Focus on Treatment of Prostate Disease During Opening of 5th-Anniversary Interventional Oncology Meeting

By Jennifer Ford

On November 5, 2015, the Synergy 2015 meeting had a successful start, celebrating 5 years of a multidisciplinary approach to interventional cancer care. The meeting welcomed nearly 500 registrants to Miami for this year’s event. Day 1, or “PAE Day,” focused on prostate interventions for both benign prostate hyperplasia (BPH) and prostate cancer. Emergent technologies and therapies, including lasers, holmium enucleation, and robotic surgery, are enabling successful treatments with few complications. Faculty emphasized the importance of managing prostate symptoms, reminding attendees of their prevalence. 

“Almost 100% of men living to 80 will have pathologic or histologic symptoms of BPH,” said Bruce Kava, MD, during his presentation on BPH. He noted that medical management, especially combination therapy, can also be very effective in treating BPH. Prostate artery embolization (PAE) symposium codirector Francisco Cesar Carnevale, MD, PhD, also presented on the interventional radiology perspective on BPH. 

“We need to understand the urologist’s language. We should start with collaboration, so we can talk to patients and urologists.” he said. 

Shivank Bhatia, MD, codirector of PAE Day, spoke on prostate artery embolization, giving an in-depth talk on anatomy. 

"Prostatic artery anatomy is very challenging, and we must understand this to avoid nontarget embolization.” Imaging also plays a big part of understanding the location of the arterial anatomy of the prostate, as supported by several presentations throughout the day. 

Bhatia also presented video of a challenging case to a panel of faculty. The patient, who had BPH and obstruction and a very poor quality of life score, received prostatic artery embolization. Panelists discussed imaging, device, and catheter and guidewire selection for the case, which was particularly difficult because the prostate was relatively small. Techniques for recognizing and avoiding nontarget embolization were also discussed. The panel agreed that the outcome was successful, with fewer side effects than may have occurred with transurethral resection of the prostate. 

“I was ecstatic, to be honest with you,” said the patient about receiving the embolization procedure in a video taken post procedure. "No one wants to have surgery if they don’t have to.” 

Sandeep Bagla, MD, gave a lunch symposium talk on the Direxion Microcatheter (Boston Scientific). Embolization is here to stay, said Bagla, not only for PAE but also for oncology and future pain applications. 

"We need technological advances to get consistency, and to get results we can replicate,” he said, adding that interventional radiology is a specialty that has poor tools for the degree of difficulty of the procedures physicians are performing. Given the increasing technical challenges of cases, it is imperative that new tools be developed. Presenters in afternoon sessions also called for more clinical research on embolization.

The exhibit hall held its grand opening, showcasing the latest therapies and devices for interventional oncology therapies, and Synergy hosted its first Novemberfest event for fellows and residents. Sessions continued again November 6 with a hands-on ablation workshop and addressed pancreatic cancer, liver cancer, and palliation.