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NEW METHOD TO TREAT PROSTATE CANCER SHOWS PROMISE AT ALLEGHENY GENERAL HOSPITAL

 PITTSBURGH, Dec. 1 ~PRNewswire~ -- Preliminary results of a 94-patient study at Allegheny General Hospital (AGH) suggest that a minimally invasive surgical procedure known as Percutaneous Ultrasound-guided Prostate Cryosurgery may be an effective treatment for prostate cancer.
 Prostate cryosurgery uses supercooled liquid nitrogen to destroy the cancerous prostate. Study results were announced today during simultaneous news conferences at the 78th Scientific Assembly and Annual Meeting of the Radiological Society of North America in Chicago and at AGH.
 According to Gary M. Onik, M.D., an interventional radiologist at AGH and a professor in the Department of Neurosurgery at the Medical College of Pennsylvania-Allegheny Campus (MCP), and Jeffrey K. Cohen, M.D., of AGH's Department of Urology and an assistant professor of surgery at MCP -- two of the study's co-authors -- prostate cryosurgery enables physicians to treat patients that heretofore have been untreatable through conventional surgery (radical prostatectomy) or radiation therapy, or where such treatments would have had unacceptable morbidity (side effects).
 Onik and Cohen said results of their initial research, a collaborative effort with Boris Rubinsky, professor of mechanical engineering at the University of California, Berkeley, and Cryomedical Sciences Inc. (CMS) of Rockville, Md., are encouraging.
 "Our results have shown the ability to eradicate the localized cancer in the prostate with minimal morbidity," they said.
 The procedure involves the placement of multiple cryoprobes through the skin and into adjacent areas of the cancerous prostate. These probes are guided through the use of real-time ultrasound imaging.
 Liquid nitrogen, cooled to below minus 196 degrees centigrade (- 196 C), is circulated through the cryoprobes and the cancerous prostate is frozen to death. The process is repeated to ensure the entire prostate has been frozen. The dead prostate tissue is left in place, absorbed by the body over a period of time.
 The patient population of 94 patients was treated with the CMS AccuProbe System, utilizing five probes. Of those 94, 53 patients have had three months of followup or greater with associated post-operative biopsies. Of these patients, 42 (80 percent) had no residual cancer, as determined through biopsies. Those who had residual cancer were treated a second time.
 By comparison, the standard current treatments for prostate cancer -- radical prostatectomy and radiation therapy -- leave residual cancer in 30 percent to 50 percent and 60 percent to 90 percent of patients, respectively.
 The cryosurgery procedure needs longer followup for a full comparison to be drawn. What is clear, however, is that patients with more extensive disease than can be currently treated by radical prostatectomy or radiation can be effectively treated by cryosurgery.
 Prostate cancer is the second leading cause of cancer deaths in men. It affects about 132,000 people annually, or one in nine American males. About 34,000 men die of prostate cancer each year in the United States. Symptoms include frequent urination and difficulty starting and stopping flow.
 The prostate gland is situated near the base of the urethra, the canal that carries urine from the bladder. The prostate is a firm, partly muscular gland. It secretes the fluid used to transport sperm.
 Use of cryosurgery to treat prostate cancer first was introduced in 1966 as a transurethral or through-the-urethra procedure. Onik and Cohen said the percutaneous method they used in their study is more desirable because it is minimally invasive and uses ultrasound imaging to closely monitor the freezing process in order to avoid destruction of healthy tissues.
 The current standard treatment for prostate cancer involves a major surgical procedure known as a radical prostatectomy in which the prostate is removed through an incision through the abdomen. Other common treatments include radiation therapy and transurethral resection.
 According to the study, cryosurgery is advantageous because it has decreased complications; involves virtually no blood loss; involves a shorter hospital stay (approximately two days); can be used to treat extensive prostate cancer untreatable by radiation or conventional surgery; and gives physicians the ability to retreat, an option not available with radiation therapy or a radical prostatectomy.
 Cryosurgery also is believed to have the potential to reduce impotence or incontinence, two of the most common side effects of standard prostate surgery, said Onik and Cohen.
 Liver cryosurgery has been performed at Allegheny General for the past six years. Onik, who pioneered the visualization method used in the liver cryosurgery procedure, said the advantages of using ultrasound to better guide the cryoprobe and monitor the freezing process are clear through his experiences with freezing liver tumors.
 "Ultrasound allows exact visualization of the freezing process by showing a rim emanating from the frozen region. We are far less likely to freeze and destroy healthy tissues and structures," he said. Onik and Cohen stressed that prostate cryosurgery is not a cure-all.
 "While our results have been extremely encouraging to date, we cannot repeat often enough that this procedure is investigative and our research is continuing," they said.
 The CMS AccuProbe System is a new, highly efficient, multi-probe cryosurgical system developed by Cryomedical Sciences Inc. The Rockville biomedical firm specializes in products used in low-temperature medicine.
 nology. Other institutions involved in a multi-center study to evaluate cryosurgery are the M.D. Anderson Cancer Center in Houston; the Catherine McCauly Health Center in Ann Arbor, Mich.; Temple University in Philadelphia; the University of Chicago; and the Urologil? Institute in London.
 -0- 12~1~92
 ~EDITORS: To arrange for interviews with Cohen and Onik or for additional information, contact the media relations department at Allegheny General Hospital at 412-359-8600. Onik is at the RSNA convention in Chicago; Cohen is at AGH. For interviews with Rubinsky, call 510-642-8220.
 Onik, Cohen and Rubinsky have an equity position in CMS. Therefore, ll data presented has been reviewed and confirmed by an independent consultant.~
 ~CONTACT: Colin McNickle, in Chicago, 312-791-6605, or DeAnn Marshall, in Pittsburgh, 412-359-8600, both of Allegheny General Hospital~


CO: Allegheny General Hospital; Cryomedical Sciences Inc. ST: Pennsylvania IN: HEA SU:

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Date:Nov 30, 1992
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