Non-aggressive surgery coming for gay men at highest risk for prostate cancer

A team of Chicago researchers is offering new hope for thousands of gay and bisexual men with prostate cancer. On October 5, 2020 – when the US Department of Defense’s healthcare policy for gay and bisexual men comes up for reauthorization- surgeons at Northwestern Memorial Hospital in Chicago will treat one of the largest ever prostate cancer surgeries performed on gay men.

The Northwestern surgery – the first in the US – will involve the removal of the entire prostate using new, minimally invasive techniques that provide surgeons with greater control over the operation. Not only will the radical prostatectomy enable surgeons to reach the cancer more easily, it will also allow surgeons to better leverage prostate cancer-fighting drugs such as prednisone. Though the stage of the surgery will be higher than the other operations that are typically done to treat the disease, surgeons from Northwestern Memorial Hospital have the experience and knowledge needed to help the men most at risk for prostate cancer.

“Most of the men who will benefit from this surgery are in the most advanced stages of the disease,” says lead researcher and Northwestern Memorial Hospital urologist, Ruchi Gupta. “Based on our rigorous research, we know that the aggressive nature of this prostate cancer means the men in this surgery could undergo long-term survival if we surgically remove the entire gland. Since we can only remove the prostate, though, most men will leave the hospital with a localized prostate that needs to be monitored. This surgery is an opportunity to save lives.”

Before the surgery, not only will investigators measure the patient’s density of lesions and look for any potential abnormal growths – called Gleason scores – they will use the new SURGEON MRI, which is currently approved by the US Food and Drug Administration (FDA) for men with advanced-stage cancer. Using radiation therapy instead of surgery, physicians can dramatically reduce the amount of time that the patient is on blood thinners, reducing the chance of serious blood clots that can be deadly.

The groundbreaking surgery will also allow the surgeons to more closely monitor the patient’s cancer. By using a medical device called the ProPath Analyzer, the University of Chicago’s Gamma Knife Center can measure the patient’s Gleason score, scan the prostate gland using a 3D imaging technique, and monitor the patient’s body temperature in addition to monitoring prostate cancerous cells. If there are anything abnormal, an automated alarm system will notify the surgeons in real time so they can stop the operation before the prostate becomes too large or cancerous.

Gupta’s five-year clinical trial will enroll between 400 and 1,000 men. Once the study concludes, gay and bisexual men between 40 and 70 years old will enroll in randomized clinical trials in which they will be randomly selected to have surgery or receive a treatment with less radiation and less risk of the side effects that come from an aggressive operation.

This research represents a new paradigm for surgeries that have been done to treat many other forms of cancer in the past. Gay and bisexual men who have undergone surgery before need not worry about not receiving optimal treatment now.

For Gupta, the research is an opportunity to help men get the information they need to make an informed decision about cancer surgery, which can be life-saving.


Stephen M. Benson

Northwestern University Medical Center

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