Prostate cancer will impact one in eight men over the course of their lifetimes.
For some of the men affected, the disease will mean surgery. The technology involved in that surgery has evolved over the years, up to and including robots in the operating room.
News4's Tony Perkins, who underwent treatment for prostate cancer earlier this year, sat down with Dr. Jonathan Hwang, his surgeon at MedStar Washington Hospital Center, to learn more about a surgical system that promises a quicker recovery time with fewer risks for patients.
It's called the Da Vinci robot, and while it's a piece of machinery, it's guided by an expert surgeon like Hwang. He's the chair of urology at MedStar Washington, and he's performed the surgery more than 3,500 times.
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The procedure, called a laparoscopic robotic prostatectomy, involves removing a patient's prostate gland. It's now a mainstream treatment option for almost all men that undergo surgery for prostate cancer.
"It is the gold standard now," said Hwang. "Rather than using a surgeon's hands, we're now using robotic assistance and that affords much more precision and also safety, and faster recovery for men."
Prostate cancer is the second leading cause of cancer death for men in the U.S. If it's caught early, the survival rate is nearly 100%. But when the disease is detected in advanced stages, the survival rate drops to 37%.
That's why early screening, and then treatments like surgery, though intimidating to patients, are so important.
The robot is brought out to the patient, and the robotic instruments -- mirroring surgeons' hands -- execute the surgery at the surgeon's direct supervision, Hwang explained.
"It's an art," he said.
"When you use the robotic tool, you pretty much eliminate any significant bleeding," Hwang said. "That allows the surgeon to really see all the delicate structures extremely well, and having these tiny tools that the surgeon can maneuver just like our own hands, that allows us to really carefully preserve all these vital structures while removing the cancerous gland."
Treatment for prostate cancer using surgery has a few advantages over other treatments like radiation, Hwang explained.
One is that surgery doesn't involve any kind of hormonal therapy, which radiation treatments sometimes do incorporate.
"I think some men just simply like to avoid any hormone shot," Hwang said.
The other advantage is that removing the prostate means there's no chance the cancer could come back in that location.
"When you do remove the prostate, you do eliminate the possibility of cancer ever forming again within the prostate gland," Hwang said.
Six weeks after his surgery, our Tony Perkins is officially cancer-free. He says, like all post-treatment patients, he will continue to get scanned every few months.
"A lot of times men will delay the treatment because of the fear of the potential side effects," Hwang said. "But at the same time, you know, the risk of that decision is that if the cancer grows outside of the prostate..."
If the cancer spreads, then a disease that could at one point be treated with "a very, very simple surgery" then becomes "much more complex," Hwang said. "It's always a very, very fine balance."
Robotic-assisted surgery is typically covered by insurance.
But as with any surgery, there are risks, including bleeding and infection, though the risk for bleeding is minimized with the use of the Da Vinci robot.
The surgery can also lead to side effects like impotence or incontinence, which can usually be treated with medication and exercise.
If you have prostate cancer and are considering the surgical option, Hwang says to do your homework, and consult with several surgeons beforehand to come up with a treatment option that’s best for you.
