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New Technology, Robotic Prostatectomy, Preserves Urinary Continence and Sexual Function for Those with Prostate Cancer

NewYork-Presbyterian Hospital at both its NewYork Weill Cornell Medical Center and Columbia University Medical Center offers a prostate health program that promotes early detection, innovative treatment, and a dedication to compassionate and humanistic care.

The program is patient-driven with an emphasis on holistic care and preventive education. And it offers a host of new, beneficial cancer treatments that do not involve surgery, such as radiation therapy, seed-implant therapy, and cryotherapy. In the event of surgery, the program offers several innovative options, including robotic prostatectomy, which preserves urinary continence and sexual function for men who require removal of their prostate.

Early detection is essential for the treatment of prostate cancer. All men age 40 and older should be screened, said Dr. Peter Schlegel, acting chairman of urology at Weill Cornell Medical College and acting urologist-in-chief at Weill Cornell Medical Center at NewYork-Presbyterian Hospital. The screening consists of a simple digital rectal exam and blood test.

Those diagnosed with prostate cancer deserve to maintain their regular lifestyle during treatment, said Dr. Carl Olsson, chairman of urology and J.K. Lattimer Professor of Urology at Columbia University College of Physicians & Surgeons and director of the J. Bentley Squier Urological Clinic at Columbia University Medical Center at NewYork-Presbyterian Hospital. Our patient-driven, minimally invasive, and holistic program makes this possible. Doctors at NewYork-Presbyterian listen to their patients and design a program accordingly, aiming to minimize discomfort while vigorously promoting health.

Columbia University Medical Center is known for its Center for Holistic Urology, which guides patients in a set of complementary programs, including nutritional counseling and herbal therapy. Over the past few years, a number of foods, vitamins, and minerals have been found to be beneficial for the prevention and treatment of prostate cancer. Dietary items including selenium; vitamins A, C, and E; garlic; green tea; and soy are part of a well-balanced and individualized patient meal plan.

Weill Cornell Medical Center offers prostate cancer patients a state-of-the-art pain prevention and management program. Weill Cornell has been an innovator in the use of epidural anesthetics at time of surgery, and early post-surgery walking and feeding resulting in a dramatic decrease in the length of stay in the hospital and faster recovery with less pain. The program also includes use of medications to prevent the development of pain after treatment as well as a comprehensive patient education and physical therapy plan.

Prostate cancer is the second most common cancer death after lung cancer. Each year, over 200,000 Americans are diagnosed with prostate cancer, and as many as 32,000 die.

Robotic Prostatectomy

Prostatectomy, or removal of the prostate, is another option as treatment of prostate cancer. An advanced new procedure, robotic prostatectomy, offers several advantages over the traditional open procedure. The advantages include less blood loss, less recovery time, and less pain. In addition, the number of days needed to carry a catheter after robotic surgery is three days, compared to two weeks for open surgery. Robotic prostatectomy also makes possible a high level of precision that allows for preservation of the local nerves associated with erection and urinary continence.

Importantly, robotic prostatectomy has the same anti-cancer benefits as traditional open surgery, said Dr. David Samadi, assistant professor of urology at Columbia University College of Physicians & Surgeons and assistant attending urologist at Columbia-Presbyterian Medical Center at NewYork-Presbyterian Hospital.

During the procedure, the physician makes five small incisions in the abdomen, through which surgical instruments and a tiny camera are inserted. The camera improves visibility, and robotic arms make for easier suturing.

Dr. Samadi and Dr. Olsson performed the first robotic prostatectomy at Columbia University Medical Center last year. Dr. Samadi and Dr. Olsson completed fellowships in laparoscopic urology in France, the world leader in the technique.

Robotic prostatectomies make use of Intuitive Surgical's Da Vinci Surgical System, which has been approved by the Food and Drug Administration for a number of innovative clinical procedures employed at NewYork-Presbyterian Hospital.

Other Prostate Cancer Treatments

Other treatments for non-metastatic prostate cancer, or cancer confined to the prostate, include radiation treatment, brachytherapy, and cryotherapy:

• One new kind of radiation therapy used by NewYork-Presbyterian is Intensity Modulated Radiation Therapy (IMRT). Rather than having a single large radiation beam pass through the body, IMRT breaks the radiation into thousands of tiny pencil-thin beams. With millimeter accuracy, these beams enter the body from many angles and intersect with the cancer. This allows for effective treatment with few side effects.
• Brachytherapy, also known as seed implant therapy, is an advanced cancer treatment whereby radioactive seeds are placed in or near the tumor, giving a high radiation dose to the cancer while reducing the radiation exposure to the surrounding healthy tissues.
• For patients who don't respond to these treatments, cryotherapy can be an effective weapon against the cancer. In this treatment, liquid nitrogen or argon gas flows through a freezing probe and initiates the creation of an ice ball starting at the tumor's center and gradually expanding outward.

For additional information, patients can call Dr. Peter Schlegel at Weill Cornell at 212-746-5491, or Dr. Carl Olsson at Columbia University Medical Center at 212-305-0100.