Brian J. Miles, M.D.

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Specialist in Urologic Oncology with additional interest in treatment of enlarged prostate and kidney stones

 

Education

B.S.E., Michigan State University
M.S.E., University of Michigan
M.D., University of Michigan
Surgical Internship, Georgetown University, Washington, DC
Residency in Urology, Walter Reed Army Medical Center, Washington, DC
Board Certified

Awards and Activities

• Listed in "America's Top Doctors," each year 2000 - Present
• Listed in "America's Top Doctors for Cancer," 2005  - Present
• Listed in "Best Doctors in America," each year 2002-2006
• Listed as a Texas Super Doctor " in Texas Monthly Magazine 2005 - 2008

• Medical Director, Robotic Surgery, The Methodist Hospital 2008 - Present

Clinical Interests

Urologic oncology, especially prostate cancer, robotic-assisted laparoscopic prostatectomy for cancer, urinary tract reconstruction, and general urology

Research Interests

Prostate cancer patterns of care and outcomes analysis. Development of a means of measuring "Quality of Life" in prostate cancer patients. Gene and vaccine therapy for prostate cancer. Detection of prostate cancer.

Selected Publications

Yang G Addai J, Wheeler TM, Frolov A, Miles BJ, Kadmon D, Thompson TC: Correlative evidence that prostate cancer cell-derived caveolin-1 mediates angiogenesis. Hum Pathol 38(11):688-695, 2007.

Yanagisawa N, Li R, Rowley D, Hao L, Kadmon D, Miles BJ, Wheeler TM, Ayala G: Stromogenic prostatic carcinoma pattern (carcinomas with reactive stromal grade 3) in needle biopsies predict biochemical recurrence-free survival in patients after radical prostatectomy. Hum Pathol 38: 1611-1620, 2007.

Teh BS, Bastasch MD, Mai WY, Kadmon D, Miles BJ, Butler EB: Preliminary report of the effect of high-dose adjuvant intensity modulated radiation therapy on the sural nerve graft for cavernosal nerve sacrifice after radical prostatectomy. Am J Clin Oncol 30:395-400, 2007.

Timme TL, Fujita T, Wang H, Naruishi K, Kadmon D, Amato RJ, Miles BJ, Ayala G, Wheeler TM, Teh BS, Butler EB, Thompson TC: Cytokine gene therapy for genitourinary cancer. Chapter 14 In: Cancer Drug Discovery and Development: Gene Therapy for Cancer. Edited by Hunt KK, Vorburger S. Swisher SG, Totawa NJ: Humana Press, Inc, 2007, pp223-241.

Tetzlaff MT, Teh BS, Timme TL, Fujita T, Satoh T, Tababta K, Mai WY, Vlachaki MT, Amato RJ, Kadmon D, Miles BJ, Ayala G, Wheeler TM, Aguilar-Cordova E, Thompson TC, Butler EB: Expanding the therapeutic index of radiation therapy by combining in situ gene therapy in the treatment of prostate cancer. Technol cancer Res treat 5:23-26, 2006.

Tahir SA, Frolov A, Hayes TG, Mims MP, Miles BJ, Lerner SP, Wheeler TM, Ayala G, Thompson TC, Kadmon D: Preoperative serum caveolin-1 as a prognostic marker for recurrence in a radical prostatectomy cohort. Clin Cancer Res 12:4872-4875, 2006.

Saichi AL, Lee JJ, Taylor RJ, Thompson IM, Miles BJ, Tangen CM, Minasian LM, Pisters LL, Caton JR, Basler JW, Lerner SP, Menter DG, Marshall JR, Crawford ED, Lippman SM: Selenium accumulation in prostate tissue during a randomized, controlled short-term trial of I-selenomethionine: A Southwest Oncology group Study. Clin Cancer Res 12:2178-2184, 2006.

Kattan MW, Miles BJ: Decision making for clinically localized prostate cancer. In: Atlas of the Prostate. Edited by PT Scardino, KM Slawin, Philadelphia: Current Medicine LLC, 2006, pp 137-144.

Ayala G, Satoh T, Li R, Shalev M, Gdor Y, Aguilar-Cordova E, Frolov A, Wheeler TM, Miles BJ, Rauen K, Teh BS, Butler EB, Thompson TC, Kadmon D: Biological response determinants in HSV-tk + ganciclovir gener therapy for prostate cancer. Molecular Therapy 13:716-728, 2006.

My Mission

I look forward to seeing you in consultation and discussing your particular cancer questions. We will have a lengthy discussion regarding your diagnosis, grade of cancer (Gleason score), stage of cancer, and all the various treatment options including watchful waiting, external beam radiation therapy, brachytherapy (radioactive seeds implants into the prostate), cryosurgery (freezing the prostate) and removal of the prostate either by the robotic surgery or open techniques. I am, first and foremost, a cancer surgeon. It is important to understand the parameters that define your cancer because they will be used to individualize your treatment and your operation. Each prostate and each cancer of the prostate should be viewed as individual and different; therefore, each operation should be tailored to the individual patient and their needs. This is why I am a strong proponent of each biopsy core being individually sent so that I know where the cancer is located. There are some men in whom open prostatectomy may be more prudent, but, as my experience has expanded, I am able to perform a high-quality cancer operation in essentially all men using the robotic technique. Some will require the removal of pelvic lymph nodes in association with their cancer. These are generally men with a Gleason score of 3+4 or higher. Those with very high Gleason scores, 4+4 or higher, are patients in whom I will do an extended pelvic lymph node dissection, that is to get as many lymph nodes as possible, both for diagnostic but also for therapeutic reasons. This again will be discussed in great detail during your consultation.

 

I have performed a substantial number of open radical prostatectomies, in excess of 2,000 of these operations. Recognizing the important contribution robotic surgery could bring to the treatment of men with prostate cancer I quickly embraced this technology. I started out slowly, being certain the quality of the operation I was performing robotically was at least as good as what I could provide using the traditional open technique. After four years of increasing experience, I know that I can provide excellent “quality of life conserving” cancer care with either technique. To date, I performed over 1,000 robotic prostatectomies. I am a cancer surgeon who uses the robotic technique. I am not a robotic surgeon who treats cancer. Having extensive open experience brings the best cancer surgical treatment skills that you deserve.

 

There are some who say that the robotic technique is not as good as the open. As a cancer surgeon with over 23 years of open experience, I can assure you that this is not true. This is an operation that within the next 10 years will be by far the primary way of managing adenocarcinoma of the prostate. The cancer control outcomes in the hands of experienced surgeons such as myself are certainly as good as those done when using the open technique. Recovery of urinary control is quicker because of some additional techniques we can bring to bear during that operation. Preservation of potency is the same as in a well done nerve-sparing open prostatectomy, but I found that the recovery of normal sexual activity tends to be quicker in the robotically performed prostatectomy.

 

I encourage you to continue to educate yourself regarding your prostate cancer and its management.  I look forward to seeing you in person to discuss your cancer and the different ways to treat it and which might be most appropriate for you.

 

Sincerely,

 

Brian J Miles, MD