Robotic Prostate Cancer Surgery
Five Star Treatment and Care
Shortly before Ken White, 68, of Blackstone underwent surgery to remove his prostate, he asked to see the da Vinci® Surgical System that would be used during his procedure. He marveled at the miniaturized instruments attached to four robotic arms, and the console where the surgeon would guide the movement of those instruments.
“I remember thinking it was something out of Star Wars,” recalls Ken, a retired sixth grade teacher for the Medway school system. “We’re so fortunate to be in the age of technology.”
Ken had his robotic-assisted laparoscopic radical prostatectomy at Milford Regional on March 2 after a prostate cancer diagnosis. His urologist, Dr. Jeffrey Steinberg of Wayne B. Glazier, MD, PC, Urology (GPS Urology) located in Hopedale, had offered a few treatment options, but Ken chose surgery, which removes the cancer while preserving important nerves and blood vessels that control urinary and sexual function. The procedure is done through small incisions with robotic arms that translate the surgeon's hand motions into finer and more precise actions. The surgeon controls the arms at a console where he can view a magnified, high-resolution 3-D image of the surgical site.
“It’s extremely effective at getting rid of cancer, but also at not interfering with the nerves next to the prostate,” explains Dr. Steinberg. “The nerves that control potency and continence are as thin as a human hair. These are tiny devices that can cut, stitch and grasp with very precise movements and get rid of any tremor that a surgeon might have. There is fifteen times magnification plus it’s three-dimensional.”
Dr. Steinberg notes that treatment for prostate cancer depends on the stage of the disease, age, health and personal preference. Robotic-assisted laparoscopic radical prostatectomy can be considered if the cancer has not spread outside the prostate. “With the surgery, the whole prostate is taken out,” Dr. Steinberg says. “Robotic surgery enables a man to go back to his normal activities in a couple weeks. Because of the small incisions, they have much less pain and much less blood loss than with open surgery. They go home with a catheter for about a week.”
He relates that the surgery is a good choice for men who are seventy and under, otherwise fairly healthy, who are concerned about maintaining sexual potency. If the cancer has gone beyond the prostate, then radiation and hormone treatments are options. “There are many treatments," Dr. Steinberg notes, "and we tailor it to the characteristics of the cancer and the preferences of the man and his significant other. The nice thing about prostate cancer is that it doesn’t matter what stage you’re in, there is a treatment.”
According to Dr. Steinberg, because prostate cancer grows so slowly, most men are more likely to die of heart disease or stroke than the cancer itself. However, eventually the cancer could cause fractures in bones and obstruction of the kidneys and urinary tract so a younger man with the disease would eventually develop symptoms. “We’re looking for aggressive tumors in younger otherwise healthy men where the treatment would improve their quality and duration of life,” he clarifies.
Ken was one such candidate, although the diagnosis stunned him. In January, his primary care doctor informed him that his PSA level was rising. He strongly recommended visiting a urologist. Upon the recommendation of one of Ken's former students, he made an appointment with Dr. Steinberg. After another blood test showed rapidly rising numbers, Dr. Steinberg performed a biopsy. “There was no way I thought I had cancer, but a week later I went in and he said that I did. My student had told me that Dr. Steinberg had a good bedside manner, and I learned how important that was.”
Ken underwent a bone scan, kidney test and CAT scan to determine whether the cancer had spread. At the next appointment, Dr. Steinberg reassured him that the cancer was confined to the prostate. The doctor reviewed options including radiation, seed implants and surgery. “He said my results were two very large areas of cancer and he didn’t want to take a chance of them spreading,” relates Ken. “I never felt rushed. I couldn’t ask for a better person to be telling us all this. I had such confidence in him.”
Having decided on the robotic-assisted radical prostatectomy, Ken checked into the hospital six weeks later for surgery. “I was walking that night, doing loops around the floor,” Ken remembers. “I could get up whenever I wanted to walk around. I was on liquids at first, but when I could order from the menu, it was unbelievable. You can order anytime of day like you are in a restaurant. Everyone was so pleasant."
During his two and a half day stay, Ken only took a couple of pain pills. Dr. Steinberg checked on him every morning and night. “I was so impressed with him coming in to see me twice a day,” marvels Ken.
After being discharged, Ken was driving in a week and biking ten miles on local trails within a month. Now the father of three and grandfather of five says life has gone back to normal. He calls Milford Regional a “top notch hospital” and looks back on the experience as positive. “Between the nurses, the doctors and the food, it is a five-star hospital," says Ken. "My wife said, 'Are you sure you want to go home? You seem to be having too much fun.'”