In my personal practice, I see approximately 350 to 400 new prostate cancer patients each year and operate on approximately 250 men annually. I’m in my 28th year of doing cancer surgery exclusively and have more than 12 years of experience with robot-assisted surgery.
Throughout these years, my focus has been to optimize the use of this technology and to ensure that we achieve the very best results for each and every patient. In the case of prostate cancer, this means treating the cancer in the most effective way possible while preserving urinary and sexual function to the maximum extent possible.
We’ve entered the age of what I like to call “technologically enhanced surgery.” The major advance of the past decade has been the introduction of the surgical robot. Going forward, my focus is to further develop technology that will enhance what we see — and therefore what we’re able to do — during surgery.
For example, I’m working with my colleagues on a method to take a three-dimensional rendering of a patient’s prostate MRI and bring it into the surgeon’s visual field as he or she operates. This means that surgeons will have right in front of them a real-time view of the surgical anatomy as well as a detailed MRI as a guide.
Another example of my work involves research to develop an agent that can be given to patients prior to surgery that uses laser light to enhance visualization of nerves to avoid nerve injury during surgery.
No single treatment strategy is right for every man. A treatment decision needs to be based on the extent of the disease and the aggressiveness of the cancer, as well as the age, overall health, and quality of life considerations of the patient and his partner. Some men do very well with what we call active surveillance (sometimes called watchful waiting), meaning that no treatment is needed immediately and we carefully monitor the cancer for any indication that it’s growing or becoming more aggressive. Other men require treatment.
But no patient should ever feel rushed or pressured into making a hasty decision. It’s vital to get information and expert opinions. I also believe it’s important to involve your family — especially your partner, if you have one — in the process so that they too can help gather information, evaluate your options, and support your decision before, during, and after treatment.
Finally, my greatest satisfaction comes in getting to know my patients and their families — learning about what’s important to them and assisting them in making the best possible decisions regarding their cancer care. I want to make certain that whatever decision they arrive at, it will serve them well in the immediate term and for the rest of their lives.
