Benefits of Robotic Surgery for Prostate (Prostatectomy) Cancer

Robotic Surgery has revolutionized the medical field by storm. This surgery is gaining immense popularity for prostatectomy, hysterectomy, and heart related diseases. It is a minimally invasive surgery performed by a robot, wherein the systems are controlled by the surgeon and his/her movement’s are translated in the computer and further carried out by the robot on patients. Here, the robotic arms are attached to long instruments and are placed through small keyhole openings in the patient’s abdomen instead of the surgeon’s hands.

Though, the robot performs the operation but the entire process is actually controlled by the surgeon, which includes handling the forceps with the help of ‘master control’. The surgeon monitors the robot’s work and every movement step by step. Da Vinci Surgical System – state-of-the-art technology is used for this surgery.

Why is Robotic Surgery gaining popularity to cure prostate cancer?

Basically, prostate cancer is a malignant tumor forming in the small outer part of the masculine gland. It usually happens when the prostate cells grow without any control and invades nearby tissues to spread rapidly throughout the body. Usually if the disease is detected at an early stage it’s curable but if it’s not detected and treated on time then it can prove futile.

The reason why robotic surgery for prostate cancer is gaining popularity is due to its high level of precision during operation compared to traditional surgeries. Robotic Prostatectomy removes the entire prostate, which involves taking out all the prostatic tissue and lymph nodes. After completion of the surgery the patient can go through Prostate-specific antigen (PSA), where the results for any disease will show negative as the cancer gets eliminated completely due to this low-dose radiation.

Robotic Surgery

Besides there are numerous other potential benefits of Robotic Prostatectomy over traditional (open) prostate surgery, this includes:

  • Small incisions
  • Very low amount of blood loss
  • Faster recovery
  • Less expensive and shorter period of stay in hospital
  • Minimal pain
  • Less risk of infection & scarring
  • Better erectile function

Moreover, the best part of this surgery is that the patient’s life won’t change very drastically due to it and they will be able to return back to their normal life as soon as possible. It’s indeed amazing that how this technology has expanded with leaps & bounds to completely eradicate certain urological diseases like prostate cancer.

Treatments Related to Various Stages of Prostate Cancer

Prostate cancer is a form of cancer that grows in the prostate, a gland in the male reproductive system. Prostate cancer is most common in the developed world with cumulative rates in the developing world and it is the sixth leading cause of cancer among men globally.

Based on the three factors such as TNM stage, PSA and Gleason score, the patients are classified into high, intermediate and low risk groups. The low risk patients are usually treated with radical prostatectomy or radiotherapy alone.

Patients who are classified in intermediate risk disease are usually treated with radiotherapy and a short duration (less than 6 months) of hormonal therapy. It depends upon surgeon’s decision to prefer for robotic radical prostatectomy or not. Although the role of surgery in these patients remain uncertain, and the patient with high risk disease are usually treated with radiotherapy and a long duration of hormonal ablation. Many high risk patients are not cured by this treatment.

Stages of Prostate Cancer Using TNM System:

Prostate cancer is staged using the TNM system. This is used all over the world. It separately assesses the tumor (T), lymph nodes (N) and secondary cancer (metastases – M).

  • T – For tumor — describes the size of the main area of prostate cancer.
  • N – For nodes — describes whether cancer has spread to any lymph nodes and to what extent.
  • M – For metastasis — means distant spread of prostate, for example, to the bones or liver.

Different Stages of Prostate Cancer:

Stages of Prostate CancerThere are four Stages of Prostate Cancer that we have discussed it below. Following are the different Stages along with their treatments.

Stage I

In stage I, cancer is found in the prostate only. The cancer is found by needle biopsy or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower. It is found in one-half or less of one lobe of the prostate. It cannot be felt during a digital rectal exam and is not visible by imaging. They usually grows very slowly and do not show any symptoms at the early stage. The cancer is very small and completely inside the prostate gland, which feels normal during a rectal examination.

Treatment:

  • Surgery to remove the prostate gland (called radical prostatectomy). Since it is too small, surgery is not preferred at this stage.
  • Watchful Waiting or Active Surveillance. In this therapy, the doctors closely watch the tumor to see if it causes any symptoms or it appears to be growing. Common test such as PSA is usually done in this method.
  • Radiation Therapy: It uses high frequency x-ray beam to kill prostate cancer cells or to refrain them from being divided and grow rapidly.

Stage II

In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. If it is not treated then it is likely to spread outside of prostate. If the patient is so elder or having more complex diseases or after watchful waiting there are no any significant increase in growth of cancer tumor, then in such cases

Radical Prostatectomy and Radiation Therapy are the preferred options. Stage II is divided into stage IIA and stage IIB.

In stage IIA, cancer:

The PSA level is lower than 20 but higher than 10 and the Gleason score is 6-7. It is found by needle biopsy or in a small amount of tissue during surgery for other reasons.

In stage IIB, cancer:

Such cancer is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10. In some cases, the tumor has not spread outside the prostate and such tumors cannot be felt during a digital rectal exam and not visible by imaging. In such cases, the PSA level is 20 or higher and the Gleason score can range from 2 to 10.

Treatment:

  • Radiation therapy with ADT
  • Hormone Therapy: It is used to stop the production of testosterone and all androgens either temporarily or permanently. Prostate cancer grows when it is exposed in presence of testosterone, so this therapy is used to stop its production.
  • Radical prostatectomy and sometimes proceeded by hormonal therapy. In some cases the lymph nodes are removed.
  • Brachytherapy and external beam radiation combine. The radiation theraphy also includes follow up of hormone therapy.

Stage III

In this stage, the cancerous cell has significant growth. Cancer tumor has spread beyond the prostate gland but not has reached to bladder, lymph nodes, rectum or any other organs. Some times for elders doctors prefer to go for watchful waiting stage. This is preferred only if patient is having many sever complications or other illness.

The PSA can be any level and the Gleason score can range from 2 to 10.

Treatment:

  • External beam radiation plus hormone therapy
  • Radical prostatectomy in selected cases. Many times pelvic lymph nodes are also removed. Radiation therapy may be followed after this surgery.
  • In some cased only hormone therapy is preferred.

Stage IV

This is the final stage of the cancer and usually it is not curable. It has grown into the bladder or rectum, or has spread to the lymph nodes or another part of the body. It may spread to the bones, liver or lungs type of distant places. In this case, removing any part of the body will not solve the problem. It is preferred to wait and watch for the elder person.

Treatment:

  • Hormone therapy
  • Chemotherapy
  • External beam radiation plus hormone therapy (in selected cases)
  • Surgery such as TURP which helps in reducing symptoms such as bleeding
  • Some reliving treatments are also done to reduce symptoms such as bone pain.

We have discussed here different stages of prostate cancer along with their Prostate Cancer Treatment.

For more information you can visit our website: http://www.mpuh.org/centreforroboticsurgery/

Prostate Cancer Treatment in India

For Prostate cancer treatment robotic surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the gland (stage T1 or T2 cancers).

The main type of robotic surgery for prostate cancer is known as a radical prostatectomy surgery. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles. A radical prostatectomy can be done in different ways.

A less invasive surgical option – Laparoscopy is available for urologic surgery that uses small incisions. But, due to some the limitations of laparoscopy procedures it is not suggested
for more complex urologic surgeries.

One of the most modern and effective way of surgery is robotic radical prostatectomy surgery. It is a minimally invasive approach, using the latest Da Vinci Robotic Surgical System and
it is ideal for delicate urological surgeries.

Prostate Cancer Surgery

Robotic Surgery in India

Advantages of Robotic Prostatectomy:-

Robotic Prostate Surgery:

Clinically Superior Results
Reduced Risk of Complications
less post operative pain
Less Scarring
Less blood loss
A shorter hospital stay
Erectile Function
Faster recovery and return to normal activities
Fater return of urinary continence

Dr. Mahesh desai is the head of robotic surgery for prostate, kidney and urinary bladder cancer at Muljibhai patel urological hospital ( Centre for Robotic Surgery) in India. He is Top Urologist in world. It is the first super specialty hospital in India dedicated to Urology. We serve our patients for more than 35 years and we are popularly known as “Nadiad Kidney Hospital in India”.

Why You Should Opt For Robotic Radical Prostatectomy

Radical Prostatectomy is the operation done to remove the prostate gland and nearby tissue in order to remove prostate cancer. Earlier, the prostatectomies were done using open surgeries, but with the modern advances in the field of surgery, laparoscopic surgeries (also known as minimally invasive surgeries or keyhole surgeries) have become the more preferred and common type. And even though there always are certain risks involved when it comes to surgery, for prostate cancer surgery turns out to be the most effective type of treatment as it removes malignant tumors without producing the painful side effects of radiation therapy or chemotherapy.

During the last decade, robot-assisted prostatectomy procedures have vastly outnumbered the open radical prostatectomy surgeries. In fact,according to a study conducted in 2013, robot-assisted prostatectomies accounted for around 85% of all radical prostatectomies (compared to just 22% in 2003).

Here are some of the main reasons why both surgeons and patients prefer robotic surgery for prostate cancer over the open surgeries.

robotic radical prostatectomy

Benefits of Robot Assisted Radical Prostatectomy

Some of the most notable advantages of robotic prostate cancer surgery include:

    • Better Results

Robotic surgical systems like the da Vinci system (also used at Centre for Robotic Surgery), are known to provide better clinical results for prostate cancer surgery as compared to other traditional procedures. This is since such a robotic surgical system offers the surgeon with more degrees of freedom than a human hand and magnified 3-D image of the ongoing procedure, as well as enables the surgeon to make much more precise movements inside the incision than they ever could on their own.

As a result, the efficiency and ease of robotic radical prostatectomy is far higher compared to non-robotic surgeries, and it also reduces damage to the healthy tissue and scar tissue build up. Therefore, the overall clinical results are far superior in a robotic prostatectomy.

    • Lesser Complications

While any prostatectomy is not completely safe, the risk of complications is much less in a robot-assisted radical prostatectomy than in other types. The development of infection at the incision site, which is a primary cause of delayed recovery, is more common with open surgeries compared to robotic.

The surgical systems such as the da Vinci surgical system requires only four to five incision which are smaller than two inches; while other traditional open surgeries require bigger, six-to-eight inch incisions instead. As a result, the chances of post-operative infections are much higher in non-robotic surgeries.

    • Quicker Recovery

The use of robotic surgical systems has many benefits, chief of those being smaller incisions, less number of sutures, more effective removal of cancerous tissue, less damage to the healthy tissue, minimal bleeding, and reduced contact between the incision walls and the surgical instruments. All these benefits translate directly into a speedier and more hassle-free post prostatectomy recovery of the patient.

    • Minimum Scarring

Apart from the obvious aesthetic benefit, minimum scarring caused by robotic surgeries also ensures better healing. This is because in certain rare cases, open surgeries can lead to excess scar-tissue build up, which can affect the normal functioning of the prostate.

And therefore, among the various prostate cancer treatment options, robotic radical prostatectomy has fast become a top choice for both doctors and patients. To learn more about prostate cancer, outcomes of robotic prostatectomy, post-operative care, etc., click here.