Paving New Roads

http://www.getnside.com/atx/magazine/medical/current/profiles/1631-Dr_Richard_Chopp/

Paving New Roads

Austin businessman Richard Schwab prides himself on being brave. Had a kidney transplant a few years back and handled the situation well. But prostate cancer? Big-time scary. And the traditional treatments didn't sound encouraging to him, either.

Dr. Richard (Dick) Chopp, senior member of The Urology Team, told Schwab they could wait and see what the nasty cancer cells would do, go straight to a surgeon or try radiation. Schwab, troubled by thoughts of invasive operations, long drawn-out therapy and maybe dreaded side effects, kept shaking his head. Then the doctor said something that piqued the patient's interest. There was this newer treatment called HIFU, which stands for High Intensity Focused Ultrasound. Although not available yet in this country-it's still in FDA phase-three clinical trials-it was being used with great success elsewhere, especially in Japan. It could be done in a single session on an outpatient basis with no follow-up therapy. Of course, Schwab would need to fly to Cancun, Mexico.

Ultimately, the man who heads a thriving Texas uniform company decided to take the trip. Hey, what did he have to lose? It turned out to be one of the best (and speediest) trips of his life.

"I flew down to Mexico on a Friday in October of 2008, met Dr. Chopp, had the procedure on Saturday and was back home in my living room watching a ballgame on television on Sunday," Schwab recalls. "The whole thing was over so fast that it was surreal - like prostate cancer was just a bad dream and never happened to me. I have been absolutely thrilled with the results and what I hear whenever I go in for tests."

So far, tests indicate the patient is prostate-cancer free. This also is the case to date with 40 others who Dr. Chopp has treated in a similar way and continues to monitor closely. As for possible side effects like impotence and incontinence, Chopp reports that they've been minimal or non-existent with his HIFU cases (no incontinence, a mere 8 to 10 percent decrease in potency). And he's further encouraged by studies that have taken place outside the United States, which prove the procedure's oncology results are comparable to standard therapies, while being minimally invasive and not using potentially harmful ionizing radiation.

"I can tell you right now that I'd choose HIFU as my own therapy if I were diagnosed with cancer of the prostate tomorrow," the urologist declares. "It's really a remarkable treatment."

Just how does this remarkable HIFU work?

The procedure utilizes rapid heat elevation and carefully targeted ultrasound energy or sound waves to "cook" bad tissue at a focal point, destroying the cancer but leaving good surrounding tissue untouched and intact. The only drawback is that the technology, though first explored in the 1940s, wasn't scientifically perfected until fairly recently and as such, hasn't been available long enough to determine effectiveness over time. (However, 10-year follow-up from Japan shows that HIFU is as effective in curing prostate cancer as radiation or surgery, but with fewer side effects, which mainly include continence and potency.)

"To be honest, we don't know yet for sure about HIFU's results in the long haul," the doctor explains. "But we certainly have high hopes, and not just for treatment of prostate cancer, which is every man's nightmare, but for pancreatic cancer and other cancers, as well."

Indeed, the technology's possibilities are truly exciting to contemplate, according to the senior member of The Urology Team so exciting that they've re-energized his career and made him fall in love with medicine all over again.

Chopp, who was born in Grand Rapids, Minn., 63 years ago, first fell in love with medicine at a tender age, likely influenced by members of his family in the dental and medical fields. He attended the University of Minnesota Medical School and completed his internship and residency at the University of Southern California, where he was involved with general urology and adult and renal service. He received a position as an assistant professor at the USC Medical Center and, later, a fellowship in urology oncology at the Memorial Sloan Kettering Cancer Center.

The physician moved to Austin in 1983, joining The Urology Team (then called Austin Urology Associates) and was responsible for introducing laparoscopic urology surgery to the city's medical community in 1991. In the early days of his career in Austin, he was on the kidney transplant team and performed living donor nephrectomy. But then sub-specialization took over within his medical group, with each physician focusing on one or more specific aspects of urology. Chopp chose vasectomies, metabolic kidney stone disease, endocrine urology disorders, Peyronie's disease and the new and challenging therapy of HIFU.

Dr. Eric Giesler, Chopp's colleague from The Urology Team, admires Chopp's determination to pursue cutting edge therapies.

"Dr. Chopp has been a leader of urology in Austin for many years ... looking for more effective and less invasive alternative therapies for cancerous and non-cancerous problems of the prostate. As a result, his, as well as the rest of The Urology Team's, patients have benefited," Giesler declares.

The Urology Team now boasts two offices in Austin and one in Round Rock, with a total of 10 physicians on staff. These experts offer treatment for dozens of urinary/genital-related disorders, including things as diverse as erectile dysfunction and pelvic floor prolapse. When not involved with HIFU procedures and investigations, Chopp is usually busy doing vasectomies, which comprise a major part of his practice.

According to the urologist, the number of men seeking a "vas" has considerably increased since the nation's economic downturn. People are having to limit their families because they just can't afford to rear more children, he explains, and vasectomies are far less complicated procedures than female tube-tying or birth control pills that can have undesirable side effects. Nevertheless, Chopp warns, men shouldn't treat the operation lightly. Though reversals are possible and around 60 percent are successful, they're not easy and can be expensive. So, it pays to be at least 99- percent sure you've completed your family before taking the step.

Chopp's own family includes two grown children from an early marriage, Priscilla, 25, and Tyrrell, 22. In 2005, he married again-a charming woman who is an Austin realtor.

"My wife, Jane, and I share an interest in road-bike riding," the physician says. "I also like to go sporting clay shooting to relax."

A little leisure, he emphasizes, keeps burnout at bay. And whether you're a busy doctor or not, it's a good prescription.