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New Technology Elevates Minimally Invasive Surgery Capabilities Methodist Fundraiser
New Technology Elevates Minimally Invasive Surgery Capabilities
Earlier this year the Center City division replaced its robotics surgery equipment with the latest da Vinci® Surgical System, which provides a magnified, high-definition 3-D image and translates the surgeon’s hand movements into precise micro-movements. Essentially, this platform extends the capabilities of surgeons’ eyes and hands. Our surgeons use the robotics system for many different procedures, from appendectomies to liver and pancreas resections, and heart valve repair. The newer systems expand access and utilization for robotic surgery at TJUH and allow our surgeons to explore the full potential of this technology.
Minimally invasive procedures make operations easier for the team and allow the patient to leave the hospital sooner, experience less pain and get back to living their lives.
Costas D. Lallas, MD, FACS, Vice Chair of Education and associate director of the Urology Residency Program, was the first to perform robotic surgery at Jefferson in 2005. He has since performed thousands of robotic procedures using the technology. Dr. Lallas shared with Rich Webster, RN, MSN, President of TJUH, that the surgeons have been very happy about the upgraded equipment: “It’s like we’re kids in a candy store.”
The 12th Annual Methodist Hospital Foundation Runway Fashion fundraiser was held virtually this year. The Department of Urology and all of our collaborating providers were most grateful for this support.
The Jefferson Men’s Health Program is directed by Dr. Perry Weiner, Clinical Associate Professor of Urology. According to Dr. Weiner, “Jefferson’s Men’s Health Program is designed to provide men with a comprehensive and preventive approach to healthcare. Our healthcare services are provided in accordance with the recommendations of the American Urological Association. Patients are evaluated using a multidisciplinary approach.”
The initial evaluation is performed by a urologist with extensive experience in Men’s Health. Appropriate testing may be ordered based on the patient’s particular needs. Specialties available, in addition to urology, include preventive cardiology, sports medicine, diabetes management, and sleep medicine. After conducting individual evaluations, contributing physicians create an optimal treatment plan with specific recommendations for each patient.Additional facilitated consultations are available for ENT, dermatology, screening colonoscopy, concussion, integrative medicine, and all other Jefferson specialties.
For additional information, or to schedule an appointment with the Men’s Health Program, call 215-503-7240, 1-800-JEFF-NOW or visit JeffersonHealth.org/MensHealth.
World News Tonight Prostate Cancer Spot
In the fall of 2021 Jefferson Health sponsored public service announcements on prostate cancer screening. Dr. Leonard Gomella served as the spokesperson for Jefferson Health and the Sidney Kimmel Cancer Center. These ran during ABC’s World News Tonight broadcast.
Jefferson First in Region to Offer Newest PSMA PET Imaging
Dr. Kevin Kelly, Professor of Medical Oncology and Urology and Associate Director of Clinical Research, SKCC
Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society U.S. estimates for 2021 are 248,530 new cases of prostate cancer with 34,130 deaths. Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer, with 1 man in 41 dying of this disease.
While computed tomography (CT) scans, magnetic resonance imaging (MRI) scans and bone scans are conventional methods commonly used to image patients with prostate cancer, these approaches are limited in detection of prostate cancer lesions outside of the prostate (metastasis) particularly when the PSA is very low or the sites of spread are very small. Positron emission tomography (PET) scans can detect early signs of cancer. Radioactive tracer that detects diseases cells is injected, then an anatomic study, such as a CT scan, is combined with the PET radionuclide images. This combination PET-CT scan produces 3 dimensional images that allow more accurate diagnosis.
In December 2020, the FDA approved Gallium-68 PSMA-11 PET in the management of prostate cancer. This is a PET scan that identifies a specific protein called Prostate Specific Membrane Antigen (PSMA) on the cell surface of the prostate cancer cells. This allows clinicians to see the prostate cancer when routine bone or CAT scans cannot. The approval is based on multiple studies that indicate Ga-68 PSMA-11 PET is sensitive and highly specific in the detection of prostatic metastases even with very low prostate-specific antigen levels. However, with this good news, this first approval was limited to only two California institutions.
Several other prostate cancer specific PET scans have been available including C-11 choline, and F-18 fluciclovine. These are different from PSMA scans and they target different metabolic abnormalities present in prostate cancer cells. These prostate PET imaging agent have some limitations as they are currently only approved for use in the setting of recurrence following local therapy. The PSMA based scans are considered by many to be the leading PET molecular target to detect prostate cancer.
In May 2021, the FDA approved a second PSMA PET imaging modality, PylarifyTM (piflufolastat F- 18, Lantheus). Soon after, Jefferson Outpatient Imaging was the first in the Mid-Atlantic region to offer this latest imaging for prostate cancer. As of late December 2021, more than 70 patients have been imaged at Jefferson. PylarifyTM is indicated for PET imaging in men with suspected metastasis who are candidates for initial definitive therapy and with suspected recurrence based on elevated PSA.
According to Dr. Kevin Kelly, Professor of Medical Oncology and Urology, Associate Director of Clinical Research, Sidney Kimmel Cancer Center, “The arrival of PSMA-PET imaging at Jefferson and the Sidney Kimmel Cancer Center is terrific for patients. We believe that the ability of this imaging agent to detect the earliest evidence of prostate cancer metastasis or recurrence after definitive treatment will have a major impact on how we manage our patients. In just a few months of use, we have seen it provide information that impacted the management of many men with prostate cancer. All of us who care for men with prostate cancer at the SKCC are most appreciative of the efforts of Dr. Vijay Rao, Jefferson’s Chair of Radiology, and Dr. Charles Intenzo Chief of Nuclear Medicine and Molecular Imaging to make this exciting new imaging technology available as quickly as possible after FDA approval”. To schedule a patient for PSMA PET imaging at Jefferson please call 215-503-4923.
EXAMPLE OF PSMA PET-CT IMAGING
In the image below, the patient had newly diagnosed aggressive prostate cancer. Standard CT and MRI imaging did not reveal any obvious cancer outside of the prostate. The left panel is a standard CT image of the pelvis without any definitive lymph node metastasis. The right sided panel PET-CT scan using PylarifyTM (piflufolastat F- 18) shows evidence of prostate cancer in a lymph node near the prostate (bright spot indicated by the arrow) confirmed at the time of radical prostatectomy.
manage our patients. Dr. Kevin Kelly
Left image routine pelvis CT. Right image is the piflufolastat F-18 PSMA PET CT scan showing a positive lymph node at the arrow.
Dietz & Watson Funds Mobile Cancer Screening Program at Jefferson Health
Sidney Kimmel Cancer Center is launching a Mobile Cancer Screening program to better serve vulnerable populations in Greater Philadelphia. The mobile unit will deploy the latest imaging technology to detect cancers of the breast, prostate, head and neck, as well as melanomas. It will also provide patient education and connection to additional cancer center resources, such as the smoking cessation program and cancer clinical trials. The initiative was made possible by a $1.4 million gift from Dietz & Watson.
“The Mobile Cancer Screening program allows Jefferson to bring high-quality, preventive cancer screening directly to areas where health care is not easily accessible,” said Bruce A. Meyer, MD, MBA, president of Jefferson Health. “About 25 percent of households in Philadelphia don’t have their own transportation for health care appointments. By going directly to our neighbors who need help, we will increase rates of early detection throughout the city. We are incredibly grateful to Dietz & Watson for their commitment to the community and for partnering with Jefferson to make this possible.”
Dietz & Watson is a fourth generation, family-owned business and a trusted brand in Philadelphia. The company takes a caring and hands-on approach to their neighbors as well as their family business, supporting numerous community initiatives. The Mobile Cancer Screening program plans to work with community and business partners who may have a sizeable immigrant or limited Englishspeaking workforce or patient clientele. There will be no fee to bring the screening unit to a business or organization.
The initial screening van activities have already been launched with a focus on breast cancer screening. The 45-foot-long vehicle has private changing rooms and a mammogram area staffed by a certified mammography technologist from Jefferson Health. Equipped with the latest in advanced imaging technology, it will feature 3-D Screening Mammography, which takes multiple X-rays of breast tissue to recreate a 3-D picture of the breast. The next phase of the Screening Van initiative will involve a prostate cancer screening and other early detection programs. The program will offer general information on prostate cancer detection and treatment options. According to Dr. Leonard Gomella, Chair of Urology and Senior Director for Clinical Affairs at the SKCC, “PSA blood testing will be offered, and the effort will be in collaboration with our long-standing IRB approved screening initiative sponsored nationally by the Prostate Conditions Education Council (PCEC). Since the early 1990’s, Jefferson and the Sidney Kimmel Cancer Center have provided prostate cancer screening opportunities to thousands of men with the administrative support of the PCEC”. Dr. Mark Mann, Assistant Professor in the Department of Urology, will be the primary lead in the prostate cancer component of the screening van.
Sidney Kimmel Cancer Center’s Mobile Cancer Screening Program will deploy the latest imaging technology to areas where health care is not easily accessible.
Sidney Kimmel Cancer Center Mobile Screening Van sponsored by Deitz and Watson.
