Dr. Rochat, prostate cancer is one of the most frequent cancer diseases in men. Why do some men suffer from prostate cancer and others don’t?The majority of men will develop cancer cells in the prostate during the course of their life, which means that over 80% of 80 year old men have some kind of prostate cancer.
This doesn‘t cause problems unless you have too much cancer and too young. By too much, I mean cancer with agressive cells or significant tumor volume, and by too young I mean patients with more than 10 years of normal life expectancy.
As with most cancers, the root cause of prostate cancer remains unknown. Nevertheless, patients with prostate cancer in their family history or patients of African origin are more at risk of developing the disease.
What should men be aware of in terms of early signs and symptoms of prostate cancer?Prostate cancer is a cunning killer and unfortunately there are no early signs or symptoms that develop when it is still at a curable stage.
Selected screening by PSA test, digital rectal examination and biopsy are the only way to detect a prostate cancer at an early stage.
Is there anything individuals can do to prevent prostate cancer from developing (e.g. lifestyle changes)?Cancers in general, like cardiovascular diseases and degenerative neurological deseases, could potentially be influenced by healthy behaviour (weight control, exercise, light diet).
What are the latest developments in treating prostate cancers?
The best treatment is, by definition, the most effective treatment which has the least side effects.
Prostate cancer treatment has 3 goals: controlling the cancer in the long term, preventing urinary dysfunction, and allowing the patient to have the possibility of intercourse with or without selected medication.
We have now added 2 more quality criteria for surgery: no peri-operative complication and complete removal of the tumour: no positive surgical margins are left.
This so-called pentafecta, or five-point list of goals, has dramaticaly increased during the last 10 years.
In the field of radiotherapy, which is the other treatment option, significant developments have also been made in the last decade.
„ But in good hands the Da Vinci system allows the urologist to perform very high quality prostatectomies with functional outcome better than in conventional surgery.
As chief surgeon for Urology at the Multidisciplinary Robotic Assisted Laparoscopic Center at Clinique Générale-Beaulieu in Geneva, you have always been dedicated to the research and promotion of new technology in surgery. What are the advantages of robotic assisted prostatectomy in comparison to common prostatectomy?
The developement of mini invasive prostate cancer surgery was the first step to improve post-operative recovery.
The introduction of the robot-assisted laparoscopic prostatectomy in the early 2000‘s enhanced the quality of the laparoscopic procedure by introducing 3D visualisation in high definition and a much higher precision of dissection through articulated tools controlled from a surgical console.
The console allows the surgeon to sit in a very ergonomic position to control 4 arms of the robot. Vision and precision with ergonomics is the key to a successful robotic procedure but the robot has no automatic function and is under the surgeon‘s total control.
The experience of the surgeon and his team is therefore actually more important than the system itself. But in good hands the Da Vinci system allows the urologist to perform very high quality prostatectomies with a functional outcome that is better than in conventional surgery.