Dr. Jeffrey B. Matthews

Arieh L. Shalhav, MD
Fritz and Mary Lee Duda Family Professor of Surgery
Chief, Section of Urology
Director, Minimally Invasive Urology
Director, Robotic Surgery
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Arieh L. Shalhav, MD

Improving Quality of Life for Prostate Cancer Patients

Prostate cancer is one of the most common, and lethal, cancers for men in the United States. When caught in the early stages, however, it is highly curable. While more traditional treatment options, such as removal surgery, radiation and chemotherapy, have a high success rate, the side effects can be severe and quality of life may be forever compromised.

Fortunately for those with localized prostate cancer, robotic surgery provides a treatment option that reduces complications and pain as well as recovery time, and—in experienced hands—better preserves bodily functions. Although robotic surgery is less invasive, it’s still surgery, and patients go through a significant period of recovery and discomfort. Which is only made more challenging by the complications of COVID-19.

That’s why urologists like Arieh L. Shalhav, MD, Chief of Urology at the University of Chicago Medicine, continue to search for ways to effectively fight the disease while causing less disruption to a patient’s life.

Dr. Shalhav believes the high-intensity focused ultrasound (HIFU) procedure is a groundbreaking step in the right direction.
Precision makes it possible

HIFU destroys prostate cancer through the delivery of high-intensity, focused ultrasound waves that only target the diseased prostate tissue. Because these waves are so precise, they do not damage nearby healthy tissue. This fact helps to minimize side effects like impotence or incontinence that are associated with major prostate removal surgery and radiation.

“We do not want to treat the entire prostate with HIFU. We want to be precise,” said Dr. Shalhav.

With HIFU, there is no incision. The probe is inserted transrectally, and the sound waves are concentrated on one spot the size of a rice grain. The energy creates heat, ablates the tissue and creates microscopic, disruptive acoustic damage. This produces bubbles that collapse upon themselves to destroy the tissue further, without damaging anything nearby.

“The total success rate is 60 percent,” said Dr. Shalhav. “The beauty of it is that if treatment fails, all other options—surgery, radiation—are still there. You do not burn bridges by doing a HIFU procedure.” Major surgery gives you an 80 to 85 percent chance of a successful cure, but with many more side effects and minimal options afterwards.

HIFU is appropriate for treating patients with intermediate prostate cancer. “Right now, we treat half of the prostate for patients with cancer on one side identified by MRI and biopsy, preserving the other side completely,” said Dr. Shalhav.

A shorter procedure, a quicker recovery

HIFU patients are anesthetized for about two hours and go home the same day with a catheter. Due to the minimally invasive nature of the procedure, patients experience less blood loss and need fewer pain medications. Most people return to work and normal activities within a week.

“As surgeons, we strive to find gentler ways of curing disease and developing effective treatment options that are less disruptive to the human body and quality of life.”

Arieh L. Shalhav, MD
Fritz and Mary Lee Duda Family Professor of Surgery 
Chief, Section of Urology
Director, Minimally Invasive Urology; Director, Robotic Surgery

Dr. Shalhav had been monitoring HIFU technology since the first machines were introduced in Europe about 15 years ago. The earlier iterations were less sophisticated though, and patients experienced complications and poor outcomes.

With the latest generation of machines, Dr. Shalhav finally felt the technology was developed enough to produce successful results without complications for patients. “HIFU fills a significant void between two stressful options: active surveillance and whole gland therapy,” he said. “It ultimately allows patients to maintain a better quality of life without forgoing treatment.”

Arieh L. Shalhav, MD

faculty listing

Professor of Surgery
Piyush Agarwal, MD, Professor of Surgery; Director, Bladder Cancer Program; Fellowship Director, Urologic Oncology
Gregory T. Bales, MD, Professor of Surgery
Scott Eggener, MD, Bruce and Beth White Family Professor of Surgery and Radiology; Vice Chair, Urology; Director, High Risk and Advanced Prostate Cancer Clinic
Glenn S. Gerber, MD, Professor of Surgery; Director, Endourology
Mohan S. Gundeti, MD, Professor of Surgery, Pediatrics, and Obstetrics and Gynecology; Director, Pediatric Urology
Carrie W. Rinker-Schaeffer, PhD, Professor of Surgery
Arieh L. Shalhav, MD, Fritz and Mary Lee Duda Family Professor of Surgery; Chief, Section of Urology; Director, Minimally Invasive Urology; Director, Robotic Surgery
Gregory Zagaja, MD, Professor of Surgery; Director, Prostate Cancer Program

Assistant Professor of Surgery
Sarah Faris, MD, Assistant Professor of Surgery
Parth Modi, MD, MS, Assistant Professor of Surgery
Luke Reynolds, MD, Assistant Professor of Surgery

faculty honors

Piyush Agarwal, MD, served on the FDA Oncologic Drug Advisory Committee and helped approve a PD-1 inhibitor for the treatment of non-muscle invasive bladder cancer.

Gregory T. Bales, MD, Scott Eggener, MD, Mohan S. Gundeti, MD, and Arieh L. Shalhav, MD, were named 2020 Top Doctors by Chicago magazine.

Scott Eggener, MD, was named Bruce and Beth White Family Professor in the Department of Surgery.

Mohan S. Gundeti, MD, was awarded a grant for “Phase 2: Developing the Pediatric Minimally Invasive Surgery Program in India and Southeast Asia” by the University of Chicago Provost’s Global Faculty Awards for India. He presented a European Society for Paediatric Urology webinar, “Robotic Ureteric Reimplantation–Nuances.” He received an Excellence in Pediatric Urology award from the Indian Society of Pediatric Urology. He was honored with a Rao Oration and Gold Medal Award by the Society of Telangana and Andhra Pradesh Urological Surgeons.

select publications

Andolfi C, Adamic B, Oommen J, Gundeti MS. Robot-assisted laparoscopic pyeloplasty in infants and children: is it superior to conventional laparoscopy? World J Urol. 2020;38(8):1827-1833. doi: 10.1007/s00345-019-02943-z.

Andolfi C, Gundeti MS. Live-case demonstrations in pediatric urology: Ethics, patient safety, and clinical outcomes from an 8-year institutional experience. Investig Clin Urol. 2020;61(Suppl 1):S51-S56. doi: 10.4111/icu.2020.61.S1.S51.

Bales GT. Editorial Comment. Urology. 2020; 136:255-256. doi: 10.1016/j.urology.2019.09.051.

Cohen AJ, Boysen W, Kuchta K, Faris S, Milose J. Artificial urinary sphincter longevity following transurethral resection of the prostate in the setting of prostate cancer. World J Urol. 2019; 37(12):2755-2761. doi: 10.1007/s00345-019-02684-z.

Eggener SE. Recognizing and minimizing bias: Helping patients make their best choice for prostate cancer management through multidisciplinary clinics. Cancer. 2020; 126(3):470-472. doi: 10.1002/cncr.32574.

Gundeti MS, Castellan MA. Editorial: Robotic Assisted Laparoscopic Surgery (RALS) in Pediatric Urology. Front Pediatr. 2020; 8:85. Published 2020 Mar 11. doi: 10.3389/fped.2020.00085.

Harmon SA, Sanford TH, Brown GT, et al. Multiresolution Application of Artificial Intelligence in Digital Pathology for Prediction of Positive Lymph Nodes From Primary Tumors in Bladder Cancer. JCO Clin Cancer Inform. 2020; 4:367-382. doi: 10.1200/CCI.19.00155.

Kanabolo D, Rodriguez J, Waggoner D, et al. A Phenotypic Female Adolescent with Primary Amenorrhea and Dysmorphic Features. Pediatr Ann. 2019; 48(12):e495-e500. doi: 10.3928/19382359-20191118-02.

Labbate CV, Werntz RP, Galansky LB, Packiam VT, Eggener SE. National management trends in clinical stage IIA nonseminomatous germ cell tumor (NSGCT) and opportunities to avoid dual therapy. Urol Oncol. 2020; 38(8):687.e13-687.e18. doi: 10.1016/j.urolonc.2020.03.014.

Liauw SL, Ham SA, Das LC, Rudra S, Packiam VT, Koshy M, Weichselbaum RR, Becker YT, Bodzin AS, Eggener SE. Prostate Cancer Outcomes Following Solid-Organ Transplantation: A SEER-Medicare Analysis. JNCI: Journal of the National Cancer Institute, djz221. doi: 10.1093/jnci/djz221.

Malik RD, Cohn JA, Volsky J, et al. A Modern Comparison of Urodynamic Findings in Diabetic Versus Nondiabetic Women. Female Pelvic Med Reconstr Surg. 2020;26(1):44-50. doi: 10.1097/SPV.0000000000000586.

Osterberg EC, Golan S, Pes MPL, et al. International and Multi-institutional Assessment of Factors Associated With Performance and Quality of Lymph Node Dissection During Radical Nephrectomy. Urology. 2019; 129:132-138. doi: 10.1016/j.urology.2019.01.068.

Rodriguez MV, Wallace A, Gundeti MS. Robotic Bladder Neck Reconstruction With Mitrofanoff Appendicovesicostomy in a Neurogenic Bladder Patient. Urology. 2020; 137:206-207. doi: 10.1016/j.urology.2019.11.023.

Slidell MB, Kandel JJ, Prachand V, et al. Pediatric Modification of the Medically Necessary, Time-Sensitive Scoring System for Operating Room Procedure Prioritization During the COVID-19 Pandemic. J Am Coll Surg. 2020; 231(2):205-215. https://doi:10.1016/j.jamcollsurg.2020.05.015.

Stephenson A, Eggener SE, Bass EB, et al. Diagnosis and Treatment of Early Stage Testicular Cancer: AUA Guideline. J Urol. 2019; 202(2):272-281. doi: 10.1097/JU.0000000000000318.

Turkbey B, Czarniecki M, Shih JH, et al. Ferumoxytol-Enhanced MR Lymphography for Detection of Metastatic Lymph Nodes in Genitourinary Malignancies: A Prospective Study. AJR Am J Roentgenol. 2020; 214(1):105-113. doi: 10.2214/AJR.19.21264.

Wallace A, Rodriguez MV, Gundeti MS. Postoperative course following complex major pediatric urologic surgery: A single surgeon experience. J Pediatr Surg. 2019; 54(10):2120-2124. doi: 10.1016/j.jpedsurg.2018.12.004.

Werntz RP, Eggener SE. Defining risk of micrometastatic disease and tumor recurrence in patients with stage I testicular germ cell tumors. Transl Androl Urol. 2020; 9(Suppl 1):S31-S35. doi: 10.21037/tau.2019.06.20.

Werntz RP, Eggener SE. Re: Use of Active Surveillance or Watchful Waiting for Low-risk Prostate Cancer and Management Trends Across Risk Groups in the United States 2010-2015. Eur Urol. 2019; 76(2):252. doi: 10.1016/j.eururo.2019.03.041.

residents & fellows

View the Urology Residents and Fellows here.