LOS ANGELES - Surgeons from Keck Medicine of USC and UCLA Health have performed the world's first-in-human bladder transplant. The surgery was successfully completed at Ronald Reagan UCLA Medical Center on May 4, 2025, in a joint effort by Inderbir Gill, MD, founding executive director of USC Urology, and Nima Nassiri, MD, urologic transplant surgeon and director of the UCLA Vascularized Composite Bladder Allograft Transplant Program.

Groundbreaking moment in medical history 

"This surgery is a historic moment in medicine and stands to impact how we manage carefully selected patients with highly symptomatic 'terminal' bladders that are no longer functioning," said Gill, who is also Chair and Distinguished Professor of Urology and Shirley and Donald Skinner Chair in Urologic Cancer Surgery with the Keck School of Medicine of USC. "Transplantation is a lifesaving and life-enhancing treatment option for many conditions affecting major organs, and now the bladder can be added to the list."

"This first attempt at bladder transplantation has been over four years in the making," Nassiri said. "For the appropriately selected patient, it is exciting to be able to offer a new potential option."

Nassiri, formerly a urology resident with the Keck School and now assistant professor of urology and kidney transplantation at UCLA, and Gill worked together for several years at the Keck School to develop the new surgical technique, design a clinical trial and secure the necessary regulatory approvals.

Numerous pre-clinical procedures were performed both at Keck Medical Center of USC and OneLegacy, Southern California's organ procurement organization, to prepare for this first-in-human bladder transplant.

A complicated yet successful surgery 

The patient had been dialysis-dependent for seven years. He lost the majority of his bladder during surgery to resect cancer over five years ago, leaving the remainder of his bladder too small and compromised to function appropriately. Both of his kidneys were subsequently removed due to renal cancer.

To address these deficits, Drs. Gill and Nassiri performed a combined kidney and bladder transplant, allowing the patient to immediately stop dialysis and produce urine for the first time in seven years. First the kidney, then the bladder, were transplanted. The new kidney was then connected to the new bladder. The entire procedure took approximately eight hours.

"The kidney immediately made a large volume of urine, and the patient's kidney function improved immediately," Nassiri added. "There was no need for any dialysis after surgery, and the urine drained properly into the new bladder."

"Despite the complexity of the case, everything went according to plan and the surgery was successful," said Gill. "The patient is doing well, and we are satisfied with his clinical progress to date."

The recovery of the kidney and bladder from the donor was performed at OneLegacy's Transplant Recovery Center in Azusa, Calif. All parts of the procedure, including surgery and post-surgical monitoring during the transplantation, were aligned with the highest current clinical and research standards.

How a bladder transplant may benefit patients

Millions of people around the globe experience some degree of bladder disease and dysfunction. Some develop terminal bladders that are either non-functioning and/or cause constant pain, repeated infections and other complications. Current treatment for severe terminal cases of bladder dysfunction or a bladder that has been removed due to various conditions includes replacement or augmentation of the urinary reservoir. These surgeries use a portion of a patient's intestine to create a new bladder or a pathway for the urine to exit the body.

"While these surgeries can be effective, they come with many short-and long-term risks that compromise a patient's health such as recurrent infections, compromised kidney function and digestive issues," said Gill.

"A bladder transplant, on the other hand, delivers a more 'normal' urinary reservoir and may circumvent some of the challenges associated with using the intestine," said Nassiri.

The biggest risks of organ transplant are the body's potential rejection of the organ and side-effects caused by the mandatory immunosuppressive drugs given to prevent organ rejection.

"Because of the need for long-term immunosuppression, the best current candidates are those with a pre-existing organ transplant or those who need a combined kidney and bladder transplant," said Nassiri.

As a first-in-human attempt, there are naturally many unknowns associated with the procedure, such as how well the transplanted bladder will function immediately and over time, and how much immunosuppression will ultimately be needed.

"Despite the unknowns, our goal is to understand if bladder transplantation can help patients with severely compromised bladders lead healthier lives," said Gill.

Collaborative research and development leading to the transplant 

Bladder transplants have not been done previously, in part because of the complicated vascular structure of the pelvic area and the technical complexity of the procedure. As part of the research and development stage, Gill and Nassiri successfully completed numerous practice transplantation surgeries at Keck Medical Center of USC, including the first-ever robotic bladder retrievals and successful robotic transplantations in five recently deceased donors with cardiac function maintained on ventilator support.

Several non-robotic trial runs of bladder recovery were performed at OneLegacy by Gill and Nassiri, allowing them to perfect the technique while working alongside multidisciplinary surgical teams.

The bladder transplant was done as part of a UCLA clinical trial. Gill and Nassiri hope to perform more bladder transplants together in the near future.

Under Gill's leadership, USC Urology has rapidly established itself as a pioneer and world leader in the most advanced robotic urologic oncologic surgeries for kidney, bladder, prostate, testicular and penile cancers, and has achieved important milestones leveraging machine learning and artificial intelligence to optimize patient outcomes.

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LOS ANGELES — Steam eliminates wrinkles and germs, but can it destroy cancer cells too?  

Keck Medicine of USC is participating in a national, multisite clinical trial examining if a water vapor system that uses small, targeted amounts of steam to kill cancer cells is a safe and effective treatment for prostate cancer. 

Researchers hope that steam may offer patients a less invasive way of controlling or curing cancer than currently exists.  

“The most common therapies for prostate cancer often cause life-altering side effects, and we are investigating if this new treatment may not only treat the cancer, but offer our patients overall better quality-of-life outcomes,” said Andre Abreu, MD, a Keck Medicine urologist and lead investigator of the Keck Medicine clinical trial site. Abreu also leads focal therapy and artificial intelligence efforts for prostate cancer with USC Urology. 

Who may benefit from the trial   

The clinical trial is designed for patients with intermediate-risk prostate cancer, meaning that the tumor is localized in the prostate gland and has not spread to other organs. This type of cancer accounts for approximately one-third of all localized prostate cancers, according to Abreu. 

Some patients with prostate cancer may not need any treatment if the cancer is small enough and slow growing. However, when treatment is necessary, traditionally, physicians have treated patients with either surgery or radiation.  

These techniques are generally effective in treating the cancer, however, there can be side effects. The prostate is located in between the bladder, the urethra (a duct that transports urine from the bladder) and the rectum. It is surrounded by numerous nerves responsible for penile erections and the muscle that controls urine flow, the urinary sphincter. During surgery or radiation, there is a risk of injuring healthy tissue along with the cancer and damaging the delicate structures that lie next to the prostate.  

The most common side effects of surgery and radiation are impotence, urinary incontinency and bowel dysfunction. 

“While patients are happy to be free of cancer, the costs of the cure are very high,” said Abreu. “There is a growing amount of literature in the field suggesting that select patients could benefit from a procedure with fewer risks that allows them to maintain their quality of life after cancer.” 

How steam might fight cancer 

Heat is one therapy to help damage and kill cancer cells, according to the National Cancer Institute. Steam offers a targeted way to deliver heat into the body, according to Abreu.  

Before the procedure, physicians use magnetic resonance imaging (MRI) to locate the tumor cells in the patient’s prostate. During the procedure, doctors use an ultrasound and prostate mapping to guide a thin catheter through the patient’s urethra and into the area of the prostate where the tumor is located.  

Once the catheter is positioned, a fine needle is deployed in the tumor. Doctors then release a quick, targeted 10-second burst of steam from the needle, and more bursts as needed, to destroy the tumor.  

“This procedure is thought to be much gentler on the body than traditional therapies and is designed to target the cancerous tissue within the prostate,” said Abreu. “We are exploring if steam may be effective at destroying cancer cells without damaging the surrounding organs.”  

Another potential advantage to the investigational therapy is that unlike surgery, which requires an overnight stay in the hospital, the water vapor therapy is an outpatient procedure. And unlike radiation, which usually involves multiple sessions, the water vapor therapy is designed to work using only one application. 

Clinical trial details  

The clinical trial is being conducted at up to 30 hospitals and health centers across the nation. So far, more than 180 procedures have been completed. 

Keck Hospital of USC is the only Los Angeles area site participating in the study. Patients’ post-treatment cancer outcomes will be followed for five years.  

The study is sponsored by Francis Medical, Inc., a privately held medical company that developed the device being used, the Vanquish^® Water Vapor Ablation System.  

The water vapor ablation system is one of several minimally invasive treatments for prostate cancer either already in use or being developed within the field of urology.  

“Over the next decade or so, we hope to see innovative therapies revolutionize how we help patients become cancer-free while maintaining their quality of life,” said Abreu.  

Dr. Abreu declares no conflict of interest with the sponsor.

Urologists with Keck Medicine of USC have launched a clinical trial to perform the world’s first human bladder transplant.

The trial is actively screening potential participants for this first-ever type of transplantation.

During the procedure, the patient’s diseased bladder will be removed and replaced with a healthy bladder from a deceased donor.

“Transplantation is a lifesaving treatment option for conditions affecting many major organs, and transplanting a bladder could be a historic step in improving lives,” said Inderbir Gill, MD, founding executive director for USC Urology, part of Keck Medicine. Gill is also the principal investigator of the clinical trial and leading the transplantation efforts. “We could be on the verge of a medical advance that has the potential to revolutionize how we treat terminally compromised bladders.”

Hundreds of millions of people around the globe experience varying degrees of bladder disease and dysfunction. Some patients with these conditions may require a bladder reconstruction, a surgical procedure wherein the bladder is removed, and a new bladder is made from the patient’s own intestines. However, the procedure carries a high risk of early and delayed adverse side effects, and not every patient is a candidate for this surgery.

“The intention of this clinical trial is to develop a new treatment option for a certain subset of patients with debilitating bladder conditions that can severely hamper quality of life and ultimately, even shorten life,” said Nima Nassiri, MD, urologic surgeon and researcher with the Keck School of Medicine of USC and Gill’s collaborator on the clinical trial. “We have worked diligently to expand the boundaries of what is considered possible for severely compromised patients who traditionally have had few options.”

Bladder transplants have not been done previously, in part because of the complicated vascular structure of the pelvic area and the technical complexity of the procedure. Gill, Nassiri and their colleagues have spent the past few years developing and practicing numerous research procedures to prepare for the first-in-human bladder transplant, which will be done completely using robotic surgery.

Robotic surgery is an advanced form of minimally invasive surgery in which surgeons use a high-definition, three-dimensional camera to guide a robot to perform surgery using smaller, more precise incisions with more dexterity than is possible using hand-held surgical tools.

Under Gill’s direction, USC Urology has established itself as a pioneer and world leader in robotic, minimally invasive techniques for kidney, bladder and prostate cancer surgery, and achieved important milestones leveraging machine learning and artificial intelligence to optimize patient outcomes.

Keck Medicine’s USC Transplant Institute, which has a robust and nationally recognized kidney, liver, heart and lung transplant program, further provided Keck Medicine with the needed resources and skills to pioneer the first bladder transplant.

As part of the research and development stage, Gill, Nassiri and colleagues successfully completed many practice transplantation surgeries, including the first-ever robotic bladder retrievals and successful robotic transplantations in five recently deceased donors with cardiac function maintained on ventilator support.

The procurement, surgery and post-surgical monitoring during transplantation were aligned with current clinical and research standards. OneLegacy Foundation, an organ procurement organization serving Southern California, provided clinical trial funding and, with the generous agreement of donor families, enabled bladder donations that made the trial possible.

Nassiri and Gill are presenting their surgical research update April 30 at the annual meeting of the American Urologic Association, the world’s leading association for urology professionals.

Gill, in addition to directing USC Urology, is chairman and Distinguished Professor of the Catherine and Joseph Aresty Department of Urology and the Shirley & Donald Skinner Chair in Urologic Oncologic Surgery at the Keck School.

Photo caption: The Keck Medicine of USC surgical team evaluates the integrity of a bladder during the research and development stage of bladder transplantation.

Seminoma is a slow-growing form of testicular cancer that if untreated, typically metastasizes (spreads) to lymph nodes in an area behind the abdomen lining called the retroperitoneum. The standard treatment for patients at this stage is chemotherapy and radiation to shrink and kill the cancerous lymph nodes.  

While effective, chemotherapy and radiation are associated with long-term side effects, such as cardiovascular disease and secondary cancers, that adversely affect a patient’s quality of life.

Now, however, the results of a multi-institutional clinical trial recently published in the Journal of Clinical Oncology show that surgically removing the affected lymph nodes in the retroperitoneum is an effective alternative to chemotherapy and radiation with fewer long-term side effects.

“We found that the majority of participants in the study were cured with surgery alone, avoiding the toxicities associated with traditional therapies. We are confident that surgery for this disease state will be included into treatment guidelines in the near future,” said Sia Daneshmand, MD, a urologic oncologist with Keck Medicine of USC and lead investigator of the clinical trial.  

Daneshmand is also a member of USC Norris Comprehensive Cancer Center, part of Keck Medicine.

Testicular cancer is generally a treatable cancer that most commonly affects men ages 15-35. When testicular cancer only spreads to the retroperitoneum, it is classified as early metastatic or stage 2 seminoma.

The procedure to remove lymph nodes from the retroperitoneum — known as a retroperitoneal lymphadenopathy — is an established treatment for metastatic testicular cancer when chemotherapy fails to eradicate all affected lymph nodes. However, surgery has not traditionally been considered a viable stand-alone treatment for early metastatic seminoma.

The national study enrolled 55 patients across 12 institutions to investigate if surgery could replace chemotherapy and radiation as an effective treatment, thereby sparing patients the long-term risks associated with the two traditional therapies.

Study participants had previously undergone surgery to remove the testicle(s) where the original cancer occurred, and their cancer had progressed no further than to the retroperitoneum. Once enrolled, the patients underwent a retroperitoneal lymphadenopathy by certified surgeons at participating institutions around the country and one site in Canada.

Keck Hospital of USC performed 15 of the surgeries. Most of the Keck Medicine patients were able to go home 24 hours after surgery with minimal or no complications, according to Daneshmand.

Daneshmand and his colleagues found that 81% of the patients demonstrated a two-year recurrence-free survival rate. The 20% who did experience recurrence of the cancer were successfully treated with either chemotherapy or additional surgery for an overall survival rate of 100%.

“A 100% survival suggests that a cure can still be achieved even in patients who experience recurrence after the surgery,” said Daneshmand.

Daneshmand acknowledges that not all hospitals or medical centers have the expertise or resources to successfully complete retroperitoneal lymphadenopathy. He advises patients to look for an academic medical center to discuss the possibility of surgery over traditional therapies.

“Early metastatic seminoma has a very high survival rate; however if treated with chemotherapy and radiation, the cure can come at a high cost,” he said. “Surgery gives patients both the opportunity to be cured and experience a high quality of life post-cancer.”

Anne Schuckman, MD, a urologic oncologist with Keck Medicine, was also an investigator in the clinical trial.

"This study is the first to document a continued rise in metastatic prostate cancer using the most up-to-date population dataset,” said Mihir M. Desai, MD, MPH, a urologist with Keck Medicine and co-lead author of the study. “The discovery has important ramifications for men because prostate cancer, when caught early, typically through a screening, is very treatable and often curable.”

Desai is also a professor of clinical urology at the Keck School of Medicine of USC and an associate member of the USC Norris Comprehensive Cancer Center, part of Keck Medicine.

Routine prostate-specific antigen (PSA) screenings for prostate cancer began in the United States almost three decades ago. PSA screenings measure the amount of PSA in the blood, and elevated levels can indicate cancer.

The introduction of screenings resulted in drops in both metastatic prostate cancer and prostate cancer deaths. However, the benefit of routine screenings was counterbalanced by risks of overdiagnosis and overtreatment of low-risk prostate cancer.

In 2008, the United States Preventive Services Task Force (USPSTF), a leading national organization in disease prevention and evidence-based medicine, recommended against routine PSA screening for men older than 75. This was followed by a recommendation against screening for all men in 2012.

Research shows that prostate cancer screenings for men declined after the recommendations changed across all age groups and racial backgrounds.

Keck Medicine researchers wanted to assess metastatic prostate cancer trends before and after the USPSTF recommendations against screenings.

They identified men 45 and older with a diagnosis of invasive prostate cancer from 2004-2018 through the Surveillance, Epidemiology and End Results (SEER) Program cancer incidence database.

From 2004-2018, the last year for which data was available, more than 836,000 prostate cancer patients 45 or older were recorded in the SEER database. Of these, 26,642 cases of metastatic prostate cancer were reported in men 45-74, and 20,507 cases in men 75 or older.

Among the 45-74 age group, the incidence rate of metastatic prostate cancer remained stable during 2004-2010, then increased 41% during 2010-2018. For men 75 and older, the incidence rate decreased in 2004-2011, then increased 43% from 2011-2018. For both age groups, the increases were across all races.

The researchers note that these increases stand in contrast to the decreasing trends in incidence of metastatic prostate cancer between 2004-2009, before the USPSTF stopped recommending routine PSA screenings for men.

The authors also discuss the possibility that other factors besides the change in screening recommendations in 2008 and 2012 could play a role in the uptick in cancer cases, such as the use of new, cutting-edge diagnostic and staging tools that are better able to detect low-volume (less invasive) metastatic prostate cancer.

However, they conclude that such techniques are not widespread, and typically not used for first-time cancer detection, so are unlikely to be of significance in the findings.

“This data is very important as it indicates the need to constantly reassess the impact of policy decisions,” said Giovanni Cacciamani, MD, MSc, co-lead author of the study, an assistant professor of research urology and radiology at the Keck School and an associate member of USC Norris. “Otherwise, we may see a continued rise in metastatic prostate cancer.”

The original concerns for stopping the screenings — that they led to overdiagnosis and overtreatment of low-risk prostate cancer — may also be outdated, say the authors.

"Urologic centers of excellence, including USC Urology, are continually researching ways to leverage technologies to optimize patient outcomes and decrease side effects of treatment,” said Inderbir Gill, MD, chairman of the Catherine and Joseph Aresty Department of Urology, distinguished professor of urology at the Keck School, executive director of the USC Institute of Urology and a member of USC Norris. “More refined strategies, including biomarkers and magnetic resonance imaging, have already increased detection of clinically significant cancers, while active surveillance is increasingly used for low-risk and favorable intermediate-risk disease, thus mitigating the risks of overtreatment.”

Other Keck Medicine study authors include Juanjuan Zhang, a statistician at the Keck School; Lihua Liu, PhD, associate professor of clinical population and public health sciences at the Keck School, director and principle investigator of the SEER Program and a member of USC Norris; and Andre Abreu, MD, a urologist with Keck Medicine who directs the Center for Targeted Biopsies & Focal Therapy at the USC Institute of Urology.

For men, this includes providing at least one semen sample, which is analyzed to determine if there are factors reducing the sperms’ chances of fertilizing an egg.

The current gold standard of sperm fertility evaluation requires men to provide a sperm sample in a lab or clinic, which is then examined within an hour. After an hour, the sperm begin to die, and the results are no longer accurate. The study was published in Fertility and Sterility.

However, a new study from Keck Medicine of USC challenges this tight timeline, showing that an at-home, mail-in testing kit can accurately test sperm up to 52 hours after the sample was given, despite sperm degradation. 

“This is a game changer for men because it means they no longer have to come into a lab or clinic to provide a sample, an experience some find unnerving and challenging,” said Mary Samplaski, MD, a male infertility specialist with Keck Medicine and lead investigator of the study. “This allows men to secure highly accurate male fertility results while providing the specimen from the comfort of their own home.”

Such flexibility to mail in a specimen rather than give one in a provider’s office is even more important due the COVID-19 pandemic. “Some labs have closed, and people may be hesitant to visit a clinic right now,” she added.

With the goal of making sperm testing more accessible, Samplaski and colleagues compared the accuracy of a new at-home, mail-in semen analysis system with that of the one-hour, in-office sperm test.

While other at-home tests have been developed over the years, they have not been successful, said Samplaski. This new testing system, developed in 2019 with feedback from fertility urologists, was selected for the study because it contains a unique solution that promises to gauge the specimen’s fresh findings for days, even after the sperm has degraded.

For the study, researchers collected multiple semen samples from 164 men and analyzed them using the one-hour test. They evaluated the specimen for sperm count, shape and motility (the ability of the sperm to move through the woman’s reproductive tract to fertilize the egg).

Next, researchers added the mail-in kit preservation solution to the samples, retesting the semen four times during a 52-hour period from when the samples were given. (While normally a mail-in sample going to a lab would take 24 hours to reach its destination, researchers wanted to test the limits of the kit in case of a postal delay).

Specimens were also exposed to a range of temperatures that mimicked different climates a sample might have to withstand when shipped from anywhere within the United States.

At the end of their comparison, researchers discovered that the mail-in specimens were able to analyze the quality of the sperm with near perfect accuracy when compared to fresh samples.

“Essentially, there was no difference in the results,” said Samplaski. “While this study was limited in scope, the findings make the mail-in system a reliable option to consider for routine clinical use in evaluating sperm.”

She recommends that couples facing infertility ask their doctors about mail-in sperm testing.

“The more options a couple has in their fertility care, the better,” she said. “Making evaluative tests easier keeps couples moving forward and ultimately improves their chances of conception.”

During Prostate Cancer Awareness Month (September), physicians from USC Urology with Keck Medicine of USC are available to answer questions about risk factors, screening and treatment options.

Knowing your risk factors can help inform your screening decisions

“Prostate cancer is more common in men over age 50, so men should be more vigilant about screening as they age. Many of the known risk factors for prostate cancer are genetic – African American men and men with a family history of prostate cancer may need to screen earlier or more frequently.

“I recommend that men between the ages 45 to 49 have a baseline prostate specific antigen (PSA) blood test. Depending on the baseline PSA levels, they should have a PSA test every 1 to 2 years until the age of 70. Ultimately, the decision to do a PSA test should be a shared one between the patient and physician.”

- Andrew Hung, MD, urologist, Keck Medicine, and assistant professor of clinical urology, Keck School of Medicine of USC

Prostate cancer diagnostics is more than just a PSA test

“An abnormal PSA test result could indicate prostate cancer, but it also could be due to other non-cancerous prostate conditions. A prostate biopsy is typically the next step to confirm the presence of cancer; but because the prostate is a sensitive area, this can cause negative side effects like pain, incontinence or erectile dysfunction. Also, because cancer does not grow uniformly throughout the prostate, it is possible to get a false negative result.

“Keck Medicine is leading a National Institutes of Health-funded clinical trial to see if using magnetic resonance imaging (MRI) and ultrasound imaging can help us more accurately predict potential cancerous areas of the prostate. This may lead to more accurate results, fewer biopsy targets and, in some cases, eliminate the need for a biopsy altogether.”

- Inderbir S. Gill, MD, founding and executive director of USC Urology, Distinguished Professor and chair of the Catherine and Joseph Aresty Department of Urology, Shirley and Donald Skinner Chair in Urologic Cancer Surgery and associate dean for clinical innovation at the Keck School

Prostate cancer innovations help urologists create personalized treatment plans for each patient

“Urologists, oncologists and radiation oncologists have a big toolbox of treatments for prostate cancer patients, including radical therapy, like robotic prostatectomy (surgical removal of the prostate) or radiation therapy, as well as systemic treatments like hormone deprivation therapy or chemotherapy. Additionally, for select patients, focal cryoablation and high-intensity focused ultrasound (HIFU) ablation are treatments that have a lower risk of complications or side effects.

“Patients and doctors should communicate openly about all potential options to strategize tailored treatment plans for each patient’s individual needs.”

- Andre Abreu, MD, urologist, Keck Medicine, and assistant professor of clinical urology and radiology at the Keck School.

A new study from USC Urology with Keck Medicine of USC demonstrates that focal (or targeted) high-intensity focused ultrasound (HIFU) ablation of the prostate is an effective alternative to surgery or radiation, with encouraging outcomes and shortened recovery time.

Focal HIFU ablation is an outpatient procedure that uses a focused ultrasound beam to raise the temperature inside the prostate to approximately 90 degrees Celsius (194 degrees Fahrenheit) to destroy targeted areas of prostate tissue. The procedure takes around two hours and the patients are often discharged home the same day.

The study, published in The Journal of Urology, followed 100 men in the United States who underwent a HIFU procedure for prostate cancer between 2015-2019. This is the first and largest study examining the outcomes of focal HIFU ablation as a primary treatment for prostate cancer in the United States.

During follow-up, 91% of HIFU patients successfully avoided radical treatment. Also, 73% of patients did not experience treatment failure, which the researchers defined as clinically significant cancer recurrence, metastases or mortality, or the need for additional hormone therapy, chemotherapy, surgery or radiation.

The results demonstrated that focal HIFU carries a low risk of complication and can help preserve quality of life. In fact, all patients remained continent and there was no significant decrease in sexual function. There also were no serious adverse events or major complications. Minor complications, including difficulties with urination and urinary tract infection, occurred in a small proportion of the patients, and were addressed without major interventions. Patients were typically discharged the same day as their procedure and resumed regular activities shortly thereafter.

“This positive data empowers urologists to use focal HIFU ablation to effectively address prostate cancer without the intrinsic side effects of radical treatments,” says Andre Abreu, MD, urologic surgeon with Keck Medicine and first author of the study. Abreu is also an assistant professor of clinical urology and radiology at the Keck School of Medicine of USC. “We hope this study encourages prostate cancer patients to talk to their doctor about all potential treatment options to ensure that they receive a personalized care plan that addresses their individual needs.”

Urologists worldwide have used HIFU ablation to treat prostate cancer patients for many years; however, the technology was only approved by the Food and Drug Administration (FDA) for prostate tissue ablation in 2015. Keck Medicine was among the first U.S. institutions to use this technology following the FDA approval.

“USC Urology is dedicated to refining cancer care through collaboration and innovation,” says Inderbir S. Gill, MD, founding and executive director of USC Urology and senior author of the study.

“Throughout screening, diagnosis and treatment, it is important to balance accuracy and efficacy. Our physicians will continue working toward better methods to personalize that balance for every prostate cancer patient,” continues Gill, who is also Distinguished Professor and chair of the Catherine and Joseph Aresty Department of Urology, Shirley and Donald Skinner Chair in Urologic Cancer Surgery and associate dean for clinical innovation at the Keck School.

In 2010, USC Urology launched a focal therapy and image-guided surgery program to develop more accurate methods to diagnose and treat prostate cancer. Since the program’s inception, USC Urology has increased its annual image-guided prostate biopsies six-fold, with the vast majority of these procedures using a combination of MRI and ultrasound imaging. Additionally, USC Urology physicians are skilled in the most innovative therapies, including focal HIFU, cryoablation and robotic prostatectomy.

USC Urology physicians also collaborate with Keck Medicine radiologists and pathologists to create tailored, multidisciplinary treatment plans for each prostate cancer patient.

This year, U.S. News and World Report ranked Keck Medicine No. 9 in the country for Urology.

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For more information about Keck Medicine of USC, please visit news.KeckMedicine.org.

Researchers at the Keck School of Medicine of USC compared Pinktober and Movember, two monthlong cancer outreach campaigns with similar online popularity based on six years of search traffic data. They analyzed patterns of Google Trends search data for specific keywords associated with each campaign and the health behaviors that should result from increased awareness. For example, the Pinktober keywords included “Pinktober,” “Breast Cancer” and “Mammography,” while Movember keywords included terms like “Movember,” “Mustaches,” and “PSA Test OR PSA.”

The researchers found that while the peaks in breast cancer related web searches corresponded with peaks for the Pinktober campaign throughout October, the volume of web-searches for prostate cancer did not appear to be influenced by the timing of the “Movember” campaign in November.

“Between the pink ribbons and mustaches, both these campaigns have very visual elements that can reinforce their online visibility,” says Giovanni Cacciamani, MD, assistant professor of research urology at the Keck School and principal investigator of the study. “However, a successful health awareness campaign will need to go beyond reach and virality to ensure that the public understands the call to action.”

Cacciamani emphasized that the data does not necessarily reflect poorly on the Movember movement, which encourages men to grow out their mustaches in November to raise awareness for men’s health issues like prostate and testicular cancers, mental health and suicide prevention. Since its founding in 2003, the campaign has raised more than $700 million in funding.

The varied effectiveness of the two campaigns may be attributed to the target audience. The Pinktober campaign to raise awareness for breast cancer and the need for regular screening is targeted to women, who may be more likely to turn to the internet for health information. In contrast, Movember is most popular among younger to middle-aged men and lends itself to social media mustache selfies, while prostate cancer primarily affects a generation of men who may not be as active on these platforms.

Another possible explanation for the differences in search traffic could be that in 2012, the United States Preventive Services Task Force (USPSTF) recommended against routine prostate-specific antigen testing for prostate cancer. Although the USPSTF has since updated their guidelines to encourage men ages 55-69 to speak to their doctor about the frequency of screening, Movember has seen a decrease in registered participants and donations since 2012.

Cacciamani and his team continue to analyze Google traffic for insights into how patients use the internet to obtain health care information.

“The pernicious trap of fake news is always around the corner,” says Inderbir S. Gill, MD, chair and Distinguished Professor of Urology in the Catherine & Joseph Aresty Department of Urology and executive director of USC Urology. Gill is also the senior author of the study. “Understanding patients’ internet search patterns can help the medical community combat misinformation and encourage healthier habits,” concluded Gill, who is also the Shirley and Donald Skinner Chair in Urologic Cancer Surgery at the Keck School.

“Many supplements on the market merely contain vitamins and minerals, but don’t do anything to improve testosterone,” Samplaski said. “Often, people can be vulnerable to the marketing component of these products, making it difficult to tease out what is myth and what is reality.”

Testosterone is the primary male sex hormone and the reason why men produce sperm and have Adam’s apples. It’s also why men develop more “masculine” features like bulging muscles, a deep voice, broad shoulders and a hairy chest. After age 30, most men experience a gradual decline in testosterone, sometimes causing these features to diminish or new symptoms to occur, like erectile dysfunction. In an attempt to turn back the hands of time, some men will turn to T boosters.

Using a structured review approach, Samplaski and a team of researchers explored the active ingredients and advertised claims of 50 T boosting supplements. Their findings were published as an original article in The World Journal of Men’s Health.

Researchers performed a Google search with the search term “Testosterone Booster,” thus mimicking a typical internet research for someone looking to increase testosterone levels, and then selected the first 50 products that came up in their search. Then, the team reviewed published scientific literature on testosterone and the 109 components found in the supplements. Zinc, fenugreek extract and vitamin B6 were three of the most common components in the supplements.

The team also compared the content for each supplement with the Food and Drug Administration’s (FDA) Recommended Daily Allowance (RDA) and the upper tolerable intake level (UL) as set by the Institute of Medicine of the National Academy of Sciences.

Of the 150 supplements, researchers came across 16 general claims to benefit patients, including claims to “boost T or free T”, “build body lean mass or muscle mass”, or “increase sex drive or libido.”

While 90% of the T booster supplements claimed to boost testosterone, researchers found that less than 25% of the supplements had data to support their claims. Many also contained high doses of vitamins and minerals, occasionally more than the tolerable limit.

Unlike drugs, supplements are not intended to treat, diagnose, prevent, or cure diseases, according to the FDA. As such, Samplaski would like to see more regulation around testosterone-boosting supplements to protect consumers. She also would like to explore disseminating handouts to her patients with more accurate information in the hopes that it encourages patients to seek a medical professional for low testosterone issues.

While no one can escape the effects of aging, Samplaski said there is something men can do to address their concerns. “The safest and most effective way for men to boost low testosterone levels is to talk with a medical professional or a nutritionist.”

— Elyse Blye