In this presentation Dr. Dino Prato, founder of Envita Medical Centers, argues that traditional radical prostatectomy—whether open or robot‑assisted—fails to provide durable cure for many men and carries substantial urinary, sexual, and quality‑of‑life side effects. He cites ASCO and JAMA data showing biochemical recurrence rates of 20‑40% after surgery and highlights the hidden costs of incontinence, erectile dysfunction, hormonal changes, and psychological distress. Prato then introduces a precision, minimally invasive alternative that leverages interventional radiology, cone‑beam CT‑guided microcatheter delivery, and prostate artery embolization to ablate tumors directly while simultaneously releasing tumor antigens to train the immune system. He explains how this approach can avoid the collateral damage of surgery, preserve erectile and urinary function, and create systemic immune surveillance. The talk details advanced monitoring using circulating tumor cells (CTC), circulating tumor‑free DNA, and methylation scores to confirm long‑term remission. For advanced disease, Prato describes an N‑of‑1, multi‑omic workflow that integrates DNA/RNA sequencing, spatial biology, immune profiling, mitochondrial health, and root‑cause analyses (toxins, nutrition) to design micro‑dose, targeted therapies that modulate the tumor microenvironment and prevent resistance. Throughout, he contrasts this model with high‑dose chemotherapy and conventional radiation, emphasizing that precision oncology offers better functional outcomes, longer remission, and a personalized, immune‑centric strategy for prostate cancer patients.
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What if the best prostate cancer treatment doesn't cut, doesn't burn and doesn't steal your vitality? Yet it still teaches the immune system to hunt cancer everywhere. According to the American Society of Clinical Oncology, we still see a PSA rise from 20 to 50% of patients who have undergone radical prostectomy. That means surgical removal of the prostate and this is known as a biochemical reoccurrence. And it can happen whether their surgery was done with or without robotic assistance like a da Vinci or anything else. Patients can develop urinary incontinence, ed diminished sexual function. And in this episode we're going to uncover how to best overcome this with newer technology. I'm Dr. Dino Prado, founder of Envita Medical Centers. For the last 25 years we've helped patients who failed cancer treatment at the top centers across the United States. And we've developed new and innovative technology to help people using N of1 Precision Care targeting and minimally invasive procedures. The best treatments from around the world. That's what we focus on and we'll go over that today and we'll cover minimally invasive directed tumor options for prostate cancer that can be very helpful that are immune at different stages of prostate cancer. Multi omic planning where we have DNA, rna, immune spatial biology that helps guide advanced disease treatment. And yes, we're going to talk about protecting erectile and hormonal function reoccurrence. So it is not as common in the comprehensive ASCO hosted review. Here's what the evidence shows. Research emphasizes that nearly one third of men faced with biochemical reoccurrence of their PSA rising even after surgery. Other peer Review sources estimate 20 to 40% of men undergoing a radical prostectomy get their prostate removed with surgery will experience a return of elevated psa. These numbers represent thousands of men who believed that they were cured and all they had to do was confront the discomforts of surgery. And there was a hidden price to pay for that surgical cure. Surgery is often seen as a one stop solution for prostate cancer. Yet even with advanced robotics like da Vinci surgical systems, men can suffer long term side effects and deeply impact their lives. Urinary incontinence requiring pads, protective devices, erectile dysfunction, diminished sexual function, penile shortening, reshaped appearances and problems with urinary leakage during orgasm infertility urethral strictening and scarring Lymphedema in the groin and legs due to removed lymph nodes Hernias as the incision side risk of where the surgery was done persistent pelvic perineal pain, emotional toils like depression, anxiety and reduced quality of life. This is what we're going to talk about today. How do we avoid a lot of this? Even with the state of the art and robotic surgery, outcomes can be sobering. One study published in a leading urology journal reported that urinary continence declined from 99% at baseline to 54% at six months, with 17% of men still using pads. Six years later, erectile function recovery remains low. Only about 30% of men regain firm erections by one year. So this is not what anybody wants. Let's move into the future of technology. Like I said before, we've launched rockets into space and we land them on a pad, we have self driving cars, we have some of the newest technology for our iPhones. How do we get that into prostate cancer care? So let's go through this early disease direct to tumor with modern interventional radiology, oncology. This is where we have image guided surgery where we use a catheter the size of the hair, we can go right in to the prostate and affect it with genetic therapies and immunotherapies. That kills a tumor and then alerts the rest of the body of the immune system of where to find any cancers if they want to spread. And this is done through cone beam CT3D visualization. It guides the tiny needles and the microcatheter directly to the tumor and it ablates it kills it right on contact. A quick procedure, maybe 45 minutes, you're done. And you don't have the same side effects because you know exactly where you're going. And in that we can use targeted forms of treatment right to the tumor to stimulate the immune system. Prostate cancer is an immune centric cancer. We know that if your immune system knows what the targets are and the antigens, you have a longer term remission. And that's what I think is missing with a lot of the surgery. They're skipping all the immunotherapy, they're skipping training the body of where the cancer cells are and they're just trying to remove it. But the problem is oftentimes it can spread and the PSA rise regardless years. Interventional oncology improves the lesions visualization and allows us to get right with artery mapping to the exact spot. So we don't have erectile dysfunction problems, we don't have complications with urinary incontinence. We don't have any of those problems because we're going exactly where we need to go because we have high visualization and it's precise treatment to basically kill the cancer and stimulate the immune system in the prostate. Prosthetic artery embolization is already a minimally invasive procedure. So this is used widely for BPH benign prosthetic hyperfitry where men have a difficulty with inflamed prostates and they have urinary problems. This is already used widely, but we can use it very effectively as we have for cancer. Localized prostate cancer can be treated right at the region and it can be deball killed and the immune system stimulated instead of suppressed and we can get the T cells to work. And why that's important is because long term remissions are based on the body understanding and knowing where the cancer cells are. So it kills it at the micro stage. Then after treatment we monitor with CTC, CT free DNA and methylation scores. If silent for the 1 year, 2, 3, 4 years, et cetera, we know we've got a long term remission. This is the key of these processes. So why are men looking for alternatives? Because according to Jama, in 2024 men who had radical prostectomies reported worse long term urinary incontinence and early sexual dysfunction impacts. Proton versus photon debates continue and some data suggest different mixes of urinary bowel sexual side effects as is using radiation depending on the modality and those side effects. That's why we need a better model and that's where CT cone beam with intervent conventional radiology, oncology and targeted immunotherapy changes the game. JAMA published early cancers can often be treated with image guided precision aiming to preserve erectile dysfunction hormone function and keep everything healthy and get in and out. With modern day science we can visualize it, see it and when we can see it, we can go right to the area we need to without getting any errors of going in the wrong places and damaging healthy tissue, just treating the cancer and stimulating the immune system. So we need to make prostate cancer immune centric. And we do that because when we kill the cancer right at the prostate and it's taken dies immediately, we release damps and these are types of antigens danger signals that send out to the rest of the immune system and dendritic cells and natural killer cells. Here is where the tumors and cancer cells are and what they look like. So the rest of the body and the natural killer cells can go and remove any micro metastases that it's tried to spread that may have not been picked up and Then with detailed testing, we can monitor that and know that the treatment has not only been effective, but it has removed any of those circulating tumor cells or cells that have tried to get out of the tumor. So that in five and 10 years, we don't see elevated PSA. We monitor carefully and we know that those cells are kept out, meaning cancer cells are killed, not just a tumor. And that's the difference between these robotic surgeries and even radiation. No one is looking at these circulating tumor cells that we can predict that are out there and spread. Even today, with early technology, with ctc, circulating tumor cells, which are these cells that have spread away from the tumor, we can even predict whether the prostate cancer treatment is needed or not. It may be just localized to that one area. We can spot, treat it with ct, cone beam, and we're done. And the qual, this is the innovation of technology. You get a stronger immune system, stronger targeting, and we can avoid a lot of these side effects and concerns that we have surgery. You don't always know whether you're going to have a lot of these side effects and inflammation in the area and potential in the future, the growth of that PSA coming back. But when you do this type of procedure, because the visualization is so detailed and you can kill it and monitor it, then with blood work, not just tumor markers, but CTC, CT free DNA methylation, you can spot that cancer way before it would ever try to come back. And you would already know if you've got the immune system engaged so that it doesn't come back. That's the key of precision oncology. If cancer is metastatic and it returns years later, now we have a different treatment. So I went over early prostate cancer treatment and very effective with using that technology of 3D cone beam, because we can monitor and treat it. But now we're going to go into more advanced cancers. Patients may already have cancer that's spread to the bones and other parts of the body. And this is where we need multi omics, we need ngs, DNA transcriptomics, RNA and spatial biology. So now we can do full planning for the patient. And we can target these regions using similar procedures with interventional radiology, oncology. But the key here is building an immune system that recognizes and kills the cancer. And we do that through deep mapping. We map it out, we use spatial biology, look at the tumor microenvironments. And now if you can imagine a tumor with gangs around the tumor that are blocking the police of your immune system from getting to the tumor, now we can remove Those gangs so your immune system can get to it. And that's part of the planning. We also want to look at the mitochondrial health of the cancer from the perspective of is there chemical toxins, infections, heavy metals that have caused these mutations that have weakened the immune system. These are very common and they go totally undiagnosed unless you get tested. We also look for nutritional deficiencies. The body needs strong immunity and it gets it through strong nutrition and enzymatic pathways. We remove any causative factors that we see are there by looking at root cause analysis, eliminating that. So our patients are healthy now, they're eating healthy, their immune system's engaged. We spot treated the tumors and now their body's moving. Instead of the conventional model, which is the standard of care, which uses maximum chemotherapeutic doses, these are high doses that can lead to mutations and wiping out of the immune system, which is not what we want long term. We want micro doses that go right to the core. We want to affect the details of the cancer. We want to stop the body's ability to metastasize and spread. Looking at tumor microenvironment, we want to stop multi drug resistance and get the immune system engaged. So that's the very difference with precision oncology. It's a world of difference in planning, treatment and long term strategy. Instead of just a surgical removal or a radiation, hope and see, wait later, this technology allows us to monitor the patients, get to root causes and help people heal. That's the goal. We want a long term life, we want a blessed life with strong sexual function, strong urinary function, and all those other things that we want in good health. And that's how we do it, is by targeting. That's the goal behind precision oncology and interventional radiology oncology. So this is the key. The immune system is the most important aspect in many cancers, but particularly prostate cancer. And oftentimes it is not part of the planning, not part of the treatment, and it's ignored in this strategy. Not only do we go targeted to the tumor, but we elicit the immune system to recognize and go out throughout the body and kill the cancer. So I hope this was helpful and I hope this helps to show you there's a difference. In standard oncology, even with late stage prostate cancer, you might be using 2024 markers, biopsy, tumor marker and imaging. Where in precision oncology we're looking at thousands of markers, ngs, DNA, RNA transcriptomics, immune profiling. We're basically bringing in the science and technology, the bioinformatics of AI into the care which moves us way into the future. Spot treating with detailed precision to improve the quality and length of life of patients. That's the key of precision oncology. I hope this was helpful and it opened up your mind that are individual and you are unique than every other patient and need unique targeting we call that n of 1 and matching the therapies of all the treatments on you to help your body. I hope this was helpful and may the Lord bless you on your journey to heal. Sam.
