Medical Moment: A new surgery for prostate cancer

Published: Oct. 17, 2022 at 5:40 PM EDT
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(WNDU) - 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 surgery to remove all or part of the cancerous gland.

Now, surgeons are performing a “first-of-its-kind” surgery by 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,” explained Jihad Kaouk, a doctor at the Cleveland Clinic. “A new generation of robots that have one cannula, so, one cut. Through that, comes all the instruments and camera.”

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

“So, we don’t go through the belly anymore to get to the prostate,” Dr. Kaouk continued. “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 time; often, they are discharged just four hours after surgery.

Men with advanced metastatic prostate cancer that has not responded to other treatments may now benefit from a new radiopharmaceutical treatment called PLUVICTOTM.

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.

“A treatment that prolongs survival in that scenario is pretty impressive and can be a game-changer in the management of prostate cancer,” 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 from patients who were at the end of the road in terms of treatment options.