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September 2008: Screenings and Revolutionary Surgical Tools Keep Men a Step Ahead of Prostate Cancer

01 Sep 2008

Dr. Kevin C. Zorn completed his fellowship in minimally invasive surgery at the University of Chicago Medical Center. He is board-certified by the Royal College of Physicians and Surgeons of Canada and board-eligible for the American Board of Urology. He is an expert in performing robotic prostate surgery.

Screenings and Revolutionary Surgical Tools Keep Men a Step Ahead of Prostate Cancer

Kevin C. Zorn, MDCM, FRCSC
Assistant Professor of Surgery
Associate Residency Program Director
Co-Director of the University of Chicago
Minimally Invasive Urology Fellowship
Phone: (773) 564-5385

The statistics on prostate cancer are sobering—more than one in six men will be diagnosed with the disease. But prostate cancer usually grows slowly, so unlike other, more deadly cancers, only 4 percent of men die from it. Prevention and, most important, early detection are essential to optimizing treatment outcomes.

About the Prostate
The prostate gland, a key part of the male reproductive system, is linked closely with the urinary system. It’s a small gland that produces fluid for semen. The prostate is located just beneath the bladder, where urine is stored, and in front of the rectum. The urethra, a tubular structure that transports urine from the bladder to the penis during elimination, travels through the prostate organ. During ejaculation, semen is secreted by the prostate through small pores of the urethra’s walls. With age (50 years and older), the prostate grows in size. By age 50, one of four men will have some cancerous cells in the prostate. By age 80, that likelihood increases to one out of two.

Prostate cancer usually doesn’t present with any symptoms. It’s silent and microscopic. You’re not going to feel a mass. That’s why screenings are critical. With yearly screenings, beginning at age 50 for most men, you can catch prostate cancer early, when the chance of recovery is highest.

Risk Factors for Prostate Cancer
Knowing the risk factors for prostate cancer can help you decide when to begin prostate cancer screenings. The main risk factors include:

  • Age. The older you become, the greater your risk. After age 50, your chance for prostate cancer increases substantially.
  • Race or ethnicity. African-American men have a higher risk of developing and dying of prostate cancer.
  • Family history. Your risk is greater if your father or brother has prostate cancer.
  • Diet. A high-fat diet and obesity may increase your risk of prostate cancer.
  • Surgery to become infertile (vasectomy). Some studies suggest that men who’ve had vasectomies are at an increased risk for prostate cancer, however, no conclusive evidence has been found at this time. Research is ongoing.
  • High levels of testosterone. Because testosterone naturally stimulates growth of the prostate gland, men who have higher levels of testosterone—such as those with hypogonadism or those who use testosterone therapy—are more likely to develop prostate cancer than those men with lower levers of testosterone.

Prostate Cancer Screenings
Most men should begin prostate screening tests at age 50. African Americans and other men with a father or brother with prostate cancer should talk to their doctors about starting earlier. The screenings include:

  • Prostate-specific antigen (PSA) test
    This blood test measures prostate-specific antigen, an enzyme made in your prostate that may be elevated as a result of prostate cancer.
  • Digital rectal exam (DRE)
    With the digital rectal exam, your doctor uses his finger to feel for abnormalities in your prostate gland that may be signs of a tumor.

Your Options
If a screening flags a problem (PSA greater than 4 mg/ml or a prostate nodule), your next step is a biopsy to examine the prostate cells and determine if they are cancerous. If your doctor diagnoses prostate cancer, here are the primary treatment options you and your physician will discuss:

  • Surgical removal of the prostate. Either through open surgery or a laparoscopic approach (including robotic-assisted surgery), the urologist removes the entire prostate.
  • Radiation or external beam brachytherapy. Doctors shrink the cancer with radiation, either beamed from outside the body or implanted at the tumor site.
  • Active surveillance. Urologists monitor low-grade cancers with PSA levels every three to six months to check for changes and take a biopsy yearly.
  • Hormonal therapy. For patients with extensive or advanced prostate cancer (spread to lymph nodes and/or bones), hormonal treatment to stop testosterone production is the optimal therapy to shrink the disease.

If Surgery is Necessary
With the da Vinci surgical robot, surgeons at Weiss Memorial Hospital are able to remove the prostrate more precisely and less invasively than traditional, open surgery.

Our surgeons have safely performed more than 2,000 cases since 2003 and have the greatest experience in the state of Illinois and the sixth most experience in the country. Using the robotic approach compared to conventional open surgery, patient recovery time is shortened, incision scarring and bleeding are decreased, and there is greater chance of maintaining urinary control and sexual function.

In fact, with robotic-assisted surgery, men typically return to everyday life in 10 to 14 days—about half the recovery time for a traditional prostatectomy. At Weiss, the surgery typically lasts less than three hours, compared to up to six hours at other facilities where surgeon experience is limited. This robotic technology, in the hands of the highly skilled surgical team at Weiss, provides unparalleled results.

For more information about the prostate or the da Vinci surgical robot used by our surgeons, or to schedule an appointment, call (773) 564-5385.