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Latest News

Prostate cancer options for Veterans – for one VA doctor, it’s personal

Prostate Cancer

 

Lifework inspired by grandfather’s illness

While at Northwestern Medical School, Dr. Stacy Loeb learned that her grandfather was diagnosed with prostate cancer. His struggle with the illness inspired her to take on the professional challenge of becoming a clinician and researcher in the field of urology.

She was committed to finding better ways to treat this very common disease for which treatment options often came with difficult side effects. While treatment is usually less traumatic than it was even ten years ago, Dr. Loeb’s research continually looks for even better ways to manage prostate cancer.

Loeb is the daughter of a Navy Veteran and granddaughter of a Veteran who served in the Air Force in WW II.

She is a urologist at VA NY Harbor Healthcare System (Manhattan Campus) and assistant professor in the urology and population health departments at NYU School of Medicine.

She currently splits her time between seeing patients and research for multiple studies. She says she, “loves the combination,” explaining that it allows her to experience in a “full circle way,” the results of each discussion with a patient in the exam room, leading to new research ideas and then bringing the results back to the clinic to help improve patient care. Her time spent in each of these areas can lend itself, in real-time fashion, to immediate results.

All in the VA family

Loeb is proud to be working with VA at the forefront of these studies. Prostate cancer treatment and research are never far from her mind. Her husband, Dr. James Borin, is also a VA New York urologist who directs the robotic urology program for patients pursuing surgical management.

Funded by research grants from the National Institutes of Health, the New York State Department of Health, and the Prostate Cancer Foundation, Loeb and her team are able to advance the research of prostate

cancer. They are specifically studying a recent trend of what is known as “active surveillance” or “watchful waiting,” that reduces the rush to treatment and opts out of immediate surgery or radiation. For men with low-risk prostate cancer, this is a safe option that can preserve the quality of life. Personal goals and quality of life vary greatly from patient to patient and treatment options need to be tailored to these preferences.

Loeb’s research is garnering national attention. Research for which she was a primary investigator was published in the May 15 issue of Journal of the American Medical Association (JAMA). Record numbers of Veterans diagnosed with non-aggressive prostate cancer are heeding the advice of international medical experts and opting out of immediate surgery or radiation to treat their cancer.

Postponing surgery: watchful waiting

Instead, according to a study led by Loeb and her colleagues from the Manhattan campus of the VA NY Harbor Healthcare System, NYU School of Medicine, and its Perlmutter Cancer Center, increasing numbers of these men are electing to postpone additional therapy unless their symptoms worsen — a passive practice called watchful waiting — or they are choosing so-called active surveillance.

This program relies on regular check-ups, including blood tests, physical exams, and the occasional needle sampling of prostate tissue to check for any signs of a tumor getting worse, such as fast growth, before aggressive treatment is considered.

One of the largest studies of its kind, it involved a review of the medical records of 125,083 former servicemen, mostly over the age of 55, who were newly diagnosed with low-risk prostate cancer between 2005 and 2015.

Taking this research to the next step, Loeb and her team are developing a complex mathematical model guide to best practices on the type and frequency of testing to be used during active surveillance. Their hope is that this research can expand the use of active surveillance and help more men with favorable risk prostate cancer avoid unnecessary treatment.

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