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HealthWatch: Laser Surgery For Prostate Cancer

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Surgery (credit: CBS 2)

Surgery (credit: CBS 2)

maxgomez Dr. Max Gomez
Award-winning broadcast journalist Dr. Max Gomez rejoined WCBS-TV as a...
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NEW YORK (CBS 2) – With 220,000 cases a year and more than 30,000 deaths, prostate cancer is the most common cancer for men. The most common treatment is surgery, even though it can cause uncomfortable and embarrassing side effects. CBS 2HD’s Dr. Max Gomez is here with word of a new technique that may minimize both of those problems.

Prostate cancer surgery has gotten much better at avoiding impotence and incontinence, but it can take up to a year to recover those functions after surgery.

Laparoscopic and robotic surgery has improved those numbers somewhat, and now doctors are adding lasers to the mix to make things even better.

“He sat me straight down and within one sentence he said ‘you’ve got cancer’,” said Alastair Macaulay.

That was how Macaulay found out he had prostate cancer at the tender age of 53. After consulting a number of doctors, he decided on Dr. Ketan Badani because he was highly experienced at using a robot to remove a cancerous prostate.

“Everyone said you recover much quickly, more quickly from robotics,” Macaulay said.

Studies have shown that men who have their prostate removed robotically lose much less blood, so they regain energy much more quickly. They’re also up and about and out of the hospital sooner. More importantly, cancer cure rates are the same.

“We are also trying to preserve the muscles that control your urination and we’re trying to preserve the delicate nerves and arteries that control erection function in men,” said Dr. Ketan Badani of New York-Presbyterian Hospital.

Here’s why that’s so difficult. The prostate sits right at the base of the bladder, surrounded by those all important nerves, arteries and muscles. Robotic surgery uses high magnification that allows the surgeon to see and preserve those structures. But there’s still some pulling and tugging and the use of electrical cauterization can still cause collateral damage.

“So if we can figure out a way to minimize the thermal injury and the pull stretch injury, then we might see a much better result in terms of men recovering their potency in a shorter period of time,” Badani said.

That’s where a carbon dioxide laser comes in. New technology allows the laser beam to be guided by the robot arms into very precise, microscopic spots to tease and burn away the prostate from the nerves without heating them up or damaging them.

A recent study found that recovery of continence after laser assisted prostate surgery is quicker and potency may also be.

Alastair said he’s also pleased with his potency but that took much longer to return.

The study using the carbon dioxide laser was very small and many more men will have to be followed post-op for much longer to really show that using the laser improves continence and potency, but so far it seems to be at the very least as good and quite possibly, better.

All men will have incontinence and impotence for a while after surgery because, no matter how delicate and careful the operation, surgery is still traumatic. So the idea is to shorten that difficult time.

Interestingly, doctors have found that viagra, cialis and similar drugs actually have a protective effect on the erectile nerves and so they’re given as part of the rehab process ofter surgery.

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