Dr. Brian J. Moran is Medical Director at Chicago Prostate Cancer Center in Illinois and an experienced practitioner of prostate brachytherapy, having performed thousands of prostate seed implants. He is a frequent speaker at professional meetings and has authored numerous publications in medical journals and textbooks.
Chicago Prostate Cancer Center specializes in prostate brachytherapy, which is a procedure where radioactive seeds are implanted directly into the prostate gland of patients with localized prostate cancer.
Dr. Moran states that, based on his experience, prostate brachytherapy has a range of advantages over alternatives including external beam radiation and surgery. In comparison with external beam radiation, the dose of radiation is significantly higher with brachytherapy. ”And, by being able to put the radiation directly into the gland, we can avoid dose to the surrounding structures such as the bladder and rectum. You want to target the cancer, but also avoid toxicity to the bladder and rectum, and to focus on the quality of life after the procedure.”
At Chicago Prostate Cancer Center, brachytherapy patients benefit from a one time, out-patient procedure that requires no incisions or stitches, whereas external beam radiation requires nine weeks of daily radiation treatments. In order to achieve the highest level of success, Dr. Moran utilizes perineal mapping biopsies, which he describes as “having revolutionized our ability to detect and thereby treat prostate cancer. Perineal mapping biopsies are highly accurate, and limit unnecessary damage to surrounding structures. There is also a lower rate of infection.”
The perineal mapping biopsy that Dr. Moran uses is called STPB (Stereotactic Transperineal Prostate Biopsy). During this procedure, performed under general anesthesia, needles are placed behind the scrotum and through the perineum using a needle guide template. By using this template, it possible to accurately map the prostate and position the biopsies.
Chicago Prostate Cancer Center frequently treats patients who have previously had negative transrectal biopsies, but have continuously rising PSA levels. “These patients are diagnostic dilemmas”, says Dr. Moran. Based on over 3000 cases, the Center has detected cancer in 40% of these patients. Of course, some of these patients have low volume, low risk disease, but the fact is that the majority of them have what qualifies as significant disease, which means a higher Gleason grade, and bulky tumors.
“As we move into the era of focal, or targeted therapy, technology is going to continue to improve, allowing us to further focus with higher definition machines. It’s remarkable how far ultrasound technology has come in the 20 years I have been practicing.”
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