Prostate Cancer Treatments: Budgets And Benefits
Leading prostate cancer surgeon, David Samadi, MD, balances the patient benefits of robotic prostatectomy surgery with industry focus on prostate cancer treatment costs.
Researchers at the University of Michigan in Ann Arbor evaluated how certificate of need laws impact prostate cancer treatment – specifically, robotic-assisted prostatectomy surgery and radiation for prostate cancer (intensity modulated radiation therapy – IMRT). These state regulations were initiated in the 1970s and 1980s to control and align healthcare funding with patient needs, though are not consistently enforced today.
Dr. David Samadi, Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at Mount Sinai Medical Center in New York commented on the study by saying, “It's encouraging to see certain prostate cancer treatments increasing. There are likely a lot of factors at play, but one may be the increase in early diagnosis of prostate cancer through PSA testing.” Dr. Samadi specializes in minimally-invasive robotic prostate removal surgery with his SMART (Samadi Modified Advanced Robotic Technique) procedure.
Researchers in these University of Michigan studies touch on the heavily debated cost of robotic surgery verses benefits, but acknowledge that several studies demonstrate the recovery benefits of robotic prostatectomy. “While laws such as these may need to be reevaluated, I agree with the need for an appropriate balance of patient wellness and treatment costs. In my opinion, robotic prostatectomy achieves this balance,” said Dr. Samadi.
Prostate Cancer Radiation Verses Robotic Surgery
In September of this year, Dr. Samadi was instrumental in a study comparing radical prostatectomy results with those of external beam radiation therapy (EBRT) for localized prostate cancer. The findings, presented at the 2012 American Urological Associate annual meeting, showed reduced prostate cancer-specific mortality rates in prostatectomy patients verses radiation patients.
Almost 2/3 of the 1,600 participants had robotic prostate removal surgery and among them prostate cancer survival rates were 40-65% greater than those of radiation patients. In a separate study, researchers at the Mayo Clinic in Rochester, Minnesota found that patients who underwent robotic-assisted prostate removal required shorter hospitals stays and had fewer post-op complications that those who had traditional prostate removal surgery.
“With each new robotic prostatectomy study we understand more about patient recovery and survival benefits related to the procedure. Further, reductions in complications and hospitals stays are good for patients and the healthcare system as a whole; it's a win-win,” added Dr. Samadi.
Prostate Cancer Recurrence After Radiation
The risk of prostate cancer recurrence after radiation therapy is minimal, but it is important to note that, if needed, subsequent treatment options may be limited. “A salvage prostatectomy, performed after radiation for prostate cancer, is highly complex. Radiation alters the prostate and surrounding tissue in way that prohibits prostatectomy surgery in many patients,” cautions Dr. Samadi.
Additionally, radiation for prostate cancer has been linked to an increased risk of bladder cancer and rectal cancer, according to a 2008 study at the University of Miami Miller School of Medicine.
Dr. Samadi encourages a careful exploration of prostate cancer treatment options with specific attention to results, recovery, and risks. Having performed more than 4,000 successful SMART procedures, Dr. Samadi removes the cancerous prostate with extreme attention to preserving urinary function and sexual potency.
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