Men can look forward to many things as they age: retirement parties and leisure activities with a 9 iron are often top contenders. But with age also comes an increase in health risks, particularly for cancer, that can put a hold on those after-50 goals. The American Cancer Society estimates that for 2017, there will be about 161,000 new cases of prostate cancer, 61,000 men will be diagnosed with bladder cancer and about 40,500 men will be told they have kidney cancer.
New to Bergen County is Dr. Maximiliano Sorbellini, director of urologic oncology and associate director of The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Hospital and Medical Center. Dr. Sorbellini previously served as the head of urology at NewYork-Presbyterian/Lower Manhattan Hospital and received urologic oncology training from the National Cancer Institute, National Institutes of Health. He is among a select group of urologists who focus on organ-preserving surgery to treat bladder, kidney, and prostate cancer. We sat down with him to learn more about the complex world of urologic cancer.
Q: What are some of your goals for expanding care at Englewood Hospital?
Dr. Sorbellini: Urologic conditions, especially for men, can be embarrassing and as a result, patients don’t always seek treatment. So I am always working to try to make people feel comfortable having the difficult conversations. My principal goal is to address my patient’s disease or condition using the least invasive approach possible to help them get back to living their lives sooner with improved quality of life.
Q: What’s your treatment approach?
Dr. Sorbellini: I take a very individualized approach to my patients’ health needs. I’ll ask, “What do you want to accomplish in the next five to 10 years? What’s very important to you?” I want to know about their lifestyle and goals so we can decide together the best care plan. Treatments don’t come risk free or symptom free and that’s where personalized care plans make a difference – and it’s at the core of our cancer center philosophy.
Q: What technologies are available to detect urologic cancer?
Dr. Sorbellini: Lab tests, imaging studies, and diagnostic endoscopies comprise the diagnostic armamentarium we have in urology. Prostate-specific antigen (PSA) blood tests and digital rectal exams for prostate cancer are still important for screening and early detection. Biopsies of suspicious lesions are the industry standards used to diagnose prostate cancer.
Q: Are there any new tools for early detection of prostate cancer?
Dr. Sorbellini: MRI fusion-guided biopsy combines multiparametric MRI technology with real-time ultrasound images. The MRI study allows for the identification of possible prostate cancer lesions within the prostate so we can then biopsy those. It’s especially useful for men with continuously elevated PSA but a normal initial biopsy. Because noncancerous conditions can also elevate PSA levels, this technology might allow us to better understand the origin of the PSA elevation: cancer vs non-cancer.
Choline C-11 PET scan uses a PET scan and a form of choline to identify cancer cells outside the prostate. This is for patients with suspected recurrent prostate cancer who had definitive treatment but still have rising PSA levels. These patients may benefit from a more tailored treatment.
Q: How have treatments for prostate cancer improved over the years?
Dr. Sorbellini: Precision medicine using drugs that target tumor cells and radiation therapy that uses motion-management software and high-energy waves to kill tumor cells while avoiding healthy tissue. One of these is stereotactic body radiation therapy for prostate cancer, which uses a GPS-like tumor mapping system and real-time tracking to locate the tumor and deliver a precisely targeted high-dose radiation treatment in five or fewer sessions. Patients typically have fewer and milder side effects and better outcomes than conventional radiation therapies.
In my specialty, I perform minimally invasive surgical procedures whenever possible, using robotic or laparoscopic techniques to spare tissue and nerves and preserve organ function. That often means less pain and bleeding after surgery as well as a faster recovery, and lower chance of impotence, urinary incontinence, and other treatment side effects. The goal when using these therapies is to focus on destroying cancer while sparing healthy tissues.