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.

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)

Dr. Mark Allen, M.D. of North Dallas Urology Associates located in Plano, Texas has been providing urologic evaluations, treatments and surgical services in the North Texas Market for over 15 years.  Dr. Allen is commited to staying current on technologic advances that enable him to provide his urology patients with cutting-edge treatments and non-invasive surgical procedures.  Dr. Allen provides treatment for the full scope of urologic conditions such as:

• da Vinci® Robotic Prostatectomy
• Enlarged Prostate
• Erectile Dysfunction
• Female Incontinence
• Greenlight™ Laser Therapy
• Kidney Stones
• Male Incontinence
• No Scalpel Vasectomy
• Pelvic Floor Reconstruction
• Prostate Cancer
• Prostatitis
• Robotic Surgery

Baylor Plano is the first hospital in north Dallas and Collin County to offer minimally invasive robotic surgery for prostate and gynecology procedures through the FDA approved da Vinci® Surgical System.  Dr. Allen is pleased to be one of the few surgeons in North Texas trained in da Vinci robotic prostate surgery.  If you have prostate cancer or other urologic concerns please schedule a consultation with Dr. Allen today to discuss your symptoms and treatment options.