New tool sharpens hunt for prostate cancer

Joseph Camunas lost his father to prostate cancer.

And his younger brother was diagnosed with the disease at age 50.

So when doctors found a slight elevation in his annual PSA blood test, Camunas wasn't taking any chances. He wanted to know just what he faced.

A new 3D imaging and navigation tool called Artemis let him know precisely where the cancer was, and perhaps more importantly, that he didn't need surgery.

"They were able to target the nodule ... and found that I have a low-grade prostate cancer," said Camunas, 64. "This is the type of cancer that people don't die of, but die with.

"So I can just be followed closely with an annual MRI."

Named for the Greek goddess of the hunt, Artemis creates a 3D image of the prostate as well as the suspicious area, said Dr. Patrick Springhart, chief of urology at Greenville Health System.

"Artemis allows us to guide the needle in and biopsy the part that needs to be biopsied," he said, "not other areas."

So physicians can determine with more certainty whether the patient has cancer or not, and what treatment course to take, he said.

Gauging risk

The PSA, or prostate specific antigen test, has been used for years as a screening tool, Springhart said.

While PSA can identify patients who may have prostate cancer, because the cancer may be very slow-growing, it may also expose them to unnecessary procedures and surgery that pose significant side effects, he said.

Manufactured by Eigen of California, Artemis has a scoring feature that can identify patients at highest risk, he said.

"This new technology uses MRI imaging and you can now find the lesions that are more aggressive," he said. "And those are the ones that need to be treated."

Up to now, a standard ultrasound, which only provides a two-dimensional image, rarely showed the cancer, Springhart said. So doctors had to do a random biopsy, taking eight to 12 samples of the prostate.

But it was a hit-or-miss proposition - you might hit the cancer or you might not. If you didn't, the cancer would continue to grow without treatment.

"Guys who've been biopsied before and had negative results, we now can say with confidence, 'You do not have cancer,' " Springhart said. "And guys with low-grade cancers, we can do active surveillance."

'Game changer'

Artemis guides the biopsy needle to the right location, he said, and it has all the patient's data so it can put the needle back in the same place for future biopsies.

The procedure, which is covered by insurance, is done as an outpatient and results are available within 24 to 48 hours. As with all prostate biopsies, bleeding and urinary tract infection are possible, he said.

Springhart calls Artemis a "game changer" in the way physicians biopsy and diagnose men with prostate cancer.

"Before, we overtreated prostate cancer a lot more," he said. "Now we have more information to better differentiate between those who need surgery and those who do not."

Camunas, division chief for acute care and general surgery at GHS, said his brother underwent a radical prostatectomy after his diagnosis eight years ago.

Had this technology been available then, he said, he might not have had to.

"Rather than just doing a random ultrasound biopsy that they do in the office, they used the Artemis and detected a suspicious nodule," he said. "Probably using ultrasound-guided biopsy, they would never have hit the thing. I was blessed."

Greenville Health System urologists will talk about the latest options for treating prostate cancer at free Lunch and Learn events on Sept. 17 at 11:30 a.m. at the Green Valley Country Club and Sept. 22 at 12:30 p.m. at the Greenville Hilton. To register, call 1-877-447-4636 or go to ghs.org/healthevents.