Signs and Treatments of Prostate Cancer

Dr. Peter Fisher discusses the signs and treatment options for prostate cancer.

My name is Doctor Peter Fisher. I work at the Summit Urology Group. My main office is here in Holladay,and my main operating campus is St.  Mark’s Hospital. Prostate cancer happens to be the most common cancer in men,and still is affecting one out of seven, depending on who you read, one out of seven or one out of six men, and still tens of thousands of men die of this disease each year.

The first symptom to talk about with prostate cancer in its treatable phase is relatively no symptoms. I think that’s what’s so surprising to men,and the message that we try to get to the public,to address to men that they need to be screened for this disease, especially if they have a family history that puts them at a higher risk,so that they can get a prostate exam and a simple blood test.

In its later stages, prostate cancer can be symptomatic by changes in urinary function or voiding symptoms,or in extreme cases, blood in the urine, difficulty urinating or pain in the bones or skeleton or other organs where prostate cancer could spread.

Screening process for prostate cancer historically has been age 50. Current recommendations are of a younger age,with first screening at age 40. One risk factor that we know for sure is family history. So primary male relatives are where family history is important. For example, if you had a father or a brother or a son with prostate cancer, that’s where the target starts to be on your back, so to speak, that you ought to get checked.

Typically, a PSA blood test and a prostate exam would happen for a man at risk on a yearly basis. The conventional modalities to treat prostate cancer are still radiation treatment and surgery. Surgery primarily for the right candidate is done using robotics or robotic surgery, taking a longer incision and transforming it to five or six small keyhole incisions with a faster return to normal activity.

Radiation has also improved in that realm as well, that rather than doing what’s called full-field radiation,trying to pinpoint radiation delivered to the prostate gland called brachy therapy. It’s nice to be at a place like St. Mark’s, where we have robotics and brachy therapy available to patients, and we can help guide them to the treatment that can be best for them.

Urological Robotic Surgery

So, here at St.  Mark’s Hospital, I helped build and establish the robotics surgery program. It’s something that I’m very proud of, I think all of us here are very proud of. Robotic surgery, again, takes surgery that used to be done through a large incision,and do it through keyhole incisions. Length of stay at the hospital is dramatically reduced. Blood loss is reduced. And the outcomes of surgery, in my opinion,are benefiting patients. There’s less incontinence, there’s better erectile function following that procedure.

We’ve worked through a few generations of robotics here at St.  Mark’s Hospital, and I feel like our technology is cutting edge. It takes more than just a machine to build a robotics program. And the support of the staff and those who are involved with surgery make this place an ideal spot to pursue robotic surgery. Robotic surgery, initially, at St.  Mark’s Hospital started with urologists and gynecologists.

Primarily, in prostate surgery, kidney surgery and pelvic surgery. It is an expanding field. Where other modalities are utilizing robotics,from general surgery, abdominal procedures and cardiothoracic surgery involving heart procedures. There are still a wide variety of treatment options. The challenge, I think, in surgical medicine is both understanding the tools available to our trade,and providing the right tool for the right patient.