Kenny looks forward to many upcoming fishing and hunting seasons.

Information for men, including our veterans

For more information on prostate cancer and LDR brachytherapy, or to speak with a volunteer who is a ‘veteran’ of prostate cancer treatment, contact Chicago Prostate Cancer Center at 630-654-2515.  Or attend a Prostate Cancer Informational Support Group meeting at the Center.  Veterans can also contact the Veterans Choice Program to determine if they meet eligibility criteria for authorization of treatment with seed implant at our facility.


Is there a big drop in prostate cancer treatment, or just a drop in screening?

Posted on: March 8th, 2017

Since it’s development in 1984, the Prostate Specific Antigen (PSA) blood test has revolutionized diagnosis, treatment, and follow-up for prostate cancer patients. The PSA blood test measures an enzyme produced in the prostate gland that can provide a marker of possible prostate cancer.  With the availability of PSA testing, the incidence of advanced-stage prostate cancer decreased markedly, and by 2011, the U.S. saw an all-time low in prostate cancer deaths.

Change in Task Force screening recommendations

However, the U.S. Preventative Services Task Force (USPSTF)  suggested that PSA testing could lead to unnecessary biopsies and treatment of insignificant cancers.  The volunteer panel of experts revised its prostate cancer screening recommendations twice, advising against routine PSA testing for older men in 2008, and for all men in 2012.  The revised USPSTF guidelines have resulted in fewer men being offered periodic PSA—and digital rectal examination (DRE)— even at annual physicals.

How reduced screening affects men

Data is now emerging about the possible effects of USPSTF’s revised guidelines.  With the substantial decline in PSA screening across all age groups, the overall rates of prostate biopsy and prostate cancer incidence (the number of men diagnosed) have also decreased.

Yet, with less screening, there has been a significant rise in the rate of men who are now requiring treatment for more advanced prostate cancers, men who missed early stage detection and treatment.  This phenomenon has also been observed at Chicago Prostate Cancer Center (CPCC).

A recent review of the impact of the change in screening guidelines suggests critical misinterpretations of the evidence base regarding benefits and harms of PSA screening.  The authors call for more long-term followup and “smarter screening”, rather than either “screen all” or “screen none” decisions.  Of special concern are younger men who benefit the most from early detection and treatment, since early onset prostate cancer is more likely to be aggressive and fast growing.

Other researchers have demonstrated it was indeed policy changes that decreased screening, rather than changes in practice patterns among specialists.   In other words, men who receive screening and are diagnosed with prostate cancer are being treated as usual.  The authors concluded that between 2007 and 2012, the sharp decline seen in prostate cancer treatment was due in large part to prostate cancers going undetected—and therefore not being treated— due to lack of screening.

CPCC endorses smart screening

CPCC also maintains that timely prostate cancer screening  continues to be important to identify carcinomas before they have time to advance in stage, or metastasize outside of the prostate to other body organs, becoming more difficult to treat.

At CPCC, screening includes both PSA and digital rectal examination (DRE), which can uncover abnormalities associated with prostate cancer even with a normal PSA level.  DRE has the hidden benefit of uncovering clinically significant rectal tumors.  Colorectal cancer represents 8% of all new cancers, which are also more successfully treated if detected at an early stage.

Screening and diagnosis

Both PSA and DRE are considered along with a man’s family history, race, age, and lifestyle, to help determine the need to monitor PSA over time or to obtain a biopsy sample of the prostate gland to definitively test for cancerous cells.  A combination of factors may point to further, genomic testing of biopsy tissue to help determine the likelihood that a cancer will advance in stage.

Advocating prostate cancer screening, CPCC provides clinical staff for an annual free screening event  hosted with Prostate Cancer Foundation of Chicago (PCFC).  The event typically serves over 60 men, as part of CPCC efforts to work hand-in-hand with PCFC for community outreach, patient support, research and education efforts.

For more information on prostate cancer and treatment, or to schedule a consultation, contact CPCC at 630-654-2515.



Treat Older Prostate Cancer Patients According to Fitness, Not Age

Posted on: February 22nd, 2017

Fitness and Prostate Cancer Treatment

Men with prostate cancer should be treated based on their health status, not their age, according to the International Society of Geriatric OncologyUpdated guidelines suggest, “Elderly patients who are frail or who have multiple health conditions may not be able to handle aggressive cancer treatment, but aggressive treatment may be the best course for healthier older patients”.

Similarly, Chicago Prostate Cancer Center always considers not only a man’s age, but also a wide range of health status markers when defining potential treatment options for each prostate cancer patient.  Considerations include activity level, nutritional condition, body mass, mobility and cognition level (for an indication of independence and decision-making capabilities), in the context of each patient’s prostate cancer diagnosis, concurrent illnesses and medications.

Hormone Therapy for Older Men

Traditionally, many older men with early stage or advanced prostate cancer (or men in poor overall health who were not candidates for surgery or radiation) have been treated with hormone therapy, a less aggressive type of treatment.  Hormone therapy can be prescribed in many ways, and is designed either to reduce the level of male hormone production (such as testosterone) in the body, or to block cancer cells from using testosterone needed for growth.

However, recent studies have demonstrated that in some men, hormone therapy can lead to loss of energy and depression, while adding to potential risk factors for other disorders such as heart disease, diabetes, or stroke.

Seed Implant: Refined for Older Men

At CPCC we find that many older patients fare much better with low dose rate prostate brachytherapy (or seed implant) than with hormone therapy.  In seed implants, radiation sources the size of a grain of rice are placed directly into the prostate gland to stop the growth of cancer cells.

Recent developments in seed implant technique are particularly effective for use in older patients.  Based largely on research conducted with Prostate Cancer Foundation of Chicago, CPCC continually advances LDR prostate brachytherapy treatment, and provides more seed implants than any other medical center in the world.  CPCC has refined techniques for focal implants (that only treat one side of the gland) or dose painted implants (which treat the entire prostate but with seeds at a lower dose of radiation).

More Benefits of Seed Implant

Most generally healthy men at any age can readily tolerate seed implant for prostate cancer.  Older patients benefit from anesthesia used in LDR prostate brachytherapy, which is non-narcotic and short-acting, allowing patients to wake more quickly without the confusion and discomfort of more typical general anesthesia.

Seed implant can be an especially practical treatment option for consideration by older patients with prostate cancer.  Men who would otherwise find it difficult to mobilize transportation for up to 30 rounds required for external beam radiation, benefit from the convenience of one-time seed implant procedure.  Similarly, older men whose health status precludes prostate removal due to risks and recovery from surgery with full general anesthesia can be successfully treated for prostate cancer with seed implants.

For more information on prostate cancer or to schedule a consultation, contact CPCC at 630-654-2515.


Manning Up at Chicago Prostate Cancer Center Screening Event

Posted on: September 14th, 2016

Why I got screened at Chicago Prostate Cancer Center


“I would tell guys to get checked, especially if they have a family history of prostate cancer.  I had a friend who had prostate cancer and when I found out, he was already scheduled for surgery the next day!  I would have suggested he receive a second opinion here at CPCC, because it’s a great place and medical director Dr. Moran saved my father with the seed implant treatment.

Our family supports Prostate Cancer Foundation of Chicago (PCFC), which works with CPCC to keep up this helpful screening event, along with your patient support group and research studies.”   Tim L.


“I have friends who were treated here at CPCC and they said I should be sure to get checked out.  Now I tell others to keep on top of things and be sure to get screened for prostate cancer every year.”  John O.



“If you take care of your health and get screened whether or not it’s free, you can play it safe, even if you are at a certain age when prostate cancer can be more likely.  Thank you so much for doing this for us men so we can be here to enjoy and help our families.  I watch your Facebook page  to keep up with events and news about prostate cancer. “  Jim T.

CPCC and PCFC thank these forthcoming participants in the 2016 Free Prostate Screening Event for sharing their experience with us as part of National Prostate Cancer Awareness Month.   The event served 60 men, many who may not have otherwise sought screening.  Screening included PSA blood test, physical prostate examination, and consultation.  For more information contact Chicago Prostate Cancer Center at 630-654-2515, request a brochure or consultation,  or email  to arrange prostate cancer screening and discuss prostate cancer treatment options.


STPB Improves Active Surveillance of Prostate Cancer

Posted on: August 23rd, 2016

Pt jeans,white button shirt w doc in lab coat

In a recent blog , we described the practice of Active Surveillance of Prostate Cancer and CPCC’s guidelines for patients who choose to safely monitor their early stage prostate cancer rather than seek active treatment.  One key recommendation is to receive periodic biopsies, or tissue sampling, of the prostate in order to watch for tumor growth.  CPCC highly recommends men maximize the diagnostic information available from each biopsy session by undergoing a biopsy technique called Stereotactic Transperineal Prostate Biopsy (or STPB).

What is Stereotactic Transperineal Prostate Biopsy?

Most prostate cancer diagnoses are based upon a standard transrectal biopsy administered in the office by a urologist.  Yet this transrectal approach permits only random needle sampling of the prostate.  Furthermore, transrectal samples are taken at an angle that misses the lowest region of the prostate gland  (the anterior-apex area) where “hidden prostate tumors” are often located.

To better locate all tumors, Chicago Prostate Cancer Center pioneered Stereotactic Transperineal Prostate Biopsy, or STPB.

How would STPB benefit me?

STPB provides the proper angle to allow the physician to take biopsy samples that reach the entire prostate gland, without missing the apex area.   Our published research demonstrates that as many as 40% of patients originally thought not to have malignancy, indeed had hidden tumors that would otherwise have gone undetected.

Mapping improves treatment

STPB’s grid-like template allows tissue locations to be mapped as they are sampled.  This is useful information for later treating sites that may be determined cancerous.  STPB is a convenient out-patient procedure that is virtually pain-free since it is completed using general anesthesia.

Avoiding false negative biopsies

Originally, our experience using STPB was confined primarily to patients who were diagnostic dilemmas:  men who had persistent elevation of PSA level, but whose repeat transrectal biopsies continued to be negative for cancer.  Now, STPB is more and more commonly being requested by patients as their initial biopsy technique.  Patients who elect a specific treatment option (including brachytherapy) — instead of going the Active Surveillance route— also benefit from STPB’s reassurance.

Virtually eliminates risk of infection

In contrast to the transrectal approach (where a biopsy needle passes through the contaminated rectal wall), the transperineal approach (through the skin between the scrotum and the rectum) virtually eliminates the risk of infection.  Read one man’s struggle with infection.

Watch for our next blog that shares how STPB further advances the diagnostic power of biopsy when coupled with Genomic Testing.


Active Surveillance of Prostate Cancer

Posted on: August 11th, 2016

NYT Active Surveillance man w car

Prostate Cancer: Active Surveillance or Active Treatment?

If you were diagnosed with prostate cancer, what would you do after the news settled in?  Would you seek immediate treatment?  What treatment options would you explore?  According to an article recently published in the New York Times, men are more likely than ever to hold off on active treatment if their prostate cancer is detected at an early stage.  Reportedly, the number of men choosing “active surveillance” has quadrupled in the past five years.  Therefore, Chicago Prostate Cancer Center reminds men who choose active surveillance to work closely with their physician to understand how to best monitor prostate cancer for signs of progression, and determine whether and when to actively treat it.  (In a recent, related blog we share concerns that a reduction in prostate cancer screening may impact the number of cases of more aggressive cancer.)

What is Active Surveillance?

Active Surveillance (also known as “expectant management”, or “watchful waiting”) for men with prostate cancer is the postponement of immediate therapy (such as brachytherapy, external beam radiation or surgery) if there is no evidence that the patient is at increased risk for disease progression.   Active surveillance is an accepted option for the initial management of carefully selected men whose cancer cells occur within—not outside—the prostate gland, appearing almost normal under the microscope.  These men may have less risk of fast cancer cell growth and may safely choose to undergo a planned evaluation schedule including PSA tests, digital rectal examinations (DRE), and prostate biopsies.

When, or do, I switch to Active Treatment?

If there is evidence that the cancer is growing, treatment can be recommended at that time, with the intention of curing the disease.  With timely monitoring, patients can be reclassified as higher risk for disease progression and then undergo a specific therapy without substantially decreasing the chance of cure.  Read more about prostate cancer treatment options.

Is Active Surveillance right for me?

 Treating over 15,000 men with prostate cancer, Chicago Prostate Cancer Center (CPCC) created a specific set of recommendations to guide men deciding whether Active Surveillance is their best care strategy, at least for their initial approach.   Click and scroll to CPCC’s  Active Surveillance Guidelines which include a profile of Who is the Best Candidate for Active Surveillance.

While it is important to work with your doctor to discuss these guidelines in the context of your own specific health situation, it is also important to check your feelings:  patients need to be of the correct mindset for this option, as knowledge of having a cancer, but not treating it, can cause anxiety.  We work hand in hand with Prostate Cancer Foundation of Chicago, which hosts a Patient Support Group that helps men cope with prostate cancer concerns such as Active Surveillance.

Finding “hidden tumors”

Finally, CPCC Active Surveillance Guidelines recommend a specific type of prostate biopsy for the most comprehensive results possible.  Watch for our upcoming blog to discover how biopsy advancements by Chicago Prostate Cancer Center are of special benefit to men choosing Active Surveillance.


“No Change in Quality of Life” since seed implant procedure

Posted on: July 27th, 2016

Patient testimonial on how happy he is with his decision to have a seed implant procedure at Chicago Prostate Cancer Center. He feels like a new person, with a new life, now that he has had a successful treatment without pain or change in his lifestyle.


Hank Bauer Memorial Golf Outing

Posted on: July 26th, 2016

Hank Bauer 2016 4th

Philanthropy fights prostate cancer

Chicago Prostate Cancer Center works hand-in-hand with Prostate Cancer Foundation of Chicago (PCFC) to provide education and support for men facing prostate cancer and to conduct  research to conquer the disease that affects one in seven men.  PCFC counts on the generosity of patients and their families, and grants from foundations, corporations and the greater community to help provide prostate cancer screening, education and support groups.

Golf with a purpose

One of PCFC’s dedicated supporters is the remarkable family of Hank J. Bauer.  Blake and Ashly Bauer and their friends and family have worked tirelessly each of the last four years to keep the spirit of Blake’s father alive.   Hosting the Hank Bauer Memorial Golf Outing — complete with fun golf-hole prizes, raffle items sponsored by generous community businesses, and participation by over a hundred golfers — is their way to bring family and friends together to remember Hank and raise awareness and support for prostate cancer screening and educational outreach.

Remembering Hank

This year’s event at the Cary Country Club will happen August 6, 2016, just 4 days before commemorating the 4th anniversary of Hank’s passing.  However, the family draws strength and encouragement for the future in their celebration of life that goes a long way to help other men like Blake’s dad fight prostate cancer.

Register now

Register  now to golf the 9-hole scramble, or to join in the after-golf dinner event with live performance by “Ivy Ford.”  PCFC is most grateful to the Bauers and encourages everyone to join in the fun!


Aggressive prostate cancer rising: why?

Posted on: July 20th, 2016

Advanced Cancer Cases

Is prostate cancer generally becoming more aggressive and fast growing? Or have changes in prostate cancer screening practices allowed more early stage cancers to be missed, resulting in later diagnoses of more aggressive cancers?  NBC Nightly News recently showcased these questions, raised in a recent study by Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine.  These concerns are also important to advance the patient care provided by Chicago Prostate Cancer Center (CPCC).

Doubling of aggressive prostate cancer

Dr. Schaeffer’s study demonstrated that since 2004, “cases of metastatic prostate cancer — the type that has started to spread in the body — nearly doubled in men aged 55 to 69”. In 2012, the U.S. Preventative Task Force (USTPF) issued new prostate cancer screening guidelines, which suggested that the PSA test was leading to unnecessary biopsy procedures and treatment of insignificant cancers. As a result, many doctors stopped offering their patients routine screening with a PSA test and digital rectal exam (DRE).

Changes in screening guidelines

The investigators admit that recent changes in prostate cancer screening guidelines may not be totally to blame for this increase, partly since the guidelines were issued eight years into the study’s data collection time frame. At CPCC, we saw the tide shift toward less screening when the 2012 USPTF pronouncement was made. Unfortunately, over the last four years we have also seen an increasing number of men diagnosed with advanced prostate cancer.

Screening even more important

If future research demonstrates prostate cancer is becoming more aggressive across the board, CPCC suggests early screening with both PSA and DRE will be more critical than ever.  Detecting early stage prostate cancer, when its highly treatable, will save more lives. Read more about the importance of prostate cancer screening or register for free screening supported in part by Prostate Cancer Foundation of Chicago.


Student shadows Dr. Moran, volunteers with research studies

Posted on: July 13th, 2016

Eric, MB, BJM

Chicago Prostate Cancer Center (CPCC) values education about prostate cancer, not only to improve patients’ understanding of the disease and its treatment options, but to expand technical knowledge of visiting physicians and provide opportunities for students.

CPCC works hand-in-hand with Prostate Cancer Foundation of Chicago (PCFC) on research and education that advances best practices in low dose-rate brachytherapy—or seed implant— an effective, convenient option that allows men to remain active during prostate cancer treatment.

We are grateful to student intern, Eric Bernstein, a Johns Hopkins undergraduate who is volunteering with PCFC for his second summer. Eric has observed brachytherapy and cryotherapy procedures and assists with research data entry. He is co-authoring a research abstract that will look at how many times prostate cancer was initially identified in individuals screened at our annual Prostate Cancer Screening Event.

Read Eric’s blog:

Since the beginning of the summer, I’ve been working at CPCC doing data entry tasks for the research side of the operation. I’ve seen countless PSA reports and physics charts and satisfaction surveys. But, as an undergraduate student considering medical school in the future, I’ve also had the opportunity to shadow Dr. Moran and his team in the operating room. That has proven to be one of the most educational and interesting experiences that I have had.

 Although Dr. Moran only does a few different procedures here, they are, from a technological standpoint, very complicated. The course of the treatment uses several kinds of advanced imaging techniques as well as computer modeling and radiation. It begins with an ultrasound imaging of the prostate to get a rough estimate of the size and shape of the gland. A computer algorithm is then used to design the radioactive seed implant plan. Then, during the implant, a general anesthesia is used to put the patient to sleep, and the ultrasound is used again to visualize the prostate as Dr. Moran drops the seeds into place. Finally, a CT scan is performed to ensure that all the seeds are in the right place and that the correct amount of radiation was implanted.

 It seems like this procedure could be overwhelming to somebody who hasn’t had a second of medical education yet, but I actually relish the opportunity. Having all these things involved in the process means I’ve gotten to learn about how all of these things work and some of the ways they can be used. I’ve learned about the internal structure of the ultrasound probe and the physiology of sevoflurane, and more about the prostate than I ever thought I wanted to know. I know that experience will come in handy in medical school.

 The most valuable experience, however, comes from Dr. Moran and his team. The most important thing for a doctor and his or her team is how they interact with their patients. Dr. Moran has an exemplary bedside manner and his patients always seem at ease going into the OR. The nursing staff is kind and attentive, as well as knowledgeable about the procedures. I believe that most people who decide to go into health professions do so because they want to help people. Dr. Moran has reaffirmed that belief for me. He has provided me with an example of how to behave around patients. That is experience that I will take with me no matter what my future holds.