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U S A
ROBOTIC SURGERY
for Prostate Cancer

In the field of robotic prostate- cancer treatment, Florida Hospital surgeon Vipul Patel is a rock star.

Patel, who has performed the most robotic surgeries in the world, is an internationally recognized expert in a type of surgical procedure less invasive than traditional prostatectomies. Men who undergo the surgery are more likely to maintain their bladder control and sexual function.

Patel's patients are a very appreciative bunch.

Dunedin businessman Ralph Jordan is president of Patel's fan club. He was the doctor's first patient at Celebration Health, part of the Florida Hospital system. Jordan was so pleased with Patel's surgical skill and bedside manner that he started a Web site, vipfriendsonline.com. The site is filled with glowing testimonials from Jordan and other patients.

"It seems like when someone literally helps cure you of cancer, you feel this need to give back," said Jordan, 68.

Patel is largely the reason Florida Hospital's Cancer Center is one of five programs recently selected to participate in the Association of Community Cancer Centers' prostate-cancer best-practices project. Florida Hospital, where Patel is medical director of the Global Robotic Institute, will learn and share information about model prostate-cancer programs across the country.

"The need for education and support for prostate care is clearly unmet in many communities," said the association's executive director, Christian Downs.

The best-practices project, funded by Pfizer Inc. pharmaceuticals, is designed to help hospitals and other medical facilities across the country improve prostate-cancer care, Downs said.

More than 185,000 men developed prostate cancer, and nearly 29,000 died from the disease in 2005, according to the most recent data available from the Centers for Disease Control and Prevention. In Florida, there were 13,253 cases and 2,154 deaths.

Dexterous robot

Patel, who has performed more than 3,000 operations on men locally and worldwide, uses a robotic system called da Vinci to remove cancerous tumors. Seated at a console just a few feet from the operating table, Patel pushes a joystick and foot controls to remotely manipulate robotic arms at the bedside. One arm positions a three-dimensional, high-resolution camera, while the other two arms control tiny surgical instruments. Patel said the robot can remove a cancerous prostate with less anesthesia, less blood loss and need for transfusion. More important, robot-assisted prostatectomies are less likely to cause nerve damage that can lead to permanent incontinence and impotence. Patient outcomes are the best indicator of a model prostate-cancer care, Patel said. "Best practices isn't just about the type of surgical option you use, it's about the type of physicians you select, it's the nursing care, it's the support you get from administration," he said, commenting on Florida Hospital's best-practices recognition. "They all combine to provide the best level of care." Patel supports a multidisciplinary approach to prostate-cancer care in which patients not only visit with their surgeon, but they also are seen by a urologist, radiation specialist and medical oncologist. "Men should have experts to inform them about their best treatment options, provide second opinions," Patel said. "Thinking that your only option is to have open surgery and lose your sexual function is not acceptable." As for Jordan and his other devotees, Patel said they represent a growing trend among men diagnosed with prostate cancer. "Prostate cancer is coming into its own in terms of the level of knowledge and the level of public awareness," Patel said. "Men are doing their homework and asking questions."

Did his research first

When Jordan was diagnosed with cancer in July 2007, a local urologist recommended he undergo a traditional radical prostatectomy right away.

"Thank God I knew enough to do a little research first," Jordan said.

He learned that there was a variety of treatment approaches. In addition to a radical prostatectomy, where the entire prostate gland and nearby lymph nodes are removed, some doctors employ radiation therapy.

A device like an X-ray machine is used, or radioactive pellets called "seeds" are injected into the prostate gland.

For slow-growing cancers, some doctors recommend simply monitoring the tumor.

Jordan learned his tumor was growing slowly, and that he had time to determine what was best for him. In his research, Patel's name kept popping up.

Jordan, whose company specializes in outsourcing specialized surgical personnel, also contacted the manufacturer of the robot Patel uses in his surgeries.

Again, Patel got rave reviews.

"When he actually called me at home one night to talk to me about my surgery, that sort of clinched it," Jordan said.

Willing to open up

Dr. Richard Reiling, an advisory member to the best-practices project and former president of the Association of Community Cancer Centers, applauds men such as Jordan for seeking out information and sharing it with other men.

"It used to be something men didn't talk about because it meant discussing things like incontinence, erectile dysfunction and that uncomfortable exam in your doctor's office," Reiling said. "But society is opening up. Men are more willing to talk about things men of my generation once thought were too personal."

FERNANDO QUINTERO/SENTINEL STAFF WRITER

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TESTIMONY

I was a patient for Dr. Patel, but for Kidney Cancer. Similar options as to Prostate cancer - cut the patient open (traditional method) or poke a few holes in him (robotics). With my vanity and curiousity, I chose the latter. Coincidently, my sister's friend was also having the same surgery in D.C., but the traditional way.

Here are the comparisons: After my surgery, I was able to scoot myself from operating table to my room bed - illustrating that I was capable of movement and had some strength. The other patient was out cold for a day. I had most of my gizmos and stuff removed from my body throughout the night - illustrating that my body is adjusting quickly to the bodily changes that had occurred. In summary, I was walking (slowly) the next morning, out of the hospital the next day, and back to work in just a few days (light work). My sister's friend - out of commission for 6 weeks and a huge stomach scar. Me, no texture scabs, but the skin where the 4 holes were poked are a bit darker than the surrounding. The size of the holes are about as thick as a pencil.

I would recommend looking into Dr. Patel for robotic surgery if you desire a quicker recovery and minimal bodily changes (very good for us vain people). Coincidently, my best friend is also having kidney stones removed from Dr. Patel, thus showing you the variety of procedures his office can handle!

meekoatcelebration (08/14/2009, 4:46 PM )