Contemporary Management of Prostate Cancer
Spring 2013
Mission Statement | To train thought leaders in contemporary and future diagnosis and management of prostate cancer by teaching techniques in imaging, targeted, biopsy, focal therapy, and minimally-invasive/robotic treatments.
Introduction
Prostate MRI-Ultrasound Imaging and Biopsy
The »UCLA Department of Urology is pleased to offer a 1-year fellowship for a graduate urologist who is interested in advanced training in targeted prostate biopsy alongside focal therapy research and minimally-invasive/robotic interventions for prostate cancer. The fellowship is a new component of the »Institute of Urologic Oncology within the Urology Department on the Westwood campus. Recent trends in targeting prostate tumors within the organ—from both a diagnostic and therapeutic standpoint—promise to change management of the disease in the near future. This program would provide the fellow a cutting-edge opportunity to become a leader in novel technologies, such as »MRI-guided fusion biopsies, focal therapies under the direction of »Dr. Leonard Marks (»Dr. Leonard Marks’s Website, »The Urological Sciences Research Foundation), and in minimally invasive and robotic surgery under the direction of »Dr. Jim Hu (»Director of Minimally Invasive Urological Surgery).
The Position
Robotic Surgery at UCLA
A multi-disciplinary approach to focal management of prostate cancer has been pioneered at UCLA via cooperative efforts of the Departments of Urology, Radiology, Pathology, and Biomedical Engineering. A unique learning experience is assured via a large volume of clinical material, the inter-departmental support of this new work, and the multi-disciplinary expertise available. The Fellow would join a 15-person effort, from the four disciplines, working to bring prostate cancer diagnosis and treatment into the 21st century. The founding members of this team are shown here.
The Fellow would spend approximately 2/3 of his/her time performing procedures, either in the operating room or the procedure suite. OR time would be devoted almost exclusively to robotic surgery. The robotic surgery system entails the use of a master-slave laparoscopic robot. The physician’s station encompasses controllers for each arm of the robot, as well as a viewing ocula port which provides a 3D image of the patient’s internal environment. While the Da Vinci system has been in use for an established period of time, researchers at CASIT are working on many improvements, including tactile feedback addition to the controllers, which would allow the physician to feel how much pressure is being applied by the robotic arms to the tissues. The other 1/3 of the time would be spent in clinical care and research, which may be tailored to the Fellow’s interests. The Fellow would be incorporated into an ongoing NIH-funded clinical research initiative, using technologies developed in part at UCLA, including a major focal therapy research program. Collaboration with engineering scientists at the UCLA »Center for Advanced Surgical and Interventional Technology (CASIT) would be available. In the CASIT lab, surgeons have an opportunity to interact with biomedical engineers dedicated to urologic research, laying the fundamentals for new clinical interventions. Targeted »prostate biopsy at UCLA is integrated with biomedical engineering at CASIT. Having completed the Fellowship, the individual would possess the technical skills, clinical expertise, and varied contacts needed to build a program of his/her own.
Artemis Fusion Device: (a) Robarts prototype and (b) FDA-approved commercial model (Eigen)
Under Dr. Marks’s leadership, more than 1000 targeted/tracking biopsies have been performed since inception of the program in 2009, making the UCLA program one of the largest in the world. An extensive online database has been built within the urology department, allowing the Fellow an opportunity to study and explore various aspects of targeted prostate biopsy, its role in active surveillance, and the correlations with whole mount prostatectomy specimens. A major multi-disciplinary research effort in focal therapy is in the formative stages.
