Dattoli Cancer Center & Brachytherapy Research Institute

Yes

The risk of impotence and/or incontinence is greatly reduced with seeding, in comparison to the risks resulting from surgery. The surgical procedure typically requires hospitalization and a lengthy recovery period. Because most surgeries require a major incision, there is an increased risk of infection and other surgical complications. Newer laparoscopic and robotic techniques even increase the length of the procedure, thus increasing potential complications (blood clots to the lungs, infection) and many laparoscopic/robotic procedures are aborted and converted to the more formal open approach when vessels are nicked or the rectum is lacerated. At our center, we have published superior results with combination therapy (brachytherapy and IMRT with or without hormones) with intermediate and high risk patients (Stage T3, PSA >10, Gleason Score 7-10, elevated PAP) compared to surgery — with more than 80% of these patients enjoying successful long-term outcomes. It should be noted that the limitations of the open radical prostatectomy also apply to laparoscopic and robotic surgical techniques: the operation is necessarily performed “in the blind,” in the sense that the patients’ workup tests do not allow the surgeon to know with any certainty in advance whether or not the cancer has spread beyond the prostate gland. In other words, the risk of having “positive surgical margins” is the same regardless of which surgical technique is used. In our opinion, this means there is an unacceptably high risk of failure with all forms of radical surgery.

YES. DART will provide the least dose to healthy tissue and organs surrounding the prostate, minimizing the risk of side effects, and give you the best shot at a cure. In this type of case we commonly use hormones along with DART.

DART, or Dynamic Adaptive Radiation Therapy, takes 3-D Conformal Radiation Therapy to a new level of precision and control. With this increased level of precision where microbeams are literally striking targets the size of a dot (referred to as a “voxel”), we are able to far reduce the risk of damage to the bowel and bladder while maximally preserving erectile function. Here are some of the advanced features that make this level of precision possible: SonArray, an ultrasound and camera-based image guided system with intra-fractional motion gating, employed moments before each radiation treatment to make sure the prostate and the tumor are in the exact same location for each beam application (even the simple motion of breathing can shift the position of the prostate, which is tracked and corrected for by special respiratory gating, available at the Dattoli Cancer Center). Any patient movement is sensed by SonArray’s intra-fractional observer function in which case the DART goes safely into default mode; Portal Dosimetry is a computerized checks and balance system. Doctors utilize Portal-Vision® which enables them to watch your 4D treatment in ‘real time’ or later in the day at their work stations. Also, the SonArray image guided target positioning systems allows for daily remote real-time 4D review to the physicians’ personal computers using a wireless network system (the first of its kind); The On-Board image device and Cone Beam helical tomography add yet another layer of checks and balances which ultimately result in a level of precision which only five years ago was thought not to be possible.

The long-term survival rates for patients who have completed brachytherapy or combination therapy including brachytherapy under the care of a skilled radiation oncologist, are as good or better (typically greater than 90%, depending on the PSA, stage and grade) than those who have had surgical removal of the prostate. The biggest difference is in the quality of life after treatment, with far fewer incidents of erectile dysfunction while incontinence is virtually unheard of following brachytherapy (a skilled radiation oncologist will have completed not hundreds of cases, but thousands, and will have personal statistics supporting successful treatments for many years). So here we have a treatment that not only provides higher quality of life but even greater quantity!

The color-flow Doppler prostate ultrasound, introduced to the west coast of Florida by the Dattoli Cancer Center, brought a new perspective to diagnosing prostate cancers. The Doppler technology reveals in brilliant color areas of increased blood flow within the gland, indicating sites of suspected tumor growth. This information is crucial in planning the prostate biopsy, as it gives the physician color “targets” for the biopsy cores. Most biopsies for prostate cancer are performed utilizing transrectal ultrasound equipment which portrays images in hues of grey, resulting in randomly spaced biopsy cores that may often miss a cancer entirely. With the recent addition of a brand new Sonocubic computer program, physicians at Dattoli Cancer Center can look at suspected tumor growth from 360 degrees, rotating the image on the monitor to view the transparent structure from all sides, and enhancing the information needed to perform the all-important biopsy. Additionally, this same sophisticated technology is used for therapeutic reasons (that is, for patients who have already had a biopsy) allowing for the pinpoint targeting of cancerous lesions using both DART and brachytherapy (seeding).

Dynamic Adaptive Radiation (DART) is cutting edge arsenal of technologies that uses up-to-the-moment “captured” image data to adapt a patient’s treatment to constantly evolving information which occurs during a treatment course. It is well known that changes such as tumor position, size and shape occur not only during a several week treatment regimen, but also on a daily basis when patients are undergoing treatment. DART allows us to realize the single most important goal ever achieved with radiation therapy: Delivering the exact dose to the exact place at exactly the precise time, every time, even when the target (tumor) moves, shrinks or changes shape – a revolutionary and unprecedented accomplishment in the treatment of prostate cancer!

They except most insurance

Yes

2 days and it is approximately 10 minutes from dattoli treatment center

They do not do proton therapy that I am aware of.