Prostate cancer is cancer that begins in the prostate gland. Prostate cancer is not commonly found in men less than 40 years of age, though it is not altogether impossible. Prostate cancer can strike any male for a number of varying reasons. Men who have had prostate problems in the past, who have a family history of the disease, and those who have poor dietary habits and who abuse alcohol may be at a higher risk.

The symptoms of prostate cancer appear differently from one victim to another. But symptoms that are most alarming, and may directly relate to the onset of prostate cancer is blood found in the urine and a burning pain while urinating.

When the above symptoms occur it is important to see your urologist. He will most likely biopsy the tissue from the prostate gland and report the results of the test via the Gleason grade. If the Gleason grade proves to be above the number 2, then it will be time to consider prostate cancer treatments. Different prostate cancer treatments are performed for different age groups and different stages of the disease. But common prostate cancer treatments include:

• Radiation Therapy
• Chemotherapy
• Hormonal Therapy
• Surgery

Surgery is the preferred prostate cancer  treatment because it removes the cancer from the body by removing the prostate (either all or parts of it). There are two types of surgeries performed for prostate cancer, in both the prostate is completely removed in the early stages of the diagnosis to prevent further complications or the spread of the cancer into other regions, radical prostatectomy and robotic prostatectomy. Robotic Prostate surgery has become the favored prostate cancer treatment among urologists and patients.

Robotic prostatectomy is the same surgery as a radical prostatectomy, except that it is robotically-assisted. This surgery is a minimally invasive removal of the prostate.

A urologist will perform the surgery with the help of computerized robotic controlled instruments and high resolution cameras. The tools eliminate the shakiness of the surgeon’s hands and perform the surgery with more preciseness then ever before.

A robotic prostatectomy has been proven to greatly reduce post-op recovery in terms of minimizing pain levels, blood loss, hospital stay, recovery time, and side effects of a radical robotic prostatectomy. This is because unlike the radical prostatectomy the robotic prostatectomy does not require a large incision opening.

In this surgery, a urologist will enter the abdomen of the patient through a few very small incisions. The urologist then guides the robotic small instruments through the holes in the abdomen with a very tight and precise “joystick.” This allows the doctor to turn with 90 degrees of articulation and 7 degrees of freedom. The doctor will remove the prostate gland and the surgery is complete. The small incisions will leave very small circular scars that may completely heal in time.

Experts also agree that another pro to the robotic method is the lack of damage to the bladder and sexual function. A couple of common complaints of a patient who has received a radical prostatectomy are the loss of control over his bladder and the loss of ability to receive or maintain an erection. These side effects and risks are decreased with a robotic prostatectomy.

While the number of men that are diagnosed with prostate every year is increasing, it is important to note that the number of men that will die from the disease decrease every year, thanks to advanced tests, treatment options and education about prostate cancer. It is important to research the symptoms of prostate cancer, but if you think you may be suffering from the symptoms associated with this cancer then you need to see your doctor at your earliest convenience.

As a urologist in the North Dallas area, Dr. Mark Allen of North Texas Urology Associates (972.612.8037), has had the task of delivering unwelcome news to patients more times than he would like. The words, “you have prostate cancer” is never easy for a patient to hear.  If you are one of the 200,000 Americans diagnosed with prostate cancer this year, then you probably already have your clinical information memorized. You can spout off your PSA level, Gleason score and prostate cancer stage without the blink of an eye. While these tests, historically, have been sufficient in classifying cancer stages for patients, missing variables often exist that may alter the effectiveness of staging during diagnosis.

Today, more than 85% of patients that are diagnosed with prostate cancer will be considered in the low or intermediate risk category purely because they have similar clinical information.  The conflict in using this clinical information alone to treat and manage a person’s cancer and to determine prostate cancer stages has been a topic of discussion in recent years. From a purely clinical perspective, patients can often appear the same, when in fact they will have very different outcomes. One patient might have a slow growing cancer that will never be a problem and the second patient might have an aggressive cancer.

The current challenge in predicting individual patient risk is complicated by the multiple variables that must be considered, as well as the applicability and accuracy of available predictive tools and tests. Prostate Px+, a new prostate cancer test developed by Aureon, was created with these challenges in mind and is currently being adopted into urology offices like Dr. Allen’s in Plano, Texas. As a new option for physicians, this state-of-the-art test is being used to better assess the prostate cancer within each patient so that prostate cancer stages and a more accurate diagnosis and treatment plan can be offered.

About Prostate Px+

Prostate Px+ is a prostate cancer test that is ordered at diagnosis to provide physicians with objective and useful information. Unlike other tests, it uses a combination of cellular, molecular and clinical data with advanced mathematical analysis, to assist doctors in properly identifying low risk vs. high-risk patients. Prostate Px+ is based on patented technology and is the only test that combines multiple layers of data based on the patient’s tissue to provide an idea of the outcome post-therapy. In essence, when someone asks, “What is your prognosis?” a more accurate answer can be given.

Once prostate cancer has been found in a patient, a physician can order the test and use the same sample that was provided for the original biopsy. The test, which is currently only available in the United States, is analyzed and a personalized report is sent to the physician to be used for patient discussion within about five days. One of the items that will be provided back to the physician is a prostate disease Progression Score that will rank between 0-100.  This number reflects the likelihood of the patient developing disease progression (defined as bone/soft tissue metastases, death of disease and/or androgen independent rise in PSA within eight years of their diagnosis.

A Personalized, More Accurate Approach

Prostate Px+ provides personalized test results by analyzing a patient’s existing biopsy sample using molecular diagnostics, sophisticated tissue-based image analysis and advanced mathematics. The resulting information gathered from this multi-layered approach provides both the patient and physician with objective, predictive and personalized information that enables all parties to make more-informed treatment decisions.

Prior to treatment selection, Prostate Px+:

• Provides useful, objective information for anyone considering surgery as a treatment option
• Predicts serious disease progression (metastasis, death of disease, progression through androgen deprivation therapy)
• Accurately reclassifies all intermediate-risk patients as either high- or low-risk
• Reveals high-risk disease, originally masked as low-risk at diagnosis
• Predicts your tissue pathology results after surgery
• Helps alleviate patient anxiety by providing objective information about a patient’s cancer

A diagnosis of prostate cancer does not mean the end to a fulfilling and active life. If you have been diagnosed with prostate cancer but have not yet selected treatment, you are looking for as much information as possible to better understand your disease and your options. In prostate cancer, there is no one-size-fits-all. Understanding the multiple issues and challenges will help you take control of your individual health needs.

For more information on Prostate Px+ visit http://aureon.com.  To learn more about Prostate Px+ please visit the literature and brochures section of the Aueron website.

Prostate motion documented in the daily report demonstrates motion of the prostate of greater than 1cm over 6 minutes.

If you are considering radiation treatment for your prostate cancer, it is important to know about organ motion.  Organ motion is prevalent, variable, and unpredictable during radiation therapy.  It presents challenges to delivering precise external beam radiation to the prostate.  A recent multi-institutional study showed that patients experienced organ motion during treatment fractions and the direction and degree of the motion is highly variable—from patient to patient and day to day.  The common methods used for target localization cannot provide continuous, real-time, objective guidance to clinicians managing patients receiving radiation therapy treatments.  The Calypso® 4D Localization System™ and Organ Motion is Prevalent, Variable, and Unpredictable implanted Beacon® electromagnetic transponders provide improvements with continuous, real-time tumor setup and monitoring without the use of additional ionizing radiation — GPS for the Body®.

Dr. Mark Allen of North Dallas Urology Associates is committed to providing leading edge treatment options to his patients and is pleased to offer the Calypso® 4D Localization System™ / GPS for the Body®.  Please visit click here to learn more information and schedule a consultation with Dr. Allen to see if you are a candidate for this highly effective prostate cancer radiation treatment.

If you are considering a da Vinci Prostatectomy to treat your prostate cancer, here is what you can expect from initial appointment to follow-up care.

1. Initial Appointment

Typically, your primary care physician will check your PSA levels in your blood workup during your routine check-up.  If your laboratory results show an “elevated PSA”, you will be referred to a urologist for further testing.

2. Laboratory Results

The exam likely consists of a standard digital rectal exam (DRE), in which Dr. Allen manually palpates the prostate by way of the rectum. Even if he detects nothing abnormal, he will schedule a biopsy to be certain there is no evidence of prostate cancer. The biopsy is performed by inserting a tubular structure in the rectum, from which projectile needles collect 5-6 “cores” of tissue from each side of the prostate. Although many patients tolerate the biopsy without medication, Dr. Allen may offer something to alleviate your discomfort and anxiety associated with the procedure.

3. Treatment Options

If you have an early diagnosis of prostate cancer, there is usually a range of treatment options. These may include conservative management, radiation therapy with external bream or brachytherapy, cryosurgery and prostatectomy – surgical removal of the prostate. The treatment options will depend on a number of factors, including the stage of the disease, and you age, health and personal preference.

If you choose to have a da Vinci^® Prostatectomy – robotic prostate surgery – here is what you can expect:

4. Pre-Operative

You will have a physical examination and discuss the various types of anesthesia with your anesthesiologist. This visit is arranged by Dr. Allen and will likely occur the week before surgery. The evening before surgery, you will need to follow instructions for bowel preparation that Dr. Allen will provide.

5. Day of Surgery

Shortly before the operation, anesthesia is administered and you will sleep for the duration of the operation, which typically lasts 2-4 hours. The procedure begins when your abdomen is inflated with carbon dioxide gas, creating an operating space for the surgeon. Next, six small incisions, 1/4 to 1/2 inch in length, are made in your abdomen and ports are inserted to keep the incisions open.

During the procedure, Dr. Allen uses the da Vinci System’s laparoscopic surgical instruments and video camera, via the temporary ports, to direct the dissection of the prostate gland and adjacent tissue. If deemed appropriate, he tries to preserve the nerves attached to your prostate gland (nerve sparing). At the end of the surgery, the ports are removed from your abdomen and the remaining incisions are closed with sutures.

(For detailed information about this procedure, please set up a consultation with Dr. Allen.)

6. Post-Operative

After robotic prostatectomy surgery, you wake up very groggy and with a urinary catheter in place. You will likely spend one night in the hospital resting and recovering from the effects of the anesthesia. As the anesthesia wears off, there may be some discomfort, for which pain medication may be prescribed. During this time, the medical team gets you patient sitting, standing and eventually walking around, which is recommended throughout the recovery period. Because a catheter typically remains in place for approximately 7 days, Dr. Allen will review guidelines for use that will ease discomfort and ensure proper function of the catheter during this time.

7. Recovery Period

The first week post-operatively will likely be spent resting; however, frequent walks are encouraged. Depending on the your individual recovery needs, regular activities may resume as soon as soon as a few days after surgery; straining and heavy lifting is discouraged for the first four weeks post-operatively. Approximately one week after surgery, a post-operative follow-up is scheduled, at which time your bladder function may be assessed. This is done by filling the bladder with saline via the catheter, removing the catheter and then allowing you to void naturally. Some incontinence after surgery is normal and is typically managed with medication until bladder control resumes. Erectile dysfunction may also be a side effect of surgery. Like incontinence, this side effect may be discussed with the Dr. Allen and managed with medication until it lessens or completely resolves over time.

8. Follow-Up Care

After this treatment for prostate cancer, Dr. Allen will want to watch you carefully, checking to see if your cancer recurs or spreads further. Typically, Dr. Allen will outline a follow-up plan with you that includes regular visits, PSA blood tests and digital rectal exams, which will likely begin within a few months of finishing treatment. PSA tests are usually recommended about every 6 months for the first 5 years after treatment, and at least yearly after that.

Surgical side effects cut with robotics

ATLANTA, Georgia (CNN, Aug. 5 2008) — As 3D images illuminate the viewfinder, a joystick delicately maneuvers a pair of robotic arms. It may sound like a video game, but Dr. Nikhil Shah is actually performing cancer surgery.

In this case, the surgeon is removing a man’s prostate gland. Robotic surgery is a growing trend in treating prostate cancer. The number of cases have increased sevenfold in the past four years, from 10,000 in 2004 to a projected 70,000 in 2008, according to Intuitive Surgical Inc., the creators of the robotic device. The advantages of robotics — fewer side effects and quicker recovery times in many patients — have led to increased use for other surgeries, including hysterectomy, kidney cancer and some heart procedures.

“At first, men think we hook up a robot and then go get some coffee, but the reality is the robot arms are a tool that I control, just like a scalpel, ” said Shah, who has performed more than 600 robotic prostatectomies at St. Joseph Hospital in Atlanta, Georgia. . . (read entire article and see video)