Surgery that’s second to none To Jones, minimally invasive robotic surgery is the best procedure for prostate removal (prostatectomy). With robotic surgery, the surgeon controls highly precise surgical tools on robotic “arms.” One of the arms controls a high-definition camera, which provides a magnified view of the surgical site. “With robotic laparoscopy, patients have quicker recovery, and usually stay in the hospital a shorter time — typically just overnight,” Jones says. In addition, the robotic procedure carries a lower risk of infection and excessive bleeding. Patients who have the robotic procedure “feel better sooner and get back to normal activities much more quickly,” he says. Koebrich is a walking example of that speedy recovery. For him, the worst thing about the whole procedure was the catheter. “If it weren’t for that, I would have had to remind myself I’d had surgery,” he says. Most men are candidates for robotic-assisted laparoscopic prostate removal, says Jones, who has used the technique for 10 years. Jones says initial concerns that robotic surgery might be less effective than a surgeon’s hands at removing all cancer cells haven’t been borne out. “I tell patients, ‘I’m kidding you if I say I can tell what cancer feels like.’” In Koebrich’s case, surgery removed all the cancer, so radiation wasn’t necessary.
SCREENING DEBATE For years, doctors advised men to get prostate-specific antigen (PSA) blood tests, which measure a protein produced in the prostate gland. That protein is often elevated in men with prostate cancer. But the screening has become controversial over the past five years, with some experts saying some men with elevated PSA levels were undergoing unnecessary cancer treatment. In 2012, the U.S. Preventive Services Task Force advised men not at high risk for prostate cancer to skip the screening. Dr. Marklyn Jones That recommendation alarmed many, including the American Cancer Society and Marklyn Jones, MD, medical director of the robotic surgery group at Porter Adventist Hospital. Jones says he’s seeing more men diagnosed with advanced disease. This summer, a research study documented that trend. The study found that the number of men newly diagnosed with advanced prostate cancer shot up by 72 percent between 2004 and 2013. Researchers say prostate cancer may have become more aggressive. But they suspect that with fewer men being screened, cancer is being detected later. “With screening, we pick up cancer earlier,” Jones says. “We should focus less on the controversy of screening and more on which men need to be treated” for elevated PSA levels, and which can be monitored.
Risk and recovery Because he has an extensive family history of prostate cancer, Koebrich’s primary care doctor had been monitoring the level of prostate-specific antigen (PSA) in his blood closely. Koebrich’s grandfather and great uncle likely died of prostate cancer. And his father, a World War II veteran who didn’t often visit doctors, might have as well, had Koebrich not taken him to a 9Health Fair, where he was screened.
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“His PSA was off the charts. Surgery added more than a decade to his life,” Koebrich says. Eventually, Koebrich’s own PSA levels jumped. Even knowing his history, he said it was hard to believe he had cancer when he felt so good. “I had no symptoms. I didn’t feel bad.”
Learn more about how to lower your risk for prostate cancer at a FREE seminar taught by Dr. Marklyn Jones on Monday, Nov. 7. See back cover for details.
To screen or not? All men should talk to their doctor about whether prostate cancer screening is right for them. The American Cancer Society recommends men in these categories be screened:
>50 at average risk and expected to live at least 10 years
>45 at high risk, including African-American men and those with a close relative who had prostate cancer before age 65
>40 who have more than one first-degree
relative who had prostate cancer at an early age
Porter Adventist Hospital’s advanced robotic surgery program is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado and western Kansas.
porterhospital.org :: Fall 2016
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