Smart Surgery Blog Dr David B Samadi Fri, 01 Aug 2014 06:24:53 +0000 en-US hourly 1 Preventing Prostate Cancer with the Basics – Vitamin E Not the Answer Fri, 01 Aug 2014 04:56:53 +0000 There’s no magic bullet when it comes to preventing prostate cancer. This week, the Journal of the American Medical Association shares news that taking large doses of Vitamin E supplements on a regular basis may actually cause prostate cancer, not prevent it as once believed.

The findings come out of a study that began ten years ago and included 35,000 men aged 58-68. The data clearly indicated a 17% increase in prostate cancer among those taking 400 IU/day of vitamin E over a five-year period. In 2008, seven years into the study, they released data stating that vitamin E did not prove to prevent prostate cancer. Today’s news that it may actually cause it is staggering to many.

In truth, it is difficult to say from just one study whether or not prostate cancer is caused by an increased consumption of vitamin E. The more important lesson is that vitamin supplements are not the quick answer to our medical woes.

Preventing prostate cancer should really be about getting back to the basics.

If you’re a relatively healthy man who exercises regularly, plays some sports, stays active around the house, is on the go with your family, then you’re taking the first step.

If you can manage to keep up with a healthful diet that includes a wide range of foods, heavier on the fruits and veggies (particularly the colorful ones like tomatoes and broccoli), a little lighter on the red meat, then you’re establishing a strong foundation. For most men, a well-rounded diet eliminates the need for vitamin supplements.

In terms of prostate cancer, it’s important to be aware of your risk factors. Did your father or grandfather have prostate cancer? An uncle or brother? Are you African American? These are check boxes that do put you at greater risk for developing prostate cancer and should be discussed with your doctor.

So what else can you do to prevent prostate cancer?

Well, the honest answer is that you can’t prevent it completely. What you can do is be vigilant about your prostate and your overall health. Annual PSA screenings do work, particularly for those with the risk factors I just mentioned. When you get your PSA blood test each year your doctor is adding valuable data to your prostate road map. As a man ages, his prostate changes and naturally enlarges. Without a baseline, fluctuations in your PSA level cannot be accurately assessed. What comes of those numbers is your PSA velocity and that’s where significant changes can indicate prostate cancer.

The bottom line is that the media, health fanatics and even celebrities can sometimes lead us astray with the latest fads and trends in wellness and the purported benefits of supplements. Don’t allow yourself to focus on any one magic way to prevent cancer. Healthy habits are the best course of action for maintaining overall wellness and prostate health.

If you are currently taking vitamin E or a supplement that contains vitamin E, particularly in doses of 400 IU/day, consult your physician.


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Prostate Cancer: Don’t Eat That Fri, 01 Aug 2014 04:43:47 +0000 Each day we wake to new evidence of foods that cause prostate cancer. Men have long been cautioned to focus on healthy eating and exercise, making it even more confusing that regulars on the food pyramid are now under fire for contributing to the development of prostate cancer. Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, wants to help men qualify the role of specific foods in prostate cancer and fill in the blanks in the rest of prostate cancer story – annual PSA screening and early prostate cancer treatment.

Prostate Cancer Prevention – meat, eggs and other “bad guys”

Recent studies take aim at many foods that are already staples in a man’s diet. One shows consumption of red meat five times per week can more than double your risk of prostate cancer. Another says don’t eat more than two eggs per week or you’re 81% more likely to develop metastatic, or deadly, prostate cancer. Even milk is under scrutiny, as one report suggests African American men who have a calcium-rich diet may be at increased risk. “At first glance, these numbers are staggering. We’ve always been taught these foods are good for us. Stay away from junk food and eat the basics; we learn that as kids in school,” says Dr. Samadi.

For as much research as there is about what not to eat, there is also evidence that increasing our intake of foods such as tomato products, fish, green tea and cruciferous vegetables such as broccoli and cabbage can lower a man’s risk of prostate cancer. Rather than be consumed by what we consume, Dr. Samadi wants men to take a broader approach to eating and preventing prostate cancer. “Moderation is always key,” explains Dr. Samadi, “don’t be frightened by each new report. Just focus on including a wide range of fruits, vegetables, grains and proteins. And stay active.”

Prostate Cancer Detection – PSA testing still strong

While the PSA test isn’t always seen as the be-all/end-all in prostate cancer detection, Dr. Samadi knows it is currently our best line of defense against the disease. “Annual PSA tests create a roadmap of what’s going on with your prostate,” explains Dr. Samadi, “the numbers we gather each year help us create a PSA velocity which measures any increase from year to year. These numbers are very valuable.”

Some experts believe that prostate cancer is a near certainty for all men; that by age forty 40% of men will have prostate cancer and by age sixty 70% will have developed the disease. Some may only have a latent, benign form of the disease, while others will develop more serious, advanced prostate cancer. “As men age, their prostate gland grows and their PSA levels change, but without regular PSAs the degree of change cannot be seen,” says Dr. Samadi.

Prostate Cancer Treatment – Robotic surgery sure fit

“ Once prostate cancer is detected it cannot be ignored,” says Dr. Samadi. While some opt for a watch-and-wait routine and others choose radiation, he encourages patients to explore robotic prostatectomy surgery. The enhanced support of robotics allows Dr. Samadi to remove a cancerous prostate with as little disruption to delicate nerves as possible. The benefits of robotic surgery include faster recovery and decreased impact on sexual function and urinary continence.

But the win with prostate cancer surgery extends far beyond recovery time, explains Dr. Samadi. “The reality is that prior to surgery our knowledge of a man’s prostate cancer is partial. There are limitations in our ability to accurately stage the disease. Unfortunately, we often find it to be more advanced when we see it firsthand.” For this reason, Dr. Samadi believes the best way to put prostate cancer behind you is to eliminate it through robotic surgery.

“I will always support prostate cancer research,” stresses Dr. Samadi, “however, the message to men needs to be more comprehensive. Healthy lifestyle, early detection, early treatment – that’s how we win the prostate cancer battle,” concludes Dr. Samadi.

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Contradictory Findings and Using Caution When Researching Prostate Cancer Treatment Options Fri, 01 Aug 2014 04:43:23 +0000 I like when the medical community shares the positive findings of new studies on robotic radical prostatectomy procedures. I like knowing that prostate cancer patients, mine and those just beginning to explore treatment options, can read about the many current successes of robotic prostate surgery. I like when the medical community is united in helping prostate cancer patients gain access to the best treatments available.

But what I find most difficult for those exploring prostate cancer treatment options is the widely varying reports often published. Facing a prostate cancer diagnosis is extremely difficult and research is a must. I urge all prostate cancer patients to spend time with their physicians discussing all options, and to gather as much information from as many sources as possible. But what you read and learn must be as carefully considered as the treatment decision itself. The volume of data can be overwhelming and making sense of wildly differing results can be daunting.

For example, prostate cancer surgeons at Weill Cornell Medical College in New York recently studied the outcomes of 110,016 prostatectomy patients, finding significant surgical benefits in those who underwent laparoscopic or robotic procedures. Representing roughly 40% of the pool, these patients experienced less blood loss and shorter hospital stays, and an overall lower perioperative morbidity rate. I know from my own practice that a robotic-assisted prostatectomy has significant surgical advantages. Not only is vision enhanced by 10x, it is also 3D. And the dexterity of the robot in my hands is unmatched. Incisions are small, the surgical field is not obstructed by excessive blood loss, movements are precise and recovery is much faster.

Even more encouraging about this study is the fact that a subgroup analysis showed that surgeons who performed 1,000 or more procedures had the most successful outcomes. With regard to robotic surgery, this is particularly true as a solid foundation in both open, traditional prostatectomy and laparoscopic prostatectomy are critical. The robot provides great advantages, but it cannot think and perform a procedure independent of a surgeon. Without the addition of the surgeon’s knowledge and, most importantly, experience, the robot does not know what to do. Great technology cannot replace medical expertise.

So, while it’s no surprise that the study validated the success of robotic prostatectomy procedures, I am surprised by what the survey leaders concluded next – and this is the part where the findings become confusing. The report goes on to speculate that a surgeon can become proficient in robotic surgery in as few as 50 procedures verses the hundreds of procedures needed to be successful in open or laparoscopic surgery. Are they suggesting that robotic surgery is a better option because it’s easier for the surgeon to learn? Perhaps it’s a misuse of the word “proficient”? Even still, if the study indicated higher success rates in surgeons with more experience, close to a thousand patients’ worth of experience, why would 50 create proficiency? And what is a patient left to think, that any surgeon who’s had his hands on the robot for a few months can figure out what to do?

The point to be made here is that even great studies with great results can provide contradictory information. Sometimes it’s because further research is needed. Sometimes it’s due to research variables or narrow study parameters. And sometimes it’s due to the goals of the researchers. Further, what you read in an article or a study summary is not the full story. Talk to your surgeon, talk to multiple surgeons, and be sure the information that’s guiding your treatment decision is accurate and comprehensive.

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Robotic Prostatectomy Surgery and Robotic Radiosurgery – What’s the Difference? Fri, 01 Aug 2014 04:43:00 +0000 There’s a lot of buzz about robotics in all areas of medicine. Couple that with new advances and the ever changing world of branded medical tools and procedures and there’s bound to be confusion about what’s what. As we continue to read more about Prostate Cancer Awareness month, I want to offer some clarity on two similarly named, though vastly different, prostate cancer treatment options – robotic prostatectomy surgery and robotic radiosurgery.

First, robotic radical prostatectomy involves the use of surgeon-guided micro-surgical instruments and high-resolution cameras to aid in the non-invasive removal of the cancerous prostate. I believe this technique gives me, and my patients, the best of both worlds. I can draw on my vast traditional and laparoscopic surgical experience and marry it with the technological advantages of the robot – enhanced vision, precise dexterity and full mobility – to remove the prostate with as little trauma to the patient as possible. In doing so, my patients achieve a 97% cure rate.


What’s more, I have the benefit of getting in there and really seeing what’s going on with the cancer. Unfortunately, pre-surgery cancer staging tests don’t really tell the whole story. Many times, we biopsy a cancerous prostate after surgery and find out that the cancer was actually far more advanced than earlier testing indicated. Without surgery, I might never know this and a patient might choose a less aggressive, less complete form of treatment.


Robotic radiosurgery, on the other hand, involves no cutting and is not surgery – it is radiation. Branded as CyberKnife by Accuray, a radiation oncology company, radiosurgery is an FDA-approved treatment that involves a series of 1-5 procedures on different days. Also non-invasive, it targets radiation at the cancerous tissue and is believed to spare the non-cancerous surrounding tissue. One prostate cancer study involving radiosurgery patients indicated a promising 93 percent non-recurrence rate after 5 years; however, data is very limited for this relatively new procedure.

There are two things I’d like to caution you about with regard to radiosurgery. One, this procedure uses the data from CT scans to target the right location, size and shape of the prostate cancer. As I said earlier, pre-surgery cancer testing has limitations. Two, and this is important for all types of radiation, a patient’s ability to have prostatectomy surgery after radiation is severely limited. Of course the hope is that the cancer never returns, but if it does, radiation patients will require either more radiation or alternative treatments. The peace of mind that comes from a robotic radical prostatectomy will likely not be an option.

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Calling All Women: Prostate Cancer Awareness Month Fri, 01 Aug 2014 04:42:02 +0000 My favorite month is here so you know what that means: prostate cancer talk all month long. It’s a time to listen up and study up on all there is to know about preventing, detecting and treating prostate cancer. This month, my message goes out to women. I say this because you know as well as I do that women have the power to make us act. They read all the latest news and blogs, they talk to their friends and their doctors, and they prod us along.  My message is simple: women, do whatever it takes to get your husband, boyfriend, father and/or brother to the doctor this month. And while you’re at it, here’s a “honey-do” list ready for you to hand over. This list highlights the prostate cancer basics we all should know: Learn your prostate cancer risk,Improve your lifestyle, Screen annually and Treat aggressively, if necessary.

LEARN Your Risk:

Genetics – men with a father or brother with prostate cancer are 2x as likely to develop the disease; having 3 or more relatives with prostate cancer makes a diagnosis almost certain

Race – African American men have a 60% increased risk of prostate cancer over Caucasian men

Age – more than 65% of prostate cancers occur in men over 65

Weight – obese men, those with a BMI over 30, are 33% more likely to die from a prostate cancer diagnosis

IMPROVE Your Lifestyle:

Eat Right – Changing your diet a little now is much easier than the changes you’d face with prostate cancer. Add a few more fruits and veggies. Not only are they good for you, but some – such as tomatoes and broccoli – contain cancer-fighters that may help reduce your prostate cancer risk. Even red wine contains antioxidants. Cheers!

Move It – A little exercise goes a long way. Even better, a little extra sex can help too. Some studies show a reduced prostate cancer risk with more frequent ejaculations.

SCREEN Annually:

PSA Test – This quick and easy blood test should be done annually, beginning at age 50. Men with increased risk should begin at age 40.

DRE – Not fun, but this painless test is important. Your doctor will use his finger to quickly check for bumps or abnormalities on the surface of the prostate. Yes, annually, too.

Symptoms – For as much as men like to talk and make jokes about biologic and male functions, the minute they detect a problem they clam up. Prostate cancer can be near symptomless, but if you experience any of the following issues please share them with your doctor:  frequency or difficulty urinating, weak or interrupted urine flow, pain associated with urination or ejaculation, erection difficulty or blood in urine or semen.

TREAT Aggressively:

Watchful Waiting – For those who choose to postpone radiation or surgery, cancer surveillance is an option. But, prostate cancer can accelerate quickly. So unless you’re of a significantly advanced age or reduced physical capacity, please explore your treatment options thoroughly before deciding on this more passive approach.

Open or Laparoscopic Prostatectomy – Both of these options effectively remove prostate cancer; however, open surgery is associated with longer and more painful recovery and, in my opinion, laparoscopy falls a little short in the technology area. It does offer recovery benefits over traditional surgery, but there are surgical enhancements available today that better serve the patient and the surgeon.

Robotic Prostatectomy – As I’ve discussed often, I strongly believe in robotic prostatectomy using the da Vinci Surgical System. Finding a surgeon who can pair open and laparoscopic expertise with extensive robotic technology experience is a patient’s best bet. Recovery is faster and men get their lives back on track much more quickly, with minimal long-term side effects.

Radiation or Chemotherapy – In certain instances, external or internal “seed” radiation or chemotherapy may be advisable. Prostate cancer is also an individual path, but it is my belief that removal of the prostate is the best way to eliminate risk of the cancer returning and give yourself peace of mind. It is also worth reminding, that if the radiation fails or the cancer returns in a few years, prostatectomy may not be an option. Discuss this with your doctor.

I know men don’t want to go to the doctor, and certainly not when they’re feeling fine. Acknowledging that something could be “wrong” with them is very difficult and annual physicals are just not a priority. But waiting for symptoms doesn’t work with prostate cancer, and even many other diseases. Taking one morning of your life each year for an annual physical is a small inconvenience that goes a long way toward ensuring a lifetime with those who love you – including the women who keep giving you lists. So what’s one more list? This month, make her happy and check off The List.

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Kegels and Post-Prostatectomy Care Fri, 01 Aug 2014 04:41:39 +0000 The National Institute of Health Research recently weighed the benefits of using Kegels, pelvic floor toning exercises, in one-on-one physical therapy sessions. Their findings indicate that there is no substantial benefit to the individualized training, nor is it cost-effective. It’s interesting to me that the study seems to be less about the effectiveness of pelvic floor toning exercises, and more about the time (and therefore expense) of one-on-one care after prostate cancer surgery.

First, I’d like to remind patients that the level of sexual and urinary function issues they may face post-radical prostatectomy are directly linked to the skill level of the surgeon they select. While da Vinci System technology does provide tremendous benefits in visual magnification and dissection precision during surgery, it’s no replacement for time and experience. My SMART (Samadi Modified Advanced Robotic Technique) method links technology and skill, truly resulting in smart surgery. My patients are experiencing exceptional results with regard to sexual and urinary function. Ninety-six percent regain urinary continence and 87 percent regain sexual function in 12-24 months following surgery.

Second, there are instances when men need some additional support following surgery, whether to deal with sexual issues or mild stress urinary incontinence. With regard to restoring urinary continence I may employ the use of pelvic floor toning. Performing Kegels is as simple as identifying your pelvic floor muscles (those you use to stop the flow of urine), contracting them for a few seconds at a time, and repeating about ten times. Done a few times each day, these exercises can help. They’ve even been known to help sexual function.

More importantly, though, my treatment of a patient does not end with surgery. Patients become a part of my family, and I continue to work with and care for them for as long as they need me. I will do so one-on-one, whether it be cost-effective or not, because it’s what is right for the complete recovery of my patients.

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New Study About Men Leaking Urine During Sex Fri, 01 Aug 2014 04:40:38 +0000 NYU prostate specialist, Dr. Herbert Lepor just published questionnaire findings in the Journal of Urology about the incidence of post-prostatectomy men leaking urine during sex or climax. This side effect of prostate removal is coined “climacturia.” While this may not be a topic you’re too anxious to discuss, I want to help clarify the findings and share my feelings about the results.

The survey found this: 1 in 8 men are experiencing urinary incontinence during sex and 36% of those polled said the problem persisted two years after surgery. This issue is completely separate from sexual potency, and in some cases isn’t even linked to normal daytime urinary incontinence.

The questionnaire was given only to patients of Dr. Lepor’s. It included just over 1,400 men and encompassed those who underwent radical prostatectomy surgery at NYU between 2000 and 2007. The most critical part of the study I want you to keep in mind is the fact that all men had traditional open prostatectomy surgery. What this means is that no laparoscopic or robotic tools were used during the procedures.

In my experience, traditional open prostatectomy surgery has significant limitations. For the patient it means greater blood less, a longer hospital stay, a more painful recovery and increased sexual and urinary issues after surgery. For the surgeon it means reduced visibility and therefore, the chance for less precision during surgery.

It is estimated that roughly 90,000 men in the U.S. will undergo radical prostatectomy surgery this year. I fully endorse the removal of a cancerous prostate. I believe a man’s best chance for survival and a happy, healthy life is to completely remove the prostate once cancer presents itself. I caution you, however, to do your research. Think about the time you spend choosing what new car to buy or where to vacation next year. Surely life-saving surgery is worth at least that level of research, thought and discussion.

Robotic prostatectomy provides significant advantages. From my perspective, the technology significantly enhances my traditional surgical capabilities. There’s less blood in the operating field and the robot provides 3D sight with up to 10x magnification. Both factors give me a significant advantage over traditional, open surgery as I can rely on sight rather than touch. The less I touch, the less risk of trauma there is to the sphincter and areas under the pubic bone. Further, the dexterity of the robot in my hands offers unmatched precision. Being able to really see the cancer, the prostate and everything around it lets me work even more carefully at sparing the precious nerve bundles around the prostate. With my SMART (Samadi Modified Advanced Robotic Technology) surgical technique there are two key advantages I want you to understand:

1) Sex Life – I don’t open the endopelvic fascia during surgery. This tissue surrounding the prostate contains precious nerve bundles that control your sexual function. I do my best to create as little trauma to this area as possible. 87% of my patients regain sexual potency within 12 to 24 months.

2) Incontinence – I don’t suture the dorsal vein complex at the beginning of surgery. This lets me control the length of urethra left behind; the more urethra, the less risk of urinary incontinence and leaking after surgery.97% of my patients regain urinary control within two to three months.

Successful robotic prostate surgery requires the marrying of a skilled surgeon with a foundation in traditional surgical methods with the enhanced technology of robotic equipment. Further, that union must exist for a long period of time to achieve quality results. It’s estimated that a surgeon must perform more than 1,600 robotic-assisted laparoscopic prostatectomy surgeries to achieve “acceptable” outcomes. I have performed more than 3,500 successful robotic prostatectomy procedures.

Reading these new polls is part of gathering information about prostate surgery. The point I make is simply to know what you’re reading. Find out the origin of prostate surgery statistics, talk to and research multiple surgeons and fully understand your options so that you and your family can make the treatment decisions that are right for you.


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Personalized Care for Israeli Prostate Cancer Patients Fri, 01 Aug 2014 04:40:06 +0000 I’ve traveled to Israel several times to demonstrate robotic prostate cancer treatment to urologists who are relatively new to robotic surgery. My goal in Israel, and in other countries, is to help specialists continually improve the quality of healthcare they provide their patients, particularly in the area of prostate cancer treatment. While in Israel I successfully performed robotic surgeries using my SMART (Samadi Modified Advanced Robotoc Technique) method of prostate cancer treatment, all televised live to extend the reach of the training.

However, we know from experience that the learning curve for robotic surgery is very steep. Studies show that experienced surgeons require over 1,600 robotic-assisted surgeries before they achieve acceptableoutcomes. With significantly smaller caseloads, Israeli surgeons are simply not yet able to offer the level of expertise that U.S. specialists can. In time, their experience, and therefore expertise, should greatly improve.

But what of the Israeli men who are facing prostate cancer today? They certainly don’t have the time for their country’s knowledge to catch up. They are fighting for their lives and deserve the highest quality medical care available today, regardless of location. As a result, inbound medical tourism is becoming increasingly popular to those looking for the top-notch medical care that U.S. patients have access to on a regular basis. I have performed over 3,500 successful robotic prostatectomy procedures, and have a prostate cancer cure rate of 97 percent. For many, these statistics far outweigh the inconvenience or added expense of travel to another country.

That is why I feel it’s critical for my staff and me to cater to these men battling prostate cancer. The moment they become our patients, they become our family. Our international department can handle all aspects of their treatment in the United States: travel arrangements, family care, recovery, even entertainment for those traveling with them. In some cases, I’m able to arrange for several men to come here at the same time for surgery. Though their treatment remains completely individual and private, the camaraderie and comfort that comes from making the journey together goes a long way in their emotional wellbeing and lifelong recovery. This is true for both the patients and the family members who are able to share in what can be a very trying experience.

My efforts overseas will always remain a priority for me. Giving prostate cancer patients access to the highest quality treatment and medical technology in their homelands is of utmost importance. But until that goal is realized, my staff and I will continue to serve those men and their families who need life-saving prostate cancer surgery now- and we will do so with compassion and care for their unique needs as traveling patients.

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Live Robotic Prostatectomy with NYLF/MED Fri, 01 Aug 2014 04:39:34 +0000 Just days ago I had the pleasure of welcoming 130 academically outstanding high school students to witness one of my live robotic prostatectomy procedures at The Mount Sinai Medical Center. I was invited to become a part of National Youth Leadership Forum on Medicine’s (NYLF/MED) inaugural year in New York. The program gathers exceptional high school students in the greater tri-state area who are chosen based on their outstanding academic records in math and science and teacher recommendations. The forum has an 18-year history in cities throughout the country, and it was a great honor for me to be a part of bringing it to students in our area.

Students participating in the program stay in New York for 10 days, experiencing a wide range of healthcare seminars, medical experiences and even social events. The program works with medical professionals in the area to arrange site visits so the students can experience clinical settings first hand. The morning of the surgery, 130 of the program’s students chose to join me at Mount Sinai Medical Center to watch the 7:00 am surgery live on closed circuit TV. Just after, I spent time with the students discussing the surgery and answering questions. It was truly inspiring to see their enthusiasm. Their questions were so insightful and they had a genuine interest in understanding the details of the procedure. They were intrigued by the limited blood loss during robotic prostatectomy surgery and asked detailed questions about the training required to perform such procedures, as well as the recovery time. Spending the morning with young people as excited about robotic surgery as I am was a real thrill.

I see this program as a great boost to medical schools in our area. The sooner we engage bright minds in the healthcare field, the better off we all are. We need their energy and intelligence to keep moving forward with medical successes. I understand that today roughly 30 percent of the students who participate in the program nationwide go on to be a part of the healthcare field in some way. I hope to be a part of the program in the future and to do my part in increasing that number.

A big thank you to Maureeen Carnakie-Baker, Regional Manager at NYLF/MED, for inviting me to become a part of the program, and also to all of the wonderful, bright students I got to know that morning. I wish you all the best in your future healthcare endeavors.

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The Fight Against Prostate Cancer At Home And Abroad Fri, 01 Aug 2014 04:22:21 +0000 Earlier this year I talked about Kenyan Medical Services Minister, Anyang’ Nyong’o, traveling to the U.S. for life-saving, prostate cancer treatment. Following a diagnosis in his country which, it’s important to note, came only after his own persistence that something was not right, Nyong’o knew his best chance for survival was to head here. Recognizing his own country’s limitations, Nyong’o did what many in other countries are now doing, he chose a prostate cancer specialist in the United States with expertise that far surpassed his country’s offerings.

Since his return to Kenya, Nyong’o is turning his experience into a force for change. He founded the African Cancer Foundation, with the intentions of increasing the distribution of cancer information, emphasizing early screening and updating treatment options in Kenya. Reform in these areas will not be easy for Nyong’o and his group; Kenyans place a large stigma on cancer patients and, in some areas, still prefer natural healing methods. As a result, conquering late diagnosis of prostate and other cancers will be a big part of the foundation’s efforts, but it’s a fight worth fighting. In developing countries like Kenya, more deaths are caused by cancer than TB, malaria, HIV and AIDS combined. Kenyan statistics indicate 18,000 new cancer diagnoses each year, of which 50 people die every day.

It is my hope that, upon learning of their prostate cancer, more men in other countries will travel to the U.S. as patient ambassadors. Today, many countries simply do not have the advanced skills that some U.S. surgeons have in treating prostate cancer, particularly in the case of robotic prostatectomy procedures. Our robotic technology affords us great advantages in the precise removal of the prostate and surrounding cancer. But technology alone is not the champion. That’s why I continue to travel to other countries in the early stages of robotic surgery to share my knowledge and expertise face-to-face. As surgeons in these countries are able to perform more and more robotic surgeries their level of proficiency will grow. Until that day, I welcome men from all countries to my practice. Treating international prostate cancer patients and helping their families through the entire journey is the number one goal of my international department. And as these men return to their native countries, cancer-free with almost no detriment to their sexual or urinary functions, others will learn of their successes and follow suit.

I wish Mr. Nyong’o and the African Cancer Foundation Godspeed. And as their reach expands and their efforts increase, I urge them to focus on improving the expertise of their in-country surgeons treating prostate and other cancers. Education and early screening are, of course, the first critical steps. But the ability to eradicate prostate cancer in their country, on their own, saves Kenyan patients valuable time and ensures quality of life for their citizens well into the future. To achieve success, it is in Kenya’s best interest to employ the help of U.S. cancer specialists and surgical experts who can guide them to cancer treatment expertise.

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