Vice Chairman, Department of Urology
Chief of Robotics and Minimally Invasive Surgery
The Mount Sinai Medical Center
Prostate Cancer Treatment Expert
Surgeons who manage patients with prostate cancer must understand the advantages and disadvantages of each available prostate cancer treatment and procedure in order to optimize outcomes. The traditional open prostatectomy prostate cancer treatment effectively removes cancer, but has been associated with longer and more painful hospitalizations, significant blood loss, incontinence, and sexual dysfunction. The more recently developed laparoscopic prostatectomy prostate cancer treatment represents a major advance for patients with prostate cancer because it involves no incision, minimized blood loss and postoperative complications, and enables patients to recover more quickly with less pain. However, there is a steep learning curve associated with the laparoscopic approach; about 100 procedures before the technique is mastered.
Robotic Prostate Cancer Treatment Provides More Advantages
A recent addition to prostate cancer treatment is robotic prostate surgery. The procedure has the same advantages associated with laparoscopic prostatectomy—no incision, minimum blood loss, fast recovery, and minimal catheter use—but the new technology uses robotic instrumentation and two cameras for better visualization. Using two cameras enables us to ascertain a three-dimensional view of the anatomy with greater magnification. And unlike laparoscopic prostatectomy, the robotic instrumentation provides surgeons with a full range of motion, and is associated with significantly less blood loss during prostate cancer treatment. For this reason, robotic assisted prostate surgery is sometimes called bloodless prostate cancer treatment. In addition, sexual dysfunction and incontinence risks are reduced with this prostate cancer treatment because the surgeon has a clear view of the anatomy and can more accurately navigate around the nerves and structures responsible for these problems.
Prostate Cancer Treatment - Thorough Training As A Must
Few surgeons in the United States are trained in all three prostate cancer treatment surgical procedures, but it can greatly benefit patient outcomes if experience is gained in each approach. Surgeons must be skilled at laparoscopy in order to be an excellent robotic surgeon, but they must also be adept at performing the open procedure in order to obtain experience with laparoscopy. We should view the robotic laparoscopic prostatectomy as a prostate cancer treatment procedure that bridges open surgery and laparoscopy skills. There are few cases in which a laparoscopic procedure needs to be converted to an open surgery, but surgeons need to be prepared and trained to do as such if this situation arises.
A robotic laparoscopic prostatectomy should not be performed unless the surgeon is adequately knowledgeable in the prostate anatomy. Some cases may present with adhesions or scar tissues, so the laparoscopic surgeon will need to be capable of working within these conditions. This is why prostate cancer treatment and patient volume is so important. Surgeons need to have performed at least 100 cases.
Surgeons should inform patients about their experience with the prostate cancer treatment they perform. The myths and misconceptions associated with each prostate cancer treatment must be considered. Another important aspect of prostate cancer treatment is compassion for the entire family, not just the person with prostate cancer. There are many emotions involved for the patient and their supporting caregivers, and we should involve ourselves in that support.
I learned in November 2012 following a high blood PSA value and prostate biopsy, that I had prostate cancer.
It has a Gleason 7+ value, which placed it in a the problem category needing a rapid care...
Dedicated to all women whose husbands have been diagnosed with Prostate Cancer
Dr. Aharon Manes, senior Urologist, surgeon from “Hasharon” hospital in Petah Tiqwa, Israel, my doctor, a professional, attentive, patient physician, had sent me to have a blood exam on 1/9/2010, to establish my PSA level. The PSA result was 19.5.