By Jamison S. Jaffe, DO
When it comes to treatment for prostate cancer, men have a range of options, from active surveillance to radiation to surgery, just to name a few.
Which approach to choose is a highly personal decision that should consider not only the diagnosis, but your overall health, lifestyle and values.
If surgery to remove the prostate is determined to be the best course, urologists at Penn Medicine Princeton Medical Center (PMC) can perform the procedure using robotic-assisted technology that helps reduce side effects and improve outcomes.
1 in 8 Men
The prostate is a gland — about the size of a walnut — that is part of the male reproductive system and is responsible for making fluid for semen.
It is located below the bladder and next to the rectum and surrounds the urethra.
Prostate cancer is a common condition that is estimated to affect one in every eight men at some point in their lives, according to the American Cancer Society.
The Society estimates that nearly 300,000 new cases of prostate cancer will be diagnosed in 2024.
While advancing age is the biggest risk factor for prostate cancer, other risk factors include a family history of the disease and race or ethnicity.
According to the American Cancer Society, prostate cancer develops more frequently in African American men. Moreover, African American men who develop prostate cancer tend to be younger.
Talk to Your Doctor
Prostate cancer rarely causes symptoms in its early stages. If symptoms do occur, they can include:
- Blood in the urine or semen.
- Frequent urination (especially at night).
- Painful ejaculation.
- Pain in the back, hips or pelvis that doesn’t go away.
- Pain or burning during urination.
- Trouble urinating.
- Weak or interrupted flow.
If you have any of these symptoms, talk to your doctor.
Most prostate cancers are first detected through screening before symptoms even develop.
However, guidelines for prostate cancer screening differ. That is why it is important for men to have a conversation with their doctor about their risk and alert their doctor to any symptoms.
The American Urological Association updated its guidelines last year and recommends that:
- Prostate cancer screening may begin between the ages of 45 and 50.
- Men at increased risk, including men with Black ancestry, germline mutations and strong family history of prostate cancer, should be offered prostate screening beginning between the age of 40 and 45.
- Clinicians should offer regular prostate cancer screening every two to four years for people aged 50 to 69.
The Association recommends that a blood test to measure the level of prostate specific antigen (PSA) in the blood should be used as the first screening test. If PSA levels are newly elevated, the test should be repeated prior to additional testing, such as imaging and biopsy.
Surgery a Common Treatment Approach
If you are diagnosed with prostate cancer, treatment will depend on several factors, including the severity of the disease, your age, health, lifestyle and personal preference.
Surgery — called a radical prostatectomy — is a common approach to manage and cure prostate cancer in its early stage, when it has not spread beyond the prostate gland.
In a radical prostatectomy, surgeons remove the prostate gland, surrounding tissues and the seminal vesicles.
Because of the sensitive position of the prostrate, surgery can cause side effects such as urinary incontinence and erectile dysfunction.
To help reduce the risk of side effects, urologists at PMC Center use nerve-sparing techniques and robotic-assisted technology to perform radical prostatectomy.
Benefits of Robotic-Assisted Surgery
Robotic-assisted laparoscopic prostatectomy involves removing the prostate gland with the help of computer technology and long, narrow instruments attached to a robot.
To perform the procedure your surgeon typically makes five to six small incisions in your abdomen and inserts the instruments. The surgeon controls the robot at a computer console and can maneuver the instruments with enhanced precision and accuracy.
The robot enables the surgeon to maneuver instruments in places where a surgeon’s hands cannot.
Robotic-assisted laparoscopic prostatectomy typically causes less pain, blood loss and scarring than traditional open surgery. Additionally:
- The border of healthy tissue (margin) left around the prostate can be just as or more precise than open surgery. The cure rate with robotic surgery is equal to that of traditional surgery.
- Better precision enables surgeons to spare more nerves, which maximizes the chances of preserving sexual and urinary function.
- Most men who have robotic-assisted prostatectomies return to work in two to three weeks. They can often resume activities such as golf and weightlifting in about three weeks.
In addition to using robotic-assisted technology to perform radical prostatectomy, surgeons at PMC are also able to treat other forms of urologic cancer, such as kidney, bladder and testicular cancer, using the surgical robot.
If you have been diagnosed with prostate cancer, you have options for treatment. Talk with your urologist and ask if robotic-assisted laparoscopic prostatectomy is right for you.
To find a physician with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.
Jamison S. Jaffe, D0, is board certified in urology. He is a member of the medical staff at Penn Medicine Princeton Health and the Medical Director of Urology for Penn Medicine Princeton Medical Center.