Guiding Men Through the Prostate Cancer Maze. The Smilow Comprehensive Prostate Cancer Center

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1 Guiding Men Through the Prostate Cancer Maze The Smilow Comprehensive Prostate Cancer Center E X P E R I E N C E I N N O V A T I O N S A T I S F A C T I O N

2 Men face a bewildering number of questions related to prostate cancer.

3 Should I undergo prostate cancer screening? Is my PSA level normal? My father died of prostate cancer should I take a medication to prevent prostate cancer? Are there any dietary modifications or supplements that prevent or treat prostate cancer? Do I need a digital rectal examination if my PSA is normal? My PSA is rising, do I have cancer? When do I need a prostate biopsy and how many tissue cores should be obtained? What do I do if my PSA is rising despite a negative biopsy? What is the best treatment for my low risk prostate cancer? Is it safe to simply watch my cancer and not treat immediately? Am I a candidate for focal targeted ablation of my cancer? Are there any advantages to robotic radical prostatectomy? Will penile rehabilitation help restore my potency following radical surgery?

4 The Smilow Center is providing men with guidance and options.

5

6 Answering the Questions with a Comprehensive Approach The management of prostate cancer is highly controversial with a host of unanswered questions surrounding screening, chemoprevention, diagnosis and treatment. Despite the tremendous advances that have been made, prostate cancer remains the second leading cause of cancer deaths in American men. And while screening and aggressive treatments have led to a decline in death rates, there is an emerging consensus that many men are being over treated for this disease and exposed to unnecessary complications from treatment. At the Smilow Center, we recognize that not all men and cancers are the same. Therefore, there is no single optimal treatment for this disease. We believe that a comprehensive center offering personalized care supported by evidenced-based medicine offers the opportunity to identify who can best be managed with aggressive treatment and who can safely pursue a more conservative approach. One of our highest goals at the Smilow Center is helping men select a course of treatment that balances cure and quality of life in order to maximize patient satisfaction. Comprehensive Care. The Smilow Center offers truly comprehensive services for men, including the most up-to-date programs in prostate cancer prevention, screening, diagnosis, treatment, and post-treatment rehabilitation an often overlooked, but essential element in treating this disease. Urologic surgeons, naturopathic doctors, radiation oncologists, radiologists, medical oncologists and pathologists work collaboratively to achieve our fundamental goal to individualize treatment for optimal patient satisfaction. The Smilow Center is a unique facility offering truly comprehensive, state-of-the-art care grounded in evidence based medicine. TREATMENT OPTIONS ACTIVE SURVEILLANCE SURGERY OPEN ROBOTIC MINIMALLY INVASIVE HIFU CRYOTHERAPY LASER THERAPY RADIATION THERAPY BRACHYTHERAPY EXTERNAL BEAM HOLISTIC THERAPY 3

7 Individualized Treatment. Men entrusting their care to the Smilow Center appreciate that their treatment will be customized to their individual needs. Our physicians take the time to listen to and understand each patient s priorities and goals. And because we offer the full range of modalities at the Smilow Center, men can select the course of treatment that best fulfills their goals and objectives. Presenting realistic expectations for all the treatment options, based on the highest level of available medical evidence, is an integral component of the Smilow Center. Our team is comprised of world-renowned experts with tremendous clinical experience in all aspects of prostate cancer care. Smilow surgeons are highly experienced in performing radical prostatectomy and minimally invasive ablation of the prostate. For patients who choose radiation therapy, the radiation oncologists at our nationally recognized Department of Radiology will ensure the optimal level of care. We leverage the expertise of our comprehensive team to individualize treatment pathways to ensure patient satisfaction. 4

8 Empowering Patients. At the Smilow Center, we believe an informed patient is an empowered patient. We have transformed the typical waiting room into a comfortable educational center. Men and their families have an opportunity to learn about our center and its unique philosphy via a video on a large screen TV. For more in-depth information, ipads are available for patients to view educational videos produced by members of the Smilow team. These video lectures cover key topics such as screening, biopsies, open and robotic prostatectomy, focal/ablative therapies and naturopathic strategies. The patient empowered with credible information becomes an active partner in developing a personalized treatment plan. Team Approach. Every patient has access to the expertise of the entire Smilow team regardless of which doctor was his entry point. The Smilow Center doesn t advocate one treatment. We specialize in every aspect of prostate cancer management and will pursue a pathway that is driven by the risk of the cancer and the individual goals of the patient not the doctor. Once the optimal treatment is identified, the appropriate treating physician will step in to provide the patient with the highest level of care. Mark s Experience Having a comprehensive perspective on how to treat this disease and how to manage the post-cure side effects primarily the incontinence potential and the impotence potential are extraordinarily important and without that there can be serious lifestyle changing implications. Tillinger adds, Not only did they listen to me, they listened to my wife, and that gave us the comfort in coming to the Smilow Center for treatment. Mark Tillinger, Connecticut Age 51 5

9 Open or Robotic Experience is Key. In many cases, radical prostatectomy is the preferred option. Thirty years ago, a Smilow surgeon played a key role in developing the nerve-sparing radical prostatectomy and has performed over 4000 cases which is among the highest in the world. Men travel from many continents to entrust their care to our experienced surgeons. 6

10 Paul s Experience The first doctor I talked to had done 150 procedures. The doctor who performed my surgey at Smilow had done close to 4000, Paul Stumme explains why he chose Smilow. The Smilow Center and NYU Medical Center was just a really well-oiled machine. I was not the first patient to come through: the doctors, the nurses, the hospital all of the people you work with, they all knew their job and were extremely professional in doing it. Paul Stumme, Colorado Age 61 At our Robotic Surgery Center, a dedicated team of nurses and anesthesiologists has been specifically trained for robotic surgery. Using the da Vinci Surgery System, the most sophisticated surgical device in existence, our highly skilled surgeons have performed over 1000 robotic prostate surgeries. Experience 7

11 Innovation Advanced Diagnostics. Assessing the location and malignant potential of the cancer is key to treatment selection. The Smilow Center leads the country in pioneering cutting-edge diagnostic approaches to optimize risk stratification of cancers. Using new technology, our physicians are able to see tumors with unprecedented detail on MRI scans, map tumors with great accuracy with a computer-guided biopsy device, and examine a tumor s characteristics with HistoScanning an experimental advanced ultrasound device. These innovative technologies provide our physicians with the detailed information that is necessary to guide patients in selecting appropriate treatment options. HIFU uses the power of ultrasound to destroy prostate tissue without affecting the surrounding healthy tissue. The Smilow Center is only one of two facilities in the northeast currently using the Eigen Artemis System a 3D imaging and navigation device for more accurate tissue sampling during prostate biopsies. Pioneering New Treatments. At the Smilow Center we believe the paradigm for treating prostate cancer is evolving towards targeted focal therapies for low risk cases. Smilow surgeons are pioneering novel ablative technologies that have the ability to destroy small tumors while leaving the remaining prostate gland intact. In these select cases, we are able to preserve surrounding tissues alleviating incontinence, erectile dysfunction and rectal problems. Smilow surgeons were the first in the northeast to investigate the Sonablate 500 HIFU system and the Tookad Photodynamic system for ablating small tumors. 8

12 As leaders in advancing the treatment of prostate cancer, the Smilow Center and NYU Langone Medical Center have participated in clinical trial studies for HIFU and photodynamic therapy two promising minimally invasive ablative therapies. The Smilow Center also has a state-of-the-art work station for our radiologists who can help guide image-based ablative treatment, as well as two fully equipped high-tech operating rooms where cryotherapy and other minimally invasive options are offered. In many cases, the prostate cancer is focally treated in about an hour and the patient is able to return home that same day. Patients are generally back to work the next day, following minimally invasive treatment. Bob s Experience After a biopsy revealed one small spot of cancer with a Gleason score of 6, Bob s urologist recommended Active Surveillance. Bob s daughter, an oncologist, suggested he get a second opinion. A 16-core biopsy revealed three additional areas of cancer on both sides of the prostate and my Gleason score was 8, Muller explained. After exploring my options, I chose to have my prostate surgically removed. Following the path of Active Surveillance that was originally recommended could have been lethal. Bob Muller, New York Age 63 Equipped with cuttingedge conferencing technology, the Smilow Center offers hands-on experience with the latest advances in treatment to doctors from around the country. 9

13 Ed s Experience Although all indications were of a very low level of disease, with only one positive core and a PSA of 1.4, my urologist advised me to have my prostate removed robotically, explained Ed. A friend suggested I get a second opinion at the Smilow Center. An initial advanced MRI and a six month follow up biopsy showed a very small cancer that did not warrant immediate surgical treatment. After discussing treatment options, I chose to pursue the path of Active Surveillance with my physician s approval. Ed Tella, Connecticut Age 60 Holistic Support. The evidence is growing our diets and lifestyle can have a significant impact on our health. At the Smilow Center, we offer holistic approaches that complement mainstream medical care. We place special emphasis on nutrition, herbal medicine, diet modification, acupuncture, the mind/body connection and exercise all of which can be powerful supportive therapies for prostate cancer. Setting the Standard. As part of NYU Langone Medical Center and its NCIdesignated NYU Cancer Institute, the Smilow Center has access to unprecedented resources that translate into tremendous benefits for our patients. Our doctors, all members of the faculty at NYU School of Medicine, are internationally recognized as educators and thought leaders. The NYU Urology faculty hosts three annual postgraduate courses which are forums for discussing the many controversies related to prostate cancer. Physicians from all over the world look to NYU Langone Medical Center as a source for their continuing medical education. 10

14 Smilow Center Physicians Meet the physicians who make up our prostate cancer care team. Herbert Lepor, MD Director of the Smilow Comprehensive Prostate Cancer Center Martin Spatz Chairman, Department of Urology NYU Langone Medical Center William Huang, MD Assistant Professor of Urologic Oncology NYU Langone Medical Center Samir Taneja, MD Co-Director of the Smilow Comprehensive Prostate Cancer Center Director of Urologic Oncology, Department of Urology and NYU Cancer Institute NYU Langone Medical Center Stephen Scionti, MD Director of Ablative Prostate Cancer Surgery NYU Langone Medical Center Nicholas Sanfilippo, MD Clinical Medical Director, Department of Radiation Oncology NYU Langone Medical Center Geo Espinosa, ND Director of the Integrative Urology Center NYU Langone Medical Center Michael Stifelman, MD Director of the Robotic Surgery Center NYU Langone Medical Center Experience Innovation Satisfaction 11

15 How to Find Us The Smilow Comprehensive Prostate Cancer Center is conveniently located in the Murray Hill neighborhood on the east side of Manhattan. Address 135 East 31st Street, 2nd floor (between Lexington and 3rd Avenues, near the corner of Lexington) New York, NY Web site Phone

16 The patient, empowered with credible information, is an active partner in developing a personalized treatment plan.

17 Prepared by the NYU Langone Medical Center, Department of Urology Photographers: John Abbott, Bud Glick, Rene Perez Cover Illustration: 2011 James Steinberg, theispot.com Opportunities for Giving For information about contributing to the Smilow Comprehensive Prostate Cancer Center, please contact: Rebecca Nussbaum Office of Development One Park Place New York, NY Phone:

18 135 East 31st Street, 2nd Floor (between Lexington and 3rd Avenues, near the corner of Lexington) New York, NY

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