Monday, April 8, 2024

Robotic Prostate Surgery Vs Radiation

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What Are The Risks Of Surgery

Robotic Prostate Surgery vs CyberKnife Radiation Therapy

Prostate surgery is associated with risks. It is common for men to experience one or more side effects after prostate surgeries. Some side effects are short-lived, while others persist for many years after surgery.

Common side effects of prostate surgeries are:

  • Urinary complications, including painful urination, difficulty urinating, urinary incontinence. Most prostate cancer patients treated with surgery will experience urinary incontinence. This usually improves after four weeks. In some men, surgery-related urinary incontinence persists for many years.
  • Erectile dysfunction, difficulty with getting, and maintaining an erection is frequent. More than 10% of men treated with prostate surgery develop erectile dysfunction. An injury to the nerves that control erection increases the risk of developing long-term erectile problems.
  • and infertility occur in more than 90% of cases. This side effect occurs because radical prostatectomy removes the seminal vesicles .
  • Lymphedema: Surgery can damage lymph nodes around the prostate gland, causing swelling and pain. Both can be improved with treatment.

Prostate Cancer Surgery Vs Prostate Cancer Radiation

After being diagnosed with prostate cancer, many men are confused about their treatment options. They probably wonder: Do I go for radiation? Do I go for surgery? Well-intended people may give certain suggestions or recommendations. But, because prostate cancer may be a life threat, prostate cancer patients need to have accurate, scientific information about their options.

Dr. David Samadi, prostate cancer expert, highlights the benefits of robotic prostatectomy surgery over radiation for prostate cancer. A study from Memorial Sloan Kettering showed a 65 percent reduced risk of prostate cancer metastasis after surgery compared to radiation.

Also, there is an analysis of more than a dozen studies which shows that prostate cancer patients do better with surgery versus radiotherapy, especially for men who have localized prostate cancer.

Patients who were treated with radiation over surgery were twice as likely to die from prostate cancer than those treated by surgery. As with any cancer, surgery is the first line of treatment.

How Prostate Cancer Staging And Risk Stratification Affect Treatment Options

Your treatment choices are determined by several factors, including your cancers stage, aggressiveness and assigned risk stratification . Your age and current general health condition may also affect your choices.

Prostate cancer staging

Prostate cancer staging determines whether the cancer is confined to the prostate gland or whether theres evidence of metastasis, meaning its spread to other areas of the body.

Tools and methods to determine staging may include the prostate-specific antigen test, the digital rectal examination , the Gleason score and the American Joint Committee on Cancer TNM system, which provides information on the tumor, lymph node involvement and metastasis of a cancer. Imaging tests, such as a PET/CT scan, may also help determine your cancers stage.

The four stages of prostate cancer are subdivided into more precise categories, but we generally refer to three groups that indicate how far the cancer has spread:

Localized, meaning theres no indication that the cancer has spread beyond the prostate

Regional, meaning theres evidence of cancer cells in nearby lymph nodes or tissue

Distant, meaning theres evidence the cancer has spread to other organs or body parts farther from the prostate

Almost 90 percent of prostate cancers are diagnosed at the localized or regional stage. The five-year relative survival rate for men diagnosed with prostate cancer at these stages is nearly 100 percent.

Prostate cancer risk assessment

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Comparison Of The Leading Techniques Of Rp And Ebrt: Rarp Versus Vmat

A retrospective study has recently been published in Radiotherapy & Oncology, which reports comparative outcomes of RARP and VMAT, as the leading respective techniques of RP and EBRT . RARP is a novel, gold standard, surgical procedure for localized PC using the da Vinci Surgical System and has been reported to reduce blood loss complications and positive surgical margin rates, resulting in improved safety and feasibility . VMAT represents a sophisticated EBRT technique based on rotational IMRT, which delivers a highly conformal beam from a rotating radiation source to the target while avoiding risky organs such as the rectum in a short time, by computerized optimization. VMAT has been reported to reduce complications and improve oncological outcomes .

External Beam Radiation For Prostate Cancer

Robotic Radical Prostatectomy

When most patients think of radiation therapy, they think of external beam radiation therapy , in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.

In the past, EBRT required 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.

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External Beam Radiation Therapy

This is the most common type of radiation therapy, and it is painless. Before treatment, your radiation team will use computerized tomography scans and magnetic resonance imaging scans to map out the location of the prostate and tumor cells.

During each treatment session, X-ray beams are focused on the targeted cancer areas. Oncologists can change the intensity of doses and radiation beams to better deliver high doses of radiation to tumor cells while delivering lower doses to surrounding healthy tissues.

Prostate Cancer Treatment: The Cyberknife Advantage

CyberKnife has a 97% cure rate for prostate cancer.

CyberKnife treatments can be done in five radiation therapy sessions over 10 days compared to 42 to 45 over three months with other types of radiation treatments.

It has none of the risks that come with surgery.

Its quicker and safer and causes less disruption to a patients life.

Plus, its noninvasive.

The CyberKnife radiation beams, which target and destroy the tumor, are so precise which means there is less risk of side effects including impotence and incontinence.

Listen to Dr. Pomper compare CyberKnife to Robotic Prostate Surgery to health specialist Marilyn Mitzel in this short interview.

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Are Surgery And Radiation Therapy Ever Used Together

In some cases, your care team may use both surgery and radiation therapy as part of your prostate cancer treatment plan. Typically, radiation therapy is delivered after surgery to target remaining cancer cells or that came back. However, in some situations, doctors may recommend radiation therapy first to kill cancer cells in tissues near the prostate gland before performing the prostatectomy.

Robotic Radical Prostatectomy In Patients With Previous Prostate Surgery And Radiotherapy

Radiation vs. Surgery for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

Ömer Acar


Herein, we will review the available literature about robot-assisted radical prostatectomy in patients who have undergone prostate surgery or radiotherapy. Current data about this topic consists of small case series with limited follow-up. Despite being technically demanding, robot-assisted radical prostatectomy can be considered feasible in either setting. Prostate surgery or prostatic irradiation should not be considered as a contraindication for robot-assisted radical prostatectomy. Nevertheless, patient counseling about the possible complications and the need for reintervention is of extreme importance in this patient population. Early oncologic and functional results of RARP performed in case of radiorecurrent prostate cancer look promising. Regarding postprostate surgery RARP, some series have reported comparable results, while some have demonstrated more inferior outcomes than those of naive cases. In order to assess the exact functional and oncologic outcome of RARP in patients with previous prostate surgery and radiotherapy, studies enrolling higher number of patients and providing longer follow-up data are needed.

1. Introduction

2. Robot-Assisted Radical Prostatectomy after Radiation Failure

2.1. Radiotherapy for Prostate Cancer
2.2. Therapeutic Options after Radiation Failure
2.3. General Considerations about Salvage Radical Prostatectomy
2.4. Salvage Laparoscopic Radical Prostatectomy
2.5. Salvage Robot-Assisted Radical Prostatectomy

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How To Decide Between Radiation Or Surgery For Prostate Cancer

If you want to know how to decide between radiation or surgery for prostate cancer, youve come to the right place.

Prostate cancer is the second most common cancer in men, with more than 1 million cases diagnosed in 2018. It often grows slowly so that most men die of other causes before it becomes clinically advanced and hard to treat.

As most prostate cancers are diagnosed in slow-growing stages, they usually do not require immediate treatment decisions.

For localized and locally advanced prostate cancers, surgery and radiation therapy are the main treatment options.

Both options have risks, including erectile dysfunction, urinary problems, and bowel complications.

Your doctor will use the results of your diagnostic tests to balance the treatment benefits against those side effects.

Here, we explore the suitability of different treatment options. Well help you understand how to decide between radiation or surgery for prostate cancer. We offer information to help you consider the best treatment for your specific disease.

Prostate Surgery Leads To Better Survival Vs Radiation

A recent clinical update on prostate cancer in the Urology Times journal discusses new data on the survival benefits of surgical treatment of prostate cancer vs. radiation therapy.

Radical prostatectomy, which is nowadays almost always performed using a robotic surgical platform, may result in a reduced risk of developing an aggressive type of metastatic prostate cancer known as Castration-Resistant Prostate Cancer .

After any treatment for localized prostate cancer, the cancer may recur. One of the initial treatments for recurrent cancer with signs of spread, is hormonal ablation, also known as Androgen Deprivation Therapy .

A recent research study found that 32% of patients who chose radiation as their initial treatment, ended up developing the more aggressive type of advanced prostate cancer. The study also showed that men who received radiation alone had 77% higher overall mortality after developing metastatic disease.

As prostate cancer rates continue to increase, it is important for patients to be well informed regarding their options. Many physicians who do not have access to a highly trained robotic surgeon may only offer radiation therapy as a primary treatment modality.

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Data Storage And Record Retention

All data will be stored in re-identifiable form , with a list linking names and IDs kept separately. Electronic data will be stored on a password-protected computer connected to a secure network and paper data stored in a locked filing cabinet in a secure building. Data will be stored for a minimum of 7years after publication of study results, in accordance with Institutional guidelines and the Australian Code for the Responsible Conduct of Research.

The study results will be presented at local and international seminars, conferences and published in peer-reviewed journals. All investigators will be listed as authors on any presentations or publications resulting from the study.

Conditions Treated With Proton Therapy

30 Images Da Vinci Robotic Surgery Pros And Cons

Proton therapy is considered the most technologically advanced radiation delivery method for cancerous tumors. With this powerful, precise technology, tumors are more accurately targeted so healthy tissues and organs get less unnecessary radiation.

Proton therapy is commonly used to treat tumors in sensitive areas where traditional X-ray or photon radiation may not be the best option. Depending on your particular diagnosis, proton therapy may be a treatment option for cancers of the brain and central nervous system, breast, esophagus, head and neck, liver, lung, lymphatic system, eyes, pancreas, prostate, bone and others. It is particularly beneficial for many pediatric cancers.

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Why Choosing Surgery For Prostate Cancer

  • With surgery you will get the accurate prostate cancer staging How much cancer do you actually have and whether it has spread to the surrounding tissues. Also, the follow up is much easier because the PSA has to be zero.
  • Robotic radiosurgery is not surgery, is all radiation. After radiation, if cancer comes back, it is almost impossible to have surgery. Dr. David Samadi explains that he uses radiation as a back-up plan after surgery.
  • A long-term side effect of radiation is that there is a small chance to have secondary cancer. You can get cancer from radiation. Patients need to be aware that they can have bladder or rectal cancer. With robotic prostatectomy surgery, side effects and risks are reduced over time, not increased.

Many people consider surgery as being the cause of cancer spreading, impotence and incontinence. The outcome depends on the experience of the surgeon. Dr. David Samadi has successfully treated thousands of prostate cancer patients with the best results. Now, the continence is up to 95-97%, potency is between 50-80%, depending on the surgeons experience. Whats the advice? For the best results, go to a center of excellence.

Dr. David Samadi uses genetic tools and MRI imaging studies to decide who should really go for surgery and who should go for radiation. Patients have to be carefully selected because individualized care is the best way to go.

Treatment Options For Prostate Cancer

Early-stage prostate cancer is often slow-growing. Here, it is hard to balance treatment benefits against its side effects. Therefore, delaying treatment until there is evidence of cancer progression is one way to avoid unnecessary side effects.

In some cases, a doctor may recommend watchful waiting or active surveillance to avoid unnecessary treatments.

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Cyberknife Treatment For Prostate Cancer

CyberKnife treatment uses external beam radiation to treat prostate cancer.

Despite the name, CyberKnife does not involve a knife, cutting, or surgery for treatment. It uses a linear accelerator on a robotic arm to deliver radiation beams from hundreds of different angles to target and kill tumors.

CyberKnife also uses real-time Image-Guided Radiotherapy which tracks the tumor as it moves, targeting the cancer site with extreme accuracy, greatly reducing the risk of dreaded side effects like incontinence and impotence.

Radiation Therapy For Prostate Cancer

Side Effects of Surgery Vs Radiation for Prostate Cancer

If your care team is considering radiation therapy as part of your treatment regimen, youll work directly with a radiation oncologist. He or she will explain the specific type of radiation therapy recommended for your cancer and answer any questions you have.

Some prostate cancer patients wonder about the safety of this treatment. Thanks to scientific advances, radiation therapy techniques have improved over the years. More precise radiation delivery techniques are designed to help spare normal tissue from exposure and reduce the severity of side effects. In addition to the external delivery of radiation, we now also have internal delivery options. In some cases, courses of radiation treatment may be more intense and shorter in duration.

The development and use of hydrogel spacersgel thats inserted between the prostate and the rectummay also reduce damage to tissue surrounding the prostate during radiation, which in turn helps to reduce treatment-associated side effects.

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Locally Advanced Prostate Cancer

Locally advanced prostate cancer means the cancer has broken through the outer covering of the prostate gland into nearby tissues.

Your doctor might monitor your prostate cancer if you dont have any symptoms. This is called watchful waiting. You can start treatment if you get symptoms.

Treatment options include:

  • external radiotherapy with hormone therapy
  • hormone therapy on its own

A small number of men might have surgery to remove the prostate gland. But doctors dont often use it as a treatment for locally advanced cancer.

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Surgery Vs Radiation For Prostate Cancer: Uses Benefits Side Effects

This article will review how surgery and radiation treat prostate cancer. Both can be very effective forms of treatment in men with the disease. Although they may have the same goals of therapy, there are differences between these treatments.

Be sure to see your healthcare provider for the diagnosis to receive the best treatment for yourself.

The Good Brigade / Getty Images

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What Are The Risks Of Radiation Treatment

However, like surgery, radiation therapies often cause side effects. In particular, radiation may cause severe damage to healthy cells and tissues near the prostate area.

These problems are different for each patient, depending on the radiation dose and your general health. Common side effects are detailed below.

  • Erectile dysfunction
  • Radiation therapy may cause you to experience erection problems, possibly impotence. After a few years, the erectile dysfunction rates in men treated with radiotherapy is similar to that after surgery. Radiation-induced erection problems usually develop over time. This delayed erectile problem is contrary to the presentation after surgery, where erection problems occur immediately and improve over time.
  • Concerning different types of radiation therapy for prostate cancer, studies comparing rates of erection problems in brachytherapy and external beam radiation reported conflicting results.
  • Some studies found that erection problems are lower after brachytherapy compared to external beam radiation. Other studies have found that rates were not different between ways of delivering radiotherapy.
  • Urinary incontinence
  • Severe urinary problems are not common in radiation therapy. Nevertheless, you may experience frequent urination and symptoms of an irritated prostate. Urinary issues tend to improve over time, with most men making a full recovery.

Cyberknife Vs Robotic Prostate Surgery

Dallas Urologist Discusses Prostate Cancer Treatment using Calypso 4d ...

by Prostate Cancer Center | Dec 21, 2021 | CyberKnife Treats Prostate Cancer

Theres no one-size-fits-all when it comes to prostate cancer treatment.

It often depends on the stage of the cancer, a mans overall health and to some extent the treatment that hes most comfortable with given the risks, chances of curing cancer, and the side effects.

One of the most popular treatment choices is robotic-assisted prostate surgery instead of open surgery because its less invasive.

Another option, which is noninvasive and is becoming the number one treatment choice for curing prostate cancer is highly targeted radiation therapy using CyberKnife robotic technology, also known as Stereotactic Body Radiation Therapy or SBRT, instead of other forms of radiation.

Lets look at these two options.

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