Your Health

Robotic prostate cancer surgery means faster healing, recovery

For men with prostate cancer, a new surgical system is making treatment of the disease a little easier and recovery a lot faster.

Prostate cancer is the most common cancer in American men. The American Cancer Society estimates that the cancer is diagnosed in about 230,000 men annually, and each year, nearly 30,000 men will lose their lives to the disease.

Currently, prostate cancer is commonly treated with surgery, radiation or hormone therapy. The ideal treatment depends on several factors, including the patient's age, how fast the cancer is growing, whether or not it has spread, and side effects of the treatment.

For men who require surgery, a procedure known as a radical prostatectomy is often performed. In this operation, the surgeon typically removes the diseased prostate gland through a large incision in the abdomen that extends from the navel to just above the pubic bone.

Significant blood loss

In many cases, the surgery is accompanied by significant blood loss, often requiring transfusions and extended hospital stays. Afterward, men can expect to experience problems with bladder control and sexual function for weeks, or even months.

Fortunately, the development of a new robotic surgical system is reducing the severity of side effects associated with radical prostatectomy.

Using a device called the da Vinci Surgical System, doctors can now remove a diseased prostate gland through a small, one- to two-inch incision in the patient's abdomen.

Minimally invasive

The da Vinci Surgical System is the first surgical robotic system approved by the Food and Drug Administration for performing robotically assisted, minimally invasive surgery.

The device consists of a surgeon's console and four interactive, robotic arms equipped with a camera and surgical instruments.

While viewing a three-dimensional image of the surgical field at a magnification of 10- to 12-fold, the system translates the surgeon's hand movements into precise movements of the surgical instruments inside the patient's body.

Thomas Ahlering, M.D., professor of Urology and chief of Urological Oncology at University of California, Irvine, pioneered the use of the da Vinci robot.

He said, "One of the benefits is that it allows the surgeon to operate with machine-like precision."

No transfusions

In addition, he noted, "Blood loss is about one-tenth that of traditional surgery, so no transfusions are required."

Because the surgery is less invasive, use of the robotic system means less pain, a lower risk of infection and a short, overnight hospital stay compared to the usual three to five days of hospitalization.

While a recovery time of six weeks is required for most men after traditional prostatectomy, the recovery time for those undergoing surgery with the da Vinci system usually is just one week.

Complications less common

The robotic method also allows surgeons to spare more nerves bundles around the prostate gland during the procedure. As a result, typical prostatectomy complications, including erectile dysfunction and loss of bladder control, are far less common.

Robin MacKay, an outdoorsman who was diagnosed with prostate cancer at the age of 73, said his doctor offered him a choice of treatments.

"I surveyed my friends who had been treated with radiation therapy and traditional surgery, and I didn't like what I heard."

One of MacKay's friends had recently undergone a robotically assisted prostatectomy and was happy with the results.

"My friend had just had surgery a few days earlier, and he was already jumping off his boat into the water," MacKay said. "I was impressed."

Right decision

After opting for the robotic surgery himself, MacKay felt that he made the right decision. Within four days of the procedure, his pain was controlled with ibuprofen, and he was able to walk his usual five-mile route.

As the founder of a company that designs and manufactures gas turbines, MacKay liked the fact that the robotic system facilitates greater visibility and precision than the traditional method of performing prostatectomy.

"I felt that if the doctor could see the prostate gland magnified by a factor of 12 and in three-dimensions, he could be more precise."

Early detection

Although surgical methods of treating prostate cancer are improving, early detection still offers the best chance of a cure. Since the disease may not have symptoms initially, routine screening is important.

Ahlering said annual digital rectal exams are useful, but having a blood test to determine PSA, or prostate specific antigen, level is most important.

For the general population, he recommends that testing begin at age 50.

For African-American men, and for those with a family history of the disease, testing should start at age 40.

"If the diagnosis is established early on," Ahlering noted, "men may not need to have surgery at all."

Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is www.rallieonhealth.com.

© 2005 Creators Syndicate Inc.