Guest column

New technology gives this Houston hospital a competitive edge

A new prostate cancer treatment at Houston Methodist is enhancing the system's patient care. Getty Images

As the top ranking hospital in Texas and one of the biggest employers in Houston, Houston Methodist Hospital is poised to treat the thousands of Texan men who will be diagnosed with prostate cancer this year.

Building on its legacy of delivering advanced cancer treatment, the healthcare giant is one of the first hospitals in the United States to offer men a benign approach to treating localized prostate cancer, using high intensity focused ultrasound, or HIFU. HIFU is a minimally invasive procedure that allows patients to maintain their quality of life with potentially fewer side effects.

Changing the standard of care

For decades, men diagnosed with prostate cancer have had three ways to manage their disease. The first is watchful waiting or active surveillance. Prostate cancer is often slow growing and may not impact the patient during his lifetime. Despite reassuring data in large randomized trials, some patients are still uncomfortable with a diagnosis of cancer and prefer treatment.

On the other end of the spectrum is the complete treatment of the prostate, which involves either surgically removing the entire organ (radical prostatectomy) or radiation, which can last up to eight weeks, with five rounds of treatment per week. Both treatments are known to cause long term erectile dysfunction and incontinence.

But for men diagnosed with localized prostate cancer, this new HIFU treatment bridges the gap between these three approaches. Unlike diagnostic ultrasound, which people are more familiar with, HIFU uses high-frequency sound waves to heat up and burn cancerous tissue, causing cell death. Think of holding a magnifying glass above a leaf on a sunny day. The sun's rays shine through the lens and cause the leaf to burn.

New and improved

Courtesy of Houston Methodist

With HIFU, the urologist destroys the cancerous tissue without damaging other surrounding structures, which include nerves, blood vessels and muscle tissue. While HIFU has only been able to treat the entire prostate or large areas, Houston Methodist has a new technology, called the Focal One, that can zero in on specific areas to treat. The doctor can draw precise contours around the diseased tissue, destroy only that portion of the prostate and minimize any damage to surrounding tissue. This further decreases the possibility of incontinence and erectile dysfunction.

A competitive edge

Focal One gives Houston Methodist Hospital urologists the ability to plum the depths of something until recently considered heresy. The possibility of focal therapy to ablate only the diseased portion of the prostate is similar to performing a lumpectomy to remove only the diseased tissue of the breast in breast cancer. And focal therapy still leaves doctors with the options of radical surgery or radiation, should the cancer return. They don't necessarily burn any bridges.

Although focal HIFU treatment is available around the world for localized prostate cancer and studies in Europe have demonstrated its safety and efficacy, there are no long term follow up data in the U.S. at this time. So far, treatment complication rates in HIFU have shown to be as good as or better than other therapies. But urologic surgeons in the US generally need 10 years of data to establish focal therapy as a standard treatment, which is why it is important for cancer centers that embrace HIFU to enroll patients in an ongoing registry trial.


------

Brian Miles, M.D, is a practicing urologist and professor of urology at the Institute for Academic Medicine at Houston Methodist.

From a new cancer-detecting device to a digital resource for childhood cancer survivors, here are some cancer-fighting innovations from Houston. Getty Images

Not all heroes wear capes. Some wear lab coats. Almost daily, it seems there's a new breakthrough or discovery for life-saving innovations.

These three cancer-related innovations are coming out of Houston, and they are ones to watch.

University of Houston's biosensor for prostate cancer reoccurrence

Dmitri Litvinov, professor of electrical and computer engineering at the University of Houston, is on a mission to bring an effective, low-cost test for prostate cancer recurrence to doctor's offices everywhere. Photo via uh.edu

Researchers from the University of Houston have teamed up with their colleagues at the University of Pennsylvania to try to get a biosensor that can detect the recurrence of prostate cancer into the doctor's office.

The research is funded by a $399,988 grant from the National Science Foundation and led by Dmitri Litvinov, principal investigator and professor of electrical and computer engineering at UH.

"Such tests exist in clinical laboratories, but there remains a critical need for inexpensive, versatile and high-sensitivity diagnostic platforms which can bring the performance to the point of care or doctor's office," says Litvinov in a release.

The biosensor platform would be less than $3 per test — an alluring fact for patients and health care providers — and would function more or less like a pregnancy test, but without a simple positive or negative response. Rather, the test can assess how much prostate-specific antigen is in a patient's blood

"Our technology has potential to help improve survival rates with more accessible, affordable and easier testing," Litvinov says.

Rice University's study that points to new cancer-fighting drug

José Onuchic co-authored a study that's opening doors for a new approach in cancer drug development. Photo by Jeff Fitlow/Rice University

A recent study in the Proceedings of the National Academy of Sciences revealed that a cancer-linked version of the protein mitoNEET can shut the gateways of mitochondria cells that supply chemical energy.

José Onuchic, a physicist and co-director of Rice University's Center for Theoretical Biological Physics, co-authored the paper and noted that the gateways, called voltage-dependent anion channels, or VDACs, typically open and shut to allow the passage of metabolites and other small molecules between mitochondria and the rest of the cell.

"The VDAC channel transports all types of metabolites between the cytosol and the mitochondria," says Onuchic in a release. "Dysfunction of this channel is involved in many diseases including cancer and fatty liver disease."

Co-author Patricia Jennings, a structural biologist at UCSD, explains in the news release.

"The discovery that mitoNEET directly gates VDAC, the major porin of mitochondria, as well as the accompanying structural analysis and predictions for this interaction, affords a new platform for investigations of methods to induce cancer cells to commit cell suicide, or apoptosis/ferroptosis, in a cancer-specific, regulated process," she writes.

The study opens doors for a new approach to cancer-treating drugs.

"Fine-tuning a drug that specifically alters the redox-state of interaction between VDAC and mitoNEET would allow the development of new weapons to battle multiple cancers," Onuchic says.

Baylor College of Medicine's digital tool for childhood cancer survivors

Baylor College of Medicine has created an online resource for childhood cancer survivors. Photo via bcm.edu

Childhood cancer survivors face a lifetime of obstacles to overcome, and Baylor College of Medicine and Texas Children's Cancer Center have developed a resource to help these patients have the best quality of life in remission.

Passport for Care, a free online resource, features a "survivorship care plan" for the patient, his or her doctor, and family members. The program's new Screenings Recommendations Generator tool can provide a childhood cancer survivor with potential late effects and how to manage their care.

"This tool is especially helpful for patients who have moved on to other doctors who they did not see as a child and who might not be familiar with their particular treatment and the subsequent health risks," says Dr. David Poplack, founder of the Passport for Care and associate director of the Texas Children's Cancer and Hematology Centers, in a news release. "It helps physicians understand their patient's history and know how to address future health problems."

Over 37,000 cancer survivors are using Passport for Care at 138 clinics around the world. Additionally, patients can also register through the Screenings Recommendations Generator.

Passport for Care is funded by the Cancer Prevention & Research Institute of Texas, as well as through a grant from Hyundai Hope on Wheels.

"We created Passport for Care with the goal of empowering survivors in their healthcare decisions," Poplack says. "Their care doesn't end when cancer treatment is over. Survivorship care is a lifelong journey."