Prostate Cancer Robotics: "Radiosurgery" Is Not Real Surgery

Prostate cancer expert, Dr. David Samadi, recommends robotic prostate surgery over non-surgical radiosurgery

Jan 22, 2013, 08:39 ET from

NEW YORK, Jan. 22, 2013 /PRNewswire/ -- Not all robots are created equal, particularly when it comes to prostate cancer, says world-renowned prostate cancer surgeon, Dr. David Samadi. Specializing in minimally invasive da Vinci robotic prostatectomy surgery, Dr. Samadi is not only Vice Chairman, Department of Urology at The Mount Sinai Medical Center; he is also Chief of Robotics and Minimally Invasive Surgery.

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Robots are employed to treat prostate cancer in two distinct ways, according to Dr. Samadi. Robotic prostatectomy is robot-assisted surgery to remove the cancerous prostate, such as the Samadi Modified Advanced Robotic Technique – SMART Surgery. Radiosurgery, or radiation therapy for prostate cancer, uses a robot to deliver high doses of radiation to the prostate cancer tumor. According to Dr. Samadi, the differences between these treatments are significant.

Prostate cancer "radiosurgery" is not actually surgery.

Radiosurgery technicians use 3D imaging and computerized adjustments to deliver precise, high-dose radiation to the prostate. There is no surgical component to "radiosurgery" and the cancerous prostate is not removed, it is simply targeted, based on secondary imaging and biopsy data, according to Dr. Samadi.

Robotic prostatectomy, in comparison, is also enhanced by 3D visualization and precision enabled by the robot, though to a much different end. During robotic prostatectomy, the cancerous prostate and seminal vesicles are removed in entirety.

"Radiosurgery lacks what I believe to be the most critical aspects of treating prostate cancer: precise diagnosis and definitive recovery," said Dr. Samadi. "With SMART surgery, I make real-time decisions based on informed firsthand visualization. During surgery, my eye is on the prostate and after surgery that prostate is in the lab. There is no substitute for that level of prostate cancer analysis."

Prostate cancer post-treatment considerations:

  • Robotic prostatectomy surgery affords post-surgery tumor analysis to verify prostate cancer type and extent, radiosurgery does not
  • PSA (prostate-specific antigen) level should drop to undetectable levels after robotic prostatectomy surgery; after radiation PSA level continues to fluctuate
  • Radiosurgery alters prostate tissue in such a way that a prostate cancer recurrence is likely to be inoperable
  • Most SMART surgery patients regain sexual potency in 12-24 months and urinary control in 2-3 months

"Patients who lead with robotic prostatectomy over non-surgical radiosurgery are better positioned for complete prostate cancer removal and optimal recovery," says Dr. Samadi, who encourages patients to reserve radiation or radiosurgery for advanced prostate cancer or salvage treatments.

The decision to have surgery should never be taken lightly and to those patients debating the merits of noninvasive verses minimally invasive prostate cancer treatment Dr. Samadi adds, "Prostate cancer is invasive. Robotic prostatectomy is a highly successful and minimally invasive way to remove the cancer and arrest further invasion."

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