Ganesh Rao, MD
Being the largest private practice urology center in Kentucky has its advantages, said Ganesh Rao, MD, president of First Urology, PSC, in Louisville. The practice was created from a merger between Metropolitan Urology and Allied Urology. First and foremost, it means the practice can provide better and easier access to care for its patients. Rao says with its 24 physicians and offices located in greater Louisville and southern Indiana, patients can expect to receive a multidisciplinary approach to urology-related cancer treatments. Patients with genitourinary cancer can look forward to consulting with an in-house radiation oncologist, medical oncologist, and urologic oncologist.
“All 3 physicians can sit together with the patient and family to discuss the varied treatment options,” said Rao. “The patient doesn’t need to make 3 different appointments, and if the patient has a complex disease, it helps to have all the physicians sitting under the same roof working together to come up with a strategy.”
That integration is evident in the practice’s pathology department located in Jeffersonville, Indiana, which is staffed with 2 board certified pathologists licensed to practice in Indiana and Kentucky. The pathology department started providing service in 2009. The department offers expertise in urological specimens, and includes a chemistry department that specializes in prostate-specific antigen (PSA), free PSA and testosterone testing. The laboratory also offers fluorescence in situ hybridization (FISH) testing—a technique used to identify particular DNA sequences in cells, tissues, and also in tumors that may be cancerous.
Cutting Edge Technology
On more than one occasion, the practice was the first to bring cutting edge technologies to the Bluegrass State. “We were the first to bring robotic surgery to town,” said Rao. “We were the first to use intensity-modulated radiation therapy (IMRT) to treat prostate cancer here. And about 2 months ago, we were the first private urologic center in the United States to begin using high-intensity focused ultrasound (HIFU) to treat prostate cancer.”
HIFU uses ultrasound energy that is focused at a specific location in the prostate gland called the focal point. At the focal point, prostate tissue is heated to nearly 195 degrees Fahrenheit (90 degrees Celsius). The tissue at the focal point is destroyed, but the surrounding tissue remains unharmed. Because the technology uses ultrasound energy, not radiation, to destroy targeted tissue, the procedure can be repeated, if necessary. The minimally invasive procedure can be used to perform prostate ablations up to 40 cm3 without previously performing a TURP (transurethral resection of the prostate) procedure. HIFU has been widely available for 15 years in more than 40 countries in Europe, Asia, and Latin America.
“One of my partners, John Jurige, MD, has performed more than 400 HIFU procedures and he’s a national preceptor for HIFU,” said Rao. “Specialists from all over the country come here to learn how to perform the procedure from him, and patients from all over the country come here to receive treatment.” The benefit of the procedure is its minimally invasive methodology with few patients experiencing bladder control problems or erectile dysfunction, which can be common with traditional treatments. In addition, the procedure only takes about 3 hours and the patient gets to go home the same day. “There are a lot of treatments that can cure prostate cancer, but many leave the patient with erectile dysfunction and urinary incontinence,” added Rao. “With HIFU, the patient can get back to work in 3 days. With a radical prostatectomy, a full recovery can take 6 weeks.”