Mailing address:
9444 Medical Center Drive, MC 7897
La Jolla, CA 92037
Business/Practice address:
9400 Campus Point Drive, MC 7897
La Jolla, CA 92037
Prostate Cancer Risk and Screening
A major focus of our research is assessing new biomarkers to better predict those with aggressive cancers and provide options for men with an increased risk of prostate cancer. Not all men require genetic testing; however, there are specific instances in which it would be helpful, especially for those with a strong family history of breast and prostate cancer, particularly at a young age, or metastatic prostate cancer. Different types of genetic testing are available; therefore, consultation is recommended to determine which would be most useful. We offer new testing that will provide a genetic risk score, which may give more information on your specific risk for prostate cancer, allowing us to gauge your screening intensity with specific information.
Elevated Prostate Specific Antigen (PSA)
PSA, or Prostate-Specific Antigen, is a blood test traditionally used for prostate cancer screening. New data have suggested that this blood test may not be the best option for prostate cancer, yet it remains very powerful. PSA lab values tend to rise and fall, potentially giving a false reading. There are many other tests that can be utilized in addition to PSA, but sometimes a simple conversation regarding your risk factors can allow more expensive tests to be avoided. I explain that ordering a test simply because it is available is not the correct approach. We should determine how we would use the information from various tests specific to your situation. Only after we have a clear understanding of how we will use a particular test would we embark more specific and expensive tests. On the "My Approach" page is a calculator that I utilize to describe risk and serve as a focal point for our discussions.
Prostate Biopsy
A prostate biopsy is a diagnostic procedure used to identify prostate cancer. Utilizing ultrasound technology, we can visualize the prostate and obtain samples of prostate tissue. This procedure can be conducted either in a clinical office or an operating room setting. In some cases, MRI imaging may be employed during the biopsy process. Dr. Liss is a pioneer in the application of MRI fusion technology, having adopted it early on. While many practitioners utilize "cognitive fusion" techniques, which may provide close approximations, accuracy is paramount in diagnosis. As an innovator of Restriction Spectrum Imaging—a highly precise MRI modality—Dr. Liss conducted the first RSI-MRI targeted biopsy. This advanced MRI technique, coupled with high-end ultrasound technology, ensures that your prostate biopsy is performed using the most state-of-the-art methods available. It is important to note that not all MRI images are equivalent. We are also launching several clinical trials that involve RSI-MRI-guided prostate biopsy, funded by the National Cancer Institute. These initiatives support Dr. Liss in performing specialized MRIs with Restriction Spectrum Imaging for men undergoing biopsies whether they have opted for diagnostic biopsies or are participating in Active Surveillance for prostate cancer monitoring.
Cancer Monitoring (Active Surveillance)
Active Surveillance is a strategy that allows men with low-grade (slow-growing) prostate cancer to monitor their condition. There are various treatment algorithms, and not all physicians approach treatment the same way. Our aims to monitor the cancer as closely as possible while minimizing the number of visits. You can access your PSA test results through MyChart to stay informed. We also be rolling out a new platform where biomarkers and imaging tests can be stored and made available to you on demand.
The greater variation in practice means that there may not be clear guidelines to follow, making Active Surveillance an ideal area for research. We have been enrolling men in the PASS study as a founding member. The study includes sites across the United and is run out of the Fred Hutchinson Cancer Center, sponsored by the Canary Foundation. Our patients benefit from being followed under a stringent protocol, and when new biomarkers or tests become available, they may receive additional information. I also believe this is a prime area for studies that could utilize diet,, vaccines, and natural products to reduce cancer progression. We are actively pursuing these research programs to make them available to our patients.
Robotic Surgery
I'm a passionate urologic surgeon specializing in robotic surgery for the prostate, fueled by my family's history with prostate cancer. I've invested countless hours in training to ensure my patients receive the best surgical outcomes possible. My journey began at the University of California, Irvine, during the pioneering days of robotic surgery. I then enhanced my expertise through a prestigious Fellowship at the University of California, San Diego, recognized by the Society of Urologic Oncology for its rigorous standards in research and surgical excellence. With a decade of experience at UT San Antonio, I've become a leader in prostate cancer care, creating unique opportunities for my patients through large clinical research teams. Now back in San Diego, I'm excited to develop innovative translational science teams to tackle the most pressing questions in prostate cancer prevention, early detection, and surgical management.
There are two forms of radical prostatectomy that I provide.
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1. Multi-Port Prostatectomy: This is the most common and we used
several very small incisions to remove the prostate laproscopicaly.
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2. Single Port Prostatectomy: This can be used with one or two incisions
(for an assistant). This newer techinque is is more challenging and few
providers offer this surgery. Due to its difficulty there are many patient
factors to take into account which we will discuss at your visit but some
of the factors are size of your belly and size of your prostate.
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Below, you'll find links to my educational video, the Da Vinci surgery patient guide, and essential pre- and post-surgery instructions. The first figure highlights the innovative approach to prostate removal with a focus on preserving nerves, while the second figure showcases how partial nerve sparing can be achieved even in advanced cancer cases.
CLICK THE BLUE BUTTONS BELOW FOR MORE INFORMATION!
Cancer Recurrence
If cancer returns, a patient can face many options and concerns. At UT Health San Antonio we have a team of specialized that can assist with options for therapy from radiation therapy, surgery, hormonal therapy, and chemotherapy. We have research studies looking at a "liquid biopsies" that may help us selected treatments in the future. We also have an affiliation with M.D. Anderson Cancer Center that allows our doctors to use similar treatment plans. Care does not stop after your initial evaluation or therapy. As for imaging, we offer the Auxmin Scan which is a new imaging test to detect the location of prostate cancer at an earlier state. See button below for more information.
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Imaging
As for imaging, we offer the PSMA PET Scan which is a new imaging test to detect the location of prostate cancer at an earlier state. See button below for more information.
