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About

A division of UroCare, PLLC

Mission Statement

NCHIFU provides High Intensity Focused Ultrasound (HIFU), a non-invasive, alternative treatment option for men with early stage prostate cancer. HIFU revolutionizes prostate cancer treatment by preserving the quality of life for patients. We serve the prostate cancer community by providing patient-centered care along with a concierge service approach.

WE BELIEVE THAT A PERSONAL TOUCH GOES A LONG WAY and we are here to answer your questions and address your concerns. As a team, our clinical and office personnel provide unparalleled customer service, attention to detail, and continuity of care; from your first phone call to arrange a consultation, to post-operative care following your procedure, and every step in between. As for the technology, HIFU treatment for prostate cancer offers a non-invasive approach without incisions or toxic radiation. Our doctors provide expert, experienced, and custom HIFU treatment along with closely monitored follow-up care. The results allow you to resume your activities of daily living sooner and radically reduce the side effects compared to other treatments leading to a better quality of life after treatment.


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Dr. Frank Tortora

Our Team


Dr. Tortora graduated Cum Laude from Yale University and from medical school at Emory University. His internship and residency were served at UNC Hospital in Chapel Hill, NC. He is affiliated with the UNC School of Medicine as a Clinical Associate Professor in the departments of Surgery and Family Practice. Dr. Tortora is a Diplomate of Urology. Dr. Tortora is sought after nationally by developers of new urological techniques and treatments and is considered an expert for panel discussion in his field. He has helped develop medical and surgical techniques to aid the treatment of male sexual dysfunction. He specializes in robotic surgery as well as HIFU.


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The Company – NCHIFU


  • What is NCHIFU?
  • Why is NCHIFU the right treatment?
What is NCHIFU?

High Intensity Focused Ultrasound (HIFU) is a revolutionary minimally invasive procedure used to treat prostate cancer with almost no side effects or inpatient stays.

As medical technology improves, healthcare is focusing more on minimally invasive procedures that forego the expensive cost of overnight hospital stays and the inherent side effects, risks and pain that come with surgery. The HIFU procedure uses Sonablate® ultrasound technology to remove cancerous cells without a single incision or scalpel, affecting only the unhealthy tissue. The result is an outpatient procedure that often requires no pain medication or the uncomfortable erectile disfunction and urination problems that often come with invasive prostate surgery.

So how exactly does Sonablate® technology work with such precision? Think of how a magnifying glass can be used to concentrate the sun — the only point that experiences heating is the very tiny point where the sun meets the surface. HIFU is performed with a transducer customized to the patient’s body which focuses sound waves in only the specific, small area of affected tissue. This allows healthcare professionals to treat prostate cancer with next to no damage to healthy cells.

Why is NCHIFU the right treatment?

The minimally invasive nature of High Intensity Focused Ultrasound (HIFU) allows for prostate cancer to be operated on at earlier stages, giving patients more options and flexibility in their health care.

Hearing the “C” word is one of the scariest moments an individual can experience. But what can be even worse is the feeling of helplessness that comes from a cancer diagnosis without a clear plan of action to cure the disease. Many diagnosed with prostate cancer every year are told their cancer is in too early a stage to be operated on, or that an invasive and painful surgery is too risky to be performed until the cancer spreads.

High Intensity Focused Ultrasound (HIFU) offers a solution, and NCHIFU is the first and only practice in Raleigh/The Triangle to implement SonaCare Medical, LLC — the first ultrasound technology of its kind to be cleared by the FDA to treat prostate tissue directly with sound waves. With HIFU as an option, individuals can approach their prostate cancer diagnosis with the confidence of knowing they have alternatives to invasive surgery which can greatly enhance their quality of life throughout their treatment.

FEATURES

  • Sound-based, tissue sparing, surgical intervention across specialties
  • More favorable outcomes via “non-cutting” approach
  • Multi-modality imaging “sees” the outside and inside of the targeted area
  • The risk of incontinence and impotence are markedly decreased
  • Increases the number of patients appropriate for surgical intervention
  • Reduces the costs associated with surgical intervention

BENEFITS

  • Minimally invasive procedure ablates only targeted tissue
  • A reduction in the side effect profile as opposed to more radical procedures
  • A reduction in procedure times
  • Comparable clinical outcomes

The Procedure – HIFU (Prostate Cancer)


  • Who is an Ideal Patient?
  • History
Who is an Ideal Patient?

NCHIFU is ideal for men with slow-growing lesions on their prostate gland that are being watched. NCHIFU can help men with Prostate Cancer who are seeking alternative treatment and would like to benefit from a less invasive treatment with a shorter recovery time.

PROSTATE CANCER

This is the most common cancer in men, and while it is often a slow growing cancer, it is still the second leading cancer cause of death in men.

TWO IMPORTANT CONCEPTS: The GRADE (Gleason Score) and STAGE (location) of the cancer.

GRADE / Gleason Score / Tumor Aggressiveness:

A few days after the prostate biopsy specimen is taken from the patient, a pathologist will make an assessment of the cells in the specimen. The pathologist is able to identify and confirm the presence of cancer cells, by looking at the patterns of the cells under a microscope. The patterns range from 1 (closer to normal) to 5 (very aggressive and abnormal). The most common pattern is first identified and assigned a number in that range. Then, a second most common pattern is identified and assigned a number in the same range. Those two numbers are added together which creates the grade or Gleason score. For example, they will report the score as 3 + 3 = 6, with 6 being the Gleason score value. In general, a higher number indicates that the cancer is more aggressive and the lower the number, the slower growing it is. Gleason scores can range from 2 to 10.

STAGE / Location:

Prostate cancer staging refers to where the cancer is located within the body of the patient. In general, the cancer may still be confined to the prostate in the early stages or it may have spread to other areas of the body in the later stages. There are 4 stages of prostate cancer. Stage T1 and T2 means that the cancer is only located within prostate.

Stage I: The cancer is located only in the prostate

Stage II: The cancer is larger but is still located only within the prostate but may be present in both lobes of the prostate.

Stage III: The cancer has spread to lymph glands close to the prostate and may also be spread to the seminal vesicles.

Stage IV: The cancer has metastasized to other organs and / or the bones.

WHAT TO DO AFTER THE DIAGNOSIS?

It all depends on the aggressiveness of the cancer, the pre-existing health of the patient and future lifestyle expectations for the patient.

ACTIVE SURVEILLANCE OR WATCHFUL WAITING: This means no treatment intervention at this time, but the patient will be monitored very closely. Bloodwork for testing the PSA levels should be done every 3-6 months. It is probable that repeat biopsies will need to be done every 6-12 months. MRI’s of the prostate are often also employed as well as genetic testing.

PROSTATECTOMY: This surgery is the gold standard. The entire prostate is removed which will provide detailed information about the extent of the disease. This treatment option also provides the greatest chance for the patient to be cancer-free. The two most common surgical procedures are the robotic prostatectomy and open prostatectomy. The down side to surgery is a high incidence of erectile dysfunction and urinary incontinence. In certain cases, nerve-sparing prostatectomy may allow for erectile function. The robotic prostatectomy allows for a more delicate dissection, minimal blood loss, shorter hospitalization time and minimal catheter time.

RADIATION THERAPY: There are two kinds of radiation therapy; external beam radiation and internal radioactive seeds. One of the greatest advantages to radiation is that it is minimally invasive. A disadvantage of radiation is that it may damage and cause changes to the healthy tissue around the treated areas. Radiation changes the bladder and rectal tissue and can lead to problems years after the treatment. Additionally, if the cancer reoccurs, surgery cannot be performed and palliation will be the only treatment option.

HIFU (High Intensity Focused Ultrasound): This is the newest treatment option for prostate cancer. Ultrasound waves deliver energy to target early-stage disease without incisions or radiation. Focused ultrasound used in this capacity has been available for patients throughout Europe, Japan, and Canada for the past ten years. The technology recently became FDA – cleared for use in the United States in October of 2015.

THE ADVANTAGES:

  • The most minimally invasive procedure
  • Done as an outpatient procedure at an ambulatory surgical center
  • Many patients maintain erectile ability and urinary control when compared to other treatment options
  • Allows for repeat HIFU, surgery or radiation if cancer reoccurs
History

In the 1970’s, scientists at Indiana University (Indianapolis, IN) were combining ultrasound physics and medical engineering to precisely destroy targeted tissue. The result was the birth of high intensity focused ultrasound (HIFU). The first human HIFU trials, which focused on brain cancer, demonstrated encouraging improvement in patient symptoms.

In 1996, that small team evolved into the first HIFU company, Focus Surgery where they manufactured the Sonablate 450 console for prostate tissue ablation. USHIFU, LLC (USHIFU) was later established in Charlotte, NC, to implement an FDA-PMA clinical trial for prostate HIFU ablation with the Sonablate® 450.

In 2008, International HIFU, a subsidiary of USHIFU, was created to expand the use and sales of Sonablate® 500 globally. Because SonaCare Medical dates back to the foundation of HIFU, the company is respected as an authority and leader in the HIFU community both locally and internationally. To date, over 15,000 prostate cancer patients have been treated with HIFU.

Today’s healthcare environment is shifting away from therapies that over-treat, and moving towards a less invasive, focused approach with equivalent or better outcomes. Patients and doctors alike are generating the demand for this shift. In response, we provide a rational, clinically proven technology with a unique niche in the ecosystem of patient care.


The Technology – Focused Ultrasound


  • How does the procedure work?
How does the procedure work?

Focused ultrasound is a non-invasive technology that uses ultrasound waves of energy to target and treat diseased tissue within the body without incisions or radiation. Ultrasound technology has been used for over 70 years to treat other diseases and conditions such as Parkinson’s tremors, thyroid and breast cancers as well as uterine fibroids and bone metastases. In October of 2105, the FDA cleared the focused ultrasound technology to ablate diseased prostate tissue. This non-invasive approach allows for faster recovery and reduced side effects. Please visit Focused Ultrasound Foundation, one of our trusted resources for more information or contact us.


About UroCare


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UroCare, PLLC provides medical care and treatment options for a variety of male and female urological conditions and non-covered benefits at a competitive price. As insurance deductibles continue to increase, patients realize that they are now responsible for the majority of their healthcare costs. UroCare, PLLC was created eliminate the cost associated with high deductible insurance plans by offering transparent self-pay pricing. We serve our patients and the urological community by affording them the option to choose how they pay, while providing the same standard of care at a fair price.



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UroCare, PLLC offers competitive self-pay pricing for expert medical care and treatment options for a variety of male and female urological conditions.

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Call now or send us a message to answer any HIFU-related questions, to learn more about the HIFU procedure, or to schedule a consultation at one of our practice locations.

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Trusted Resources

  • SonaCare Medical
  • UNC REX Healthcare
  • United Medical Group
  • Focused Ultrasound Foundation
  • AUNC Urology
  • HIFU

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