Dr. Sleeper Discusses Diagnosing Prostate Cancer With UroNav
Dr. Sleeper is a highly trained urologist with extensive experience diagnosing prostate conditions by utilizing the latest in ultrasound guided fusion biopsy technology, UroNav. If you are currently experiencing symptoms of prostate cancer, call (985) 892-6811 to request an appointment at our urology clinic in Covington, LA today!
Melissa: Hello and welcome to healthy living, brought to you by St. Tammany health system. I’m Melissa Hodgson your host and we’re talking today about men’s health prostate cancer diagnosis, awareness, and a new technology called UroNav, which helps St. Tammany health system and local physicians diagnose and treat prostate cancer.
We’ll talk first with Dr. Joshua Sleeper a local urologist, then with Dr. Joshua Yellen a local radiologist and last we’ll talk with Kim Belsen an ultra sonographer with St. Tammany health system.
So starting with Dr. Sleeper, Good Morning, Thanks for coming!
Dr. Sleeper: Thank you, thank you for having me very glad to have you here!
Melissa: So UroNav technology aside, as a urologist can you talk a little bit about men’s health and the importance of screenings and coming in annually for diagnosis.
Dr. Sleeper: Worldwide, you know men have a overall lower life expectancy than women so urologic health certainly plays a role in that. In the U.S. prostate cancer, after skin cancer, is the most common cancer in men with approximately 190, 000 new cases and the second leading cause of cancer death after lung cancer approximately 33, 000 deaths per year.
Screening is kind of controversial and it’s gone back and forth. The U.S. has a preventative task force that makes recommendations from the role of mammograms and annual screenings for ages. They’ve gone back and forth with a psa screening but now the recommendation is generally to have the patient involved in a discussion about the risks
and benefits of screening and then start screening annually or every two years at the age of 55, between the ages of 55 and 69 or earlier if there’s a strong family history in african american men.
Melissa: Excellent, and so in your practice you see men on a routine basis and you’re screening according to best practices. So in the case of someone who maybe has those initial screens come back can you take us from that point.
Dr. Sleeper: Sure, so you know we get a lot of referrals from primary care physicians who are doing the screenings for prostate cancer which is the psa. So if a man comes in and the psa is elevated and again that’s a long discussion what what is it elevated psa but we we discuss options okay. Sometimes we’ll repeat the test and sometimes that we feel like a biopsy is indicated. Then we discuss the role of biopsy
and proceed from there.
Melissa: Certainly that’s not a first level like you’re saying that is we’ve seen something we have some concerns let’s take a look and so biopsy is an important part of your practice as a urologist and this UroNav technology makes a little bit of a difference there so can you talk about the product.
Dr. Sleeper: So the standard biopsy it involves an ultrasound and we take samplings in standard areas of the prostate so typically we take 12 cores with a needle using ultrasound the vast majority of men who have just an elevated psa. The ultrasound appears normal we don’t see a identifiable region or a tumor to actually hit and the ur the urinal involves overlaying an mri image essentially giving us a bullseye to hit on ultrasound image. There’s
been studies that have validated that it does improve detection and improves detection of higher grade
cancers and that will certainly play a role in determining treatment options for the patients.
There’s been a big push over the past decade to actually do what’s called active surveillance in men who meet certain criteria.Meaning lower risk prostate cancer based on pathology on biopsy men who have lower psas
and this mri technology is going to certainly allow us to be more comfortable and allow us to reassure men that
we’re making the right decision for them.
Melissa: Very good, so what i hear you saying okay from primary care you may see something that gets you referred to Dr. Sleeper then you’re going to work with that patient to determine okay maybe what we need to do here is a biopsy and then based on that biopsy you have this ability with the UroNav could we the uninitiated.
Dr Sleeper: Maybe think of a bit of a gps for you that helps you be sure you’re mapping to this the place in the
patient’s body that um in the prostate itself help me exactly you know when you do a biopsy it’s basically random samplings. Now we do have standard areas that we target but you’re certainly not hitting the entire prostate
and then a lot of men men who have larger prostates there’s no way to sample that area. We see certain lesions and
certain areas of the prostate we don’t routinely target. This is what the mri will allow us to do. My guess is and there’s also been recent recommendations from urologic associations in the radiology associations that men undergo MRI’s before a standard biopsy.
Melissa: I think that’s going to uh probably be the future. Okay so right now we would go from the initial test you
mentioned the psa etc and then the biopsy but you see the future of this process kind of interjecting that mri before biopsy.
Dr Sleeper: Yeah certainly, and so that may be a place that we’re going with practice.
Melissa: True yeah very good! Well certainly not every hospital has UroNav, and not every urologist has the um luxury if you will of that opportunity. We’re excited to have that here on the north shore. Can you talk a little bit about your training and how UroNav is different from what you were doing before it was available?
Dr. Sleeper: So it still involves the standard ultrasound guided biopsy that most urologists are familiar with. But, it we really rely on our radiology colleagues to assist us with this the MRI technology like Dr. Yellen will i’m sure address, is not a a standard x-ray that that most physicians can kind of pinpoint and look at and say “I see this spot” it really relies on a lot of technology and the radiologist’s expertise to identify the errors in the prostate and then use
the technology to overlay it on our ultrasound uh imaging to allow us to to biopsy the suspicious areas.
Melissa: Excellent! So, essentially what this urinal technology is doing for you the urologist is giving you much more certainty uh and confidence about where that biopsy needs to occur in the prostate.
Dr. Sleeper: Exactly! It’s a bull’s-eye for us to hit. Okay so um there’s a little less um uncertainty about where the biopsy needs to occur and like you say a bullseye we’re gonna hit the target exactly you know a lot of men who will come in for an elevated psa we’ll do the standard ultrasound biopsy. We don’t find any suspicious cancers or
suspicious cells but we continue to monitor them and their psa continues to increase and increase and that causes a lot of anxiety for patients because they say well why is this happening why is my psa increasing? This mri really gives us a much more confident technique to give those patients answers.
Melissa: Right some peace of mind and understanding what’s happening in their body right because correct me if i’m wrong but with prostate psa levels sometimes we can just be in a watch and wait. Yes the number’s rising but we’re not concerned and so for the individual man who’s seeing this number keep increasing maybe they’re sort of like well you may not be worried but i’m worried.
Dr. Sleeper: Exactly, and so this gives away that we can be much more accurate in the testing. Again, with a big
push to do what’s called active surveillance. Meaning no treatment no surgery for men who’ve had who have low risk prostate cancer no radiation therapy for men have low risk prostate cancer. It really gives not only the patient but the physician great comfort that we’re doing the right thing for these men.
Melissa: Perfect! Well Dr. Sleeper, Thank you so much for coming in to talk with us. We appreciate your time.
Dr. Sleeper: Thank you so much!