International prostate surgeon, Dr. David Samadi, cautions that the “wait-and-see” approach to prostate cancer may not give men the vision they hope.
Men are presented with many options when it comes to protecting their prostates. From the prostate-specific antigen (PSA) blood test, to active surveillance, to prostate cancer treatments, decisions abound. Those who are diagnosed with prostate cancer – typically through a PSA test, digital rectal exam (DRE), and prostate biopsy – must then decide whether or not to act.
David Samadi, MD, world-renowned SMART (Samadi Modified Advanced Robotic Technique) robotic prostate removal surgeon, works closely with each patient following diagnosis. Helping patients decide how to handle their prostate cancer, he believes, is a balance of medical research and personal wellbeing. “Active surveillance is a difficult recommendation to make to an otherwise healthy man,” says Dr. Samadi. “With robotic prostatectomy surgery I have the means to help them overcome prostate cancer. If I tell them to wait, they go home worried and potentially at risk.”
Prostate Cancer: Spread Without Symptoms
A new prostate cancer study from the University of Gothenburg, Sweden, published this September in the journal European Urology, found that 63 percent of men could go six years beyond diagnosis before needing treatment. “Could doesn’t necessarily mean should,” said Dr. Samadi who educates patients about the limits of prostate cancer diagnostics in predicting disease progression.
“So much is made of men living symptom-free with prostate cancer,” says Dr. Samadi. “But that’s a problem, not a benefit. Without symptoms it’s easy for men to assume everything is fine, they may skip an appointment or two. But prostate cancer is a master of stealth growth and waiting can be dangerous.”
Watchful Waiting or Watchful Worry?
Interestingly, almost 40 percent of participants in the Swedish study opted for treatment rather than surveillance, either because their tumor showed signs of growth or they chose not to live with the constant worry. “Beyond the science, there’s a strong emotional consideration,” added Dr. Samadi. “If you’re diagnosed with prostate cancer at 65, do you want to spend the next 20+ years in watchful worry?”
Prostate cancer is often a slow-growing disease, though current testing cannot accurately quantify individual prognosis. Prostate cancer can turn metastatic, spreading into the lymph nodes, blood, and other organs.
Much is made of the unpleasant side effects of prostate cancer treatment, but as Dr. Samadi reminds, cancer itself is unpleasant. “Unfortunately, cancer impacts the lives of many people, particularly when left untreated. The degree to which varies from one patient to the next, but it is my firm belief that robotic prostatectomy offers the best case scenario for most men.” Through his SMART robotic innovations, Dr. Samadi has removed more than 4,000 cancerous prostates.
Urinary continence is restored in 96% of Dr. Samadi’s patients just a few months after surgery and erectile function in 85% within 12-24 months. “For most men, SMART surgery makes prostate cancer a very surmountable hurdle. They are cured with minimal, short-term side effects and they go on with their lives in peace.”
David Samadi, MD serves as Vice Chairman, Department of Urology and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City.Press Release