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Prostate Cancer Surgery: Which is best?

By John Carter - bio l email

CHARLOTTE, NC (WBTV) - Prostate cancer is the most common cancer found in men.  I've documented my own case on WBTV many times and I get a lot of questions about it. 

Most people ask me which is the best surgery for prostate cancer -- Traditional open surgery or the newer daVinci robotic surgery? 

Since robotic surgery has been around for several years, making that decision is not quite as difficult as it once was.

The daVinci robotic prostate surgery procedure first came to Charlotte in 2004.  It promised fewer complications and shorter recovery time than traditional open surgery.  

Dr. Chris Teigland is based at McKay Urology in Charlotte and is considered one of the nation's leading prostate cancer specialists.  He has performed more than 300 robotic surgeries since that time and says 98 percent of the surgeries he does today are using the daVinci robot.

Ray Jones works at Carolinas Medical Center in Charlotte.  He wrote the press release announcing the arrival of robotic surgery at CMC without ever knowing he would later develop prostate cancer. 

"Emotionally, I would say it was one of the toughest things I've ever been through," Jones said.

"Anytime you hear that diagnosis, it sends a bit of a chill down your spine," said Charlotte businessman Bruce Bowers.  He was also diagnosed with prostate cancer. 

Both Bowers and Jones had their prostates removed.  Bowers chose the traditional surgery and Jones opted for the robotic procedure. 

How did they make their decisions?  Many factors were involved and both men did extensive research on surgery. 

"I had talked to some people who had robotic surgery, and honestly, some of the outcomes did not impress me," Bowers said. 

It was different for Jones, who said, "The side effects of the surgery, the healing time, and the loss of blood certainly favored using the daVinci."

So which decision was correct?  Surprisingly, the answer is both of them.  Both men are doing well today and both are satisfied with their surgeries. 

"I think finding that right doctor, that you have the confidence in, is the key to that decision and the comfort level you'll have with it," Jones said. "I don't think there's a right or wrong, I think it's what you decide is right for you after you do your research and I think that does lead to a quicker healing process and a better outcome."

That is essentially Dr. Teigland's advice.  He also suggests that patients find an experienced surgeon.

"If somebody is quite dedicated in their mind to having open surgery, they should find somebody that that's their way of doing it or if they want to have robotic surgery, they should find somebody who does it primarily that way," Teigland said.  "I think it's more about the pilot than the airplane here."

Still, there are new concerns that have been raised about robotic surgery.  

A study published in the October edition of the Journal of the American Medical Association found men who underwent robotic surgery experienced a shorter hospital stay as well as fewer respiratory and surgical complications. The study also found robotic surgery patients experienced more urinary complications, incontinence and erectile dysfunction. 

However, Dr. Teigland cautions the study did not take into account the learning curve of the adoption of a new technology.  He says the study looked at patients who underwent robotic surgery between 2003 and 2007, as the daVinci was first being used. He believes if the study were done again today, the results would be completely different because doctors have had much more experience using the device.

The bottom line about deciding on which type of surgery to have is you should do your homework.  Talk to your doctor and decide on the treatment that you feel most comfortable with.

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