With a subspeciality in urologic oncology, Dr. Chris Teigland treats a high volume of patients with prostate cancer. Dr. Teigland counsels with patients, presenting the best options and his recommendation for treatment, based on the patient's age, circumstances, presence of other disease, co-morbidity, and many other factors. For many of these patients, radiation therapy may be indicated rather than surgery to remove the prostate (radical prostatectomy). In such, cases, Dr. Teigland works closely with the Radiation Oncology Program at Carolinas Medical Center, usually teaming up with Dr. Michael Haake. As a Radiation Oncologist, Dr. Haake administers radiation therapy for all malignancies, and he has a special interest in performing surgical procedures to implant radioactive sources. Radioactive implant procedures (brachytherapy) have proven to be very effective in the treatment of prostate cancer. For this reason, Dr. Haake and Dr. Teigland have been working closely together for over a decade.
Radioactive implant therapy for prostate cancer is a surgical procedure in which radioactive pellets, or "seeds," are implanted in the prostate. The surgeon and radiation oncologist use ultrasound imaging and computer mapping techniques to achieve a precise seed dispersion pattern for maximum effectiveness. This minimizes patient discomfort, and enables the radiation oncologist to administer a real-time plan for the exact placement of the pellets. The entire procedure takes an average of 90 minutes, including Dr. Teigland's examination of the bladder following seed implantation. After a three-week recovery period, the patient returns for a CT scan, which is analyzed to ensure the quality of the implant.
Another form of radiation therapy used in the treatment of prostate cancer is External Beam Therapy. This approach has been widely used since the 1960s, and it is often employed by Dr. Haake and the Radiation Oncology team with positive results. This procedure uses a CT scan to map the prostate. The oncologist then conducts 3-D treatment planning to aim multiple beams at the prostate from numerous angles. The location where all the beams intersect is where the radiation dose is delivered.
The latest innovation in External Beam Therapy is called Intensity Modulated Radio Therapy (IMRT). This therapy is identical to 3-D treatment planning with the added capability to vary the intensity of radiation within different portions of each beam in order to sculpt the dose more precisely to the prostate. In addition, IMRT even better enables the oncologist to avoid delivering radiation to nearby areas where it is not needed, such as the rectum or the bladder, as the accuracy of beam placement allows a tighter "fit" of the beam to the prostate. In IMRT, the Radiation Oncology program uses the Novalis Unit which provides such pinpoint accuracy, it is not only used for tumors in the prostate, but for brain tumors as well. The Novalis Unit's precise control also enables the Radiation Oncology team to deliver higher radiation doses where indicated, while avoiding damage to neighboring tissue and organs.
Since Dr. Haake and Dr. Teigland began collaborating, they have used radiation therapy to treat over 350 prostate cancer patients. Dr. Teigland and Dr. Haake follow each patient's recovery by tracking his Prostate-Specific Antigen (PSA) level after completion of his treatment. Their data shows that the median PSA is 0.29 at one and a half years following treatment. After four years, the median PSA drops to 0.1. These results indicate a very low rate of recurrence.