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Minimally Invasive Technologies for the Management and Diagnosis of Prostate and Kidney Cancer

Photo of Thomas James Polascik, MD

Thomas James Polascik, MD

Office: Room 1080 Yellow Zone, Duke South DUMC, Durham, NC 27710
Campus Mail: Box 2804 Med Ctr, DUMC, Durham, NC 27710
Phone: 919-684-4946
Fax: 
919-684-5220

The Thomas Polascik, MD, Research Laboratory

Scientific Focus

The Polascik laboratory's research interests focus on translational programs, namely research projects that can have direct consequences on improving patient care and surgical therapy with emphasis on prostate cancer diagnostics, minimally-invasive prostate cancer ablative therapy, observational management of prostate cancer and racial disparities, and kidney cancer.

Prostate Cancer Diagnostics

The research group's current focus specifically includes the utilization and improved performance metrics of mpMRI, MRI-TRUS fusion image-guided prostate biopsy and molecular markers to enhance the diagnosis and risk stratification of prostate cancer. To achieve this goal, we have formed intramural multi-disciplinary research groups for prostate imaging/therapy through the Duke Cancer Institute and Pratt School of Engineering involving urologic oncology, radiology, genitourinary pathology, and biomedical engineering (BME). In conjunction with BME, we are developing Acoustic Radiation Force Impulse (ARFI) imaging as a means to detect and target prostate tumors using a real-time, non-fusion platform. The application of the aforementioned includes improved patient selection for image-guided Focal Therapy, Active Surveillance (AS) as well as surgery.

Current projects:

  • Development of a multi-parametric ultrasound (mpUS) platform for image-guided biopsy and therapy
  • Characterization of mpMRI visible and invisible lesions
  • Optimization of mpMRI for the diagnosis and staging of prostate cancer
  • Characterization of differences in mpMRI and outcomes between racial groups

Key publications:
https://www.ncbi.nlm.nih.gov/pubmed/28721479
https://www.ncbi.nlm.nih.gov/pubmed/28589398
https://www.ncbi.nlm.nih.gov/pubmed/28440322
https://www.ncbi.nlm.nih.gov/pubmed/28349978

Minimally-invasive Prostate Cancer Ablative Therapy

The goal of focal therapy is to provide a parenchyma-preserving, minimally-invasive, outpatient treatment for localized prostate cancer that will preserve a man’s quality of life.

Our researchers work with data from the Cryo On-Line Database (COLD) Registry that includes the outcomes of thousands of patients treated with cryoablation (whole, focal, primary and salvage) for prostate cancer. We also analyze prostate cryoablation performed at the DCI for quality improvement, including outcomes of anterior focal gland ablation, a new technique aimed to better preserve sexual and urinary function.

Key publications:
https://www.ncbi.nlm.nih.gov/pubmed/28635336
https://www.ncbi.nlm.nih.gov/pubmed/28385075
https://www.ncbi.nlm.nih.gov/pubmed/27502428
https://www.ncbi.nlm.nih.gov/pubmed/26915721

Observational Management of Prostate Cancer and Racial Disparities

Duke University Cancer Institute Multidisciplinary Active Surveillance (DUCIMAS) is a prospective, single center study integrating primary care physicians with urologic, medical and radiation oncologists evaluating and monitoring subjects on AS vs. immediate standard therapy. We additionally aim to query biological racial differences and improve patient selection for African American men who tend to present with more aggressive disease. The registry provides insight into racial differences in QOL and the psychosocial impact of AS to inform future interventions that may benefit the Duke male population including 20+% African American men.

Key publications:
https://www.ncbi.nlm.nih.gov/pubmed/25768694
https://www.ncbi.nlm.nih.gov/pubmed/23263824
https://www.ncbi.nlm.nih.gov/pubmed/23069729

Kidney Cancer

We analyze the outcomes of a large granular renal mass data repository including renal cryosurgery. We collaborate with international sites and interventional radiology to assess outcomes and study the association between patient factors and renal mass biological characteristics.

Key publications:
https://www.ncbi.nlm.nih.gov/pubmed/28284892
https://www.ncbi.nlm.nih.gov/pubmed/24495445
https://www.ncbi.nlm.nih.gov/pubmed/23897487

Recent Notable Achievements Resulting in Improved Clinical Care for Duke Patients

  • 2003 - Established Duke Cryotherapy Center of Excellence and training program
  • 2006 - Urology liaison, initiation of Duke mpMRI program for prostate diagnostics
  • 2008 - Founded the First International Symposium on Imaging and Focal Therapy for Prostate Cancer
  • 2013 - Edited, Imaging and Focal Therapy of Early Prostate Cancer
  • 2014 - Developed rectal swab culture program to protect patients from prostate biopsy-associated infection
  • 2015 - Initiated mpMRI image-guided fusion prostate biopsy program
  • Dec 2016 - Launched DUCIMAS registry to monitor men on Active Surveillance
  • 2017 - 2nd edition, Imaging and Focal Therapy of Early Prostate Cancer
  • Feb 2017 - Launched the DCI Multidisciplinary PSA screening platform into the EHR
  • Feb 2018 - 10th anniversary, International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer, Noordwijk, Netherlands

Collaborate with Us

The lab seeks to accommodate and collaborate with the spectrum of physicians, scientists, students, and others with similar research interests.

Please contact Efrat.tsivian@duke.edu for further information.

Latest Publications

Patel, MP, Schulman, A, Shah, KP, Anderson, JB, and Polascik, TJ. "Engaging the primary care community to encourage appropriate prostate cancer screening." Therapeutic advances in urology 10, no. 1 (January 2018): 11-16.

Full Text

Schulman, AA, Howard, LE, Tay, KJ, Tsivian, E, Sze, C, Amling, CL, Aronson, WJ, Cooperberg, MR, Kane, CJ, Terris, MK, Freedland, SJ, and Polascik, TJ. "Validation of the 2015 prostate cancer grade groups for predicting long-term oncologic outcomes in a shared equal-access health system." Cancer 123, no. 21 (November 2017): 4122-4129.

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Elshafei, A, Tay, KJ, Kara, O, Malkoc, E, Nyame, Y, Arora, H, Hatem, A, Patel, SA, Lugnani, F, Polascik, TJ, and Jones, JS. "Associations Between Prostate Volume and Oncologic Outcomes in Men Undergoing Focal Cryoablation of the Prostate." Clinical genitourinary cancer (October 28, 2017).

Full Text

Tay, KJ, Scheltema, MJ, Ahmed, HU, Barret, E, Coleman, JA, Dominguez-Escrig, J, Ghai, S, Huang, J, Jones, JS, Klotz, LH, Robertson, CN, Sanchez-Salas, R, Scionti, S, Sivaraman, A, de la Rosette, J, and Polascik, TJ. "Patient selection for prostate focal therapy in the era of active surveillance: an International Delphi Consensus Project." Prostate cancer and prostatic diseases 20, no. 3 (September 2017): 294-299.

Full Text