For men undergoing routine surgical treatment for localized cancer of the prostate, robot-assisted radical prostatectomy (RALP) does not result in better functional outcomes compared to laparoscopic radical prostatectomy (LRP), according to a study published in the April issue of Urology
The researchers found that 87.9 percent of the LRP patients and 82.6 percent of RALP patients had regained baseline urinary function scores, while 57.3 and 61.3 percent, respectively, had regained baseline sexual function scores. In both groups, nerve-sparing surgical procedures mitigated the adverse effects on sexual function. Surgical method was not associated with urinary function or sexual function at 36 months. There was an association between better urinary function and better general mental health.
For most prostate cancer patients, the options are surgery, radiation treatment or simply watching to see whether the tumour gets bigger.
There is now a low-risk and relatively painless treatment available for the thousands of Australian men who have been diagnosed with prostate cancer.
From now on, those men with low-risk prostate cancer have another option, called focal therapy.
There are several important differences. First, robotic surgery is a minimally-invasive approach, so by its very nature, patients have less abdominal trauma due to smaller incisions and patients will have less pain when compared to open surgery.
Additionally, our research shows that patients in general are more satisfied with their incisions after this procedure than after open surgery. This allows some patients to return to work rather quickly, some as quick as two weeks. Comparative studies suggest that patients after open surgery tend to take a couple of extra weeks to recover physically.
The second main benefit of robotic surgery is that the blood loss during robotic surgery is far less than during open surgery, even open surgery done by an experienced surgeon. For example, our blood transfusion rate during robotic prostatectomy is near zero percent. Even in the hands of the most experienced open surgeons in the world, the blood transfusion rate varies from 8 to 40 percent. Less blood loss and better visualization allows us to remove the cancer at an equally effective rate to open surgery, even for high-grade or advanced tumors.
With the magnification of the robotic system, sparing of the urethral sphincter muscle (important for urinary control) and sparing of neurovascular bundles (important for erections) can be done in an extremely precise fashion. Patients should know that long-term results of recovery for both urinary and sexual health are comparable between robotic and open surgery as long as the surgery is performed by a high volume, highly trained surgeon
According to a study conducted by researchers from the Cancer Institute of New Jersey, men who undergo a hormone deprivation treatment for prostate cancer are significantly more likely to suffer from fractures, and many of the men who suffer from fractures are significantly more likely to die
Based on the presence or absence of certain medical conditions (including diabetes, liver disease, paralysis, and alcohol and cigarette use) within one year before cancer diagnosis, the researchers rated the men for risk of skeletal complications such as fracture.
In a study recently presented researchers sugests eighteen months of hormone therapy for localized, high-risk prostate cancer produced a similar survival rate as the usual 36 months.
Research team concluded three years of hormonal therapy was almost picked randomly, and there’s nothing magical about that duration, and this may well change the standard of care. Other experts urged larger, longer studies before accepting these results as sufficient to change practice.