Prostate Cancer Surgery Through the Bladder


CLEVELAND, Ohio (Ivanhoe Newswire) – This year, 269,000 men will be diagnosed with prostate cancer. If the cancer is slow growing, some men will need no immediate treatment, but others will need prostate cancer surgery to remove all or part of the cancerous gland. Now, surgeons are performing a first-of-its-kind surgery – safely removing the cancerous prostate through the bladder.

For many men facing prostate cancer surgery, a robotic removal of the cancer is their best chance for a cure. But now, instead of making five tiny incisions to insert the tools needed to excise the cancer, doctors at the Cleveland Clinic say they can remove the prostate through one small opening.

“A single port robot was introduced. A new generation of robots that have one cannula, so, one cut. Through that, comes all the instruments and camera,” explains Dr. Jihad Kaouk, MD, FACS.

It’s called single port, robot-assisted radical prostatectomy. The robotic arm can rotate 360 degrees, meaning surgeons need a smaller space to work.

Dr. Kaouk further explains, “We don’t go through the belly anymore to get to the prostate. We go through the bladder where the prostate will be just there, and we do the surgery from inside the bladder.”

The transvesical approach can be done as an outpatient procedure. Patients have less pain and a quicker recovery, often discharged just four hours after surgery.

Dr. Kaouk says this single port approach through the bladder is a great option for patients whose cancer has not spread out of the prostate. The Cleveland Clinic team has performed this procedure on more than 130 patients and say they’ve found an additional benefit. While incontinence is a common side effect of prostate cancer surgery, patients can have better urine control after this approach.

Contributors to this news report include Cyndy McGrath, Producer;  Roque Correa, Editor.

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BACKGROUND: Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly. There are about 268,490 new cases of prostate cancer in the United States this year and about 34,500 deaths from prostate cancer.


DIAGNOSING: In its early stages, prostate cancer often has no symptoms. When symptoms do occur, they can be like those of an enlarged prostate or BPH. Prostate cancer can also cause symptoms unrelated to BPH. Symptoms of prostate cancer can be dull pain in the lower pelvic area, frequent urinating, blood in urine, painful ejaculation, loss of appetite, losing weight, and/or bone pain. There are two types of screening tests to diagnose prostate cancer, the prostate-specific antigen (PSA) blood test and the digital rectal examination (DRE).


NEW TECHNOLOGY: Men with advanced metastatic prostate cancer that has not responded to other treatments may now benefit from a new radiopharmaceutical treatment called PLUVICTOTM (lutetium Lu 177 vipivotide tetraxetan). Duke is one of the first cancer centers in the Southeastern region to offer PLUVICTOTM following its FDA approval in March 2022. Studies show it can extend the lives of people with this aggressive form of prostate cancer, even in the late stages, said Terence Wong MD, PhD, a nuclear radiologist at Duke Health. Dr. Wong is optimistic about treating patients with PLUVICTOTM in the future. Ultimately, he hopes to use it earlier in the course of the disease and to have the capability to fine tune dosing based on tumor size. For now, he is encouraged by the response in patients who were at the end of the road in terms of treatment options. “A treatment that prolongs survival in that scenario is pretty impressive and can be a game-changer in the management of prostate cancer.”



Hope Buggey

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