Aggressive prostate cancer is detected by advanced biopsy technology

Patient now cancer-free after UCI Health urologist removes fast-growing tumor

Paul Kroger is now cancer free after his UCI Health urologic oncologist detected and removed an aggressive prostate tumor.

Prostate cancer can be so slow-moving in some cases that there’s almost no need to treat it. In others, however, it can spread  aggressively to the patient’s bones and lymph nodes, making the disease extremely difficult to treat.

At UCI Health, Dr. Edward Uchio is leading the fight to take the guess-work out of prostate cancer diagnosis.

Uchio and his team are using Artemis, one of the most advanced prostate biopsy technologies available. It combines three-dimensional imaging, a robotic arm and a needle guidance system to hunt down prostate cancer cells.

Paul Kroger believes it has made the difference between life and death.

Kroger, 57, was originally diagnosed with prostate cancer while being treated for kidney stones. Blood tests showed that he had elevated levels of prostate-specific antigen (PSA), and a traditional biopsy revealed a small lesion on his prostate.

The Los Alamitos resident's physician put him on “active surveillance,” meaning that his PSA levels would be checked periodically to to make sure the cancer wasn’t growing fast. But Kroger didn’t want to wait. Because several men in his family, including his father, had been diagnosed previously with prostate cancer, he wanted more assurance. He went to see Uchio, a UCI Health urologic oncologist.

“His PSAs were actually very consistent and stable,” Uchio said. “That’s the problem with PSA — often in active surveillance, [the test] won’t designate who’s going to progress. And when it does go up, sometimes it’s too late.”

Uchio recommended that Kroger have a prostate biopsy using the Artemis technology. A conventional prostate biopsy involves a rectal probe, guided by ultrasound, to place a total of 12 evenly spaced needles into the patient’s prostate to detect the presence of a tumor and determine whether it’s cancerous. This method, Uchio explained, leaves a lot of the prostate untested. The biopsy could graze the edge of a tumor or miss it altogether.

At UCI Health, Uchio and his team used high-powered magnetic resonance imaging to get an accurate reading of Kroger’s prostate and the location of the lesion. The Artemis technology enabled Uchio to use that image as a road map to place the biopsy needle directly into Kroger’s tumor with the help of a robotic arm.

The biopsy showed that Kroger's tumor was far more aggressive than his earlier diagnosis had indicated, Uchio said.

“It took him out of a management plan that was probably not appropriate for him,” Uchio said. Had Kroger remained on active surveillance any longer, the tumor could have spread beyond the prostate gland, reducing his chances for a cure.

Together, patient and physician decided the best course of treatment was to remove the prostate using the da Vinci Surgical System®, a robot-assisted, minimally invasive approach. The surgery was a success, and Kroger said there has been little to no change in his quality of life.

Uchio is still following his patient closely, but for now, Kroger is cancer-free.

“One of the driving factors for me was to know what my dad had gone through,” Kroger said. “Things will never be like they were before the surgery, but I couldn’t be happier with what Dr. Uchio did. It’s been amazing.”

— Justin Petruccelli, UCI Health Marketing & Communications