Robot assisted prostate surgery, known medically as the da Vinci prostatectomy, has had a profound influence over treatment during the past decade. Robotic surgical technology was first developed by the military for use in the battlefield. However during the past decade, this technology has been rapidly applied to the general medical setting, notably in the field of prostate cancer.

BY DOUGLAS SCHERR M.D.

Dr. Douglas Scherr, MD

Obesity is becoming an increasing concern with regard to prostate cancer treatment decisions as the number of patients with a Body Mass Index (BMI) of greater than 30 grows. While there hasn’t been conclusive study into the area, it has been generally found that obesity is a negative risk factor for prostate cancer.

Senator Christopher J. Dodd of Connecticut, age 65, announced on Friday that he had prostate cancer, in an early, treatable form. His PSA blood test, taken during an annual physical exam, plus follow up biopsy and treatment are covered by his Congressional health care plan, he said.

Chicago urologist Gerald Chodak MD has launched an innovative doctor-to-patient series of videos. “This is an evidence-based site,” Dr. Chodak says, “aimed at providing free information in an easier format than the usual sites that require reading. Over 60 videos are now completed on every aspect of this disease.”

Timing of Androgen Deprivation Therapy and its Impact on Cancer-specific Survival after Radical Prostatectomy: A Matched-cohort Analysis (Abstract 601)

Adjuvant androgen deprivation therapy (ADT) can improve survival following radiation therapy or radical prostatectomy. Researchers from the Mayo Clinic in Rochester, Minnesota conducted a study that focused on 6,401 patients who underwent radical prostatectomy between 1990 and 1999 with node-negative prostate cancer. Patients were divided into five groups: those who underwent ADT in the adjuvant setting; those with ADT initiated at PSA greater or equal to 0.4 ng/ml, ADT initiated at PSA greater or equal to 1 ng/ml. ADT initiated at PSA greater or equal to 2 ng/ml and ADT at systemic progression. Median follow-up for the cohort was 10 years.

The study found that patients who underwent adjuvant ADT experienced improved 10-year systematic progression-free survival (95 percent vs. 90 percent) and 10-year cancer-specific survival (98 percent vs. 95 percent) compared to patients who did not undergo adjuvant ADT. The results do not dictate whether the initiation of ADT at any other stage can impact survival, although the survival advantage was found to diminish if ADT is administered farther in the disease process. These findings do, however, support the immediate use of ADT in high-risk radical prostatectomy patients while suggesting the limitations of ADT in enhancing survival after prostate-specific antigen progression.

This abstract will be presented during Podium Session 20 on Sunday, May 20 2007 starting at 3:30 p.m.