In a world firsttrial, Queensland researchers have found that robotic-assisted prostatectomy is providing equal outcomes for urinary and erectile function to open prostatectomy.
Published inTheLancet Oncology, the study, led by researchers at the Royal Brisbane and Women’s HospitalandGriffith’s Menzies Health Institute Queensland,and funded by Cancer Council Queensland,found that the advanced robotic technology also offered a saferand minimally invasive option formen diagnosedwith prostate cancer.
Rapid adoption
Robot-assisted surgery for prostate cancerhas been rapidly adopted by health professionals and is now the most widely utilisedsurgical approach for prostatectomy.
Royal Brisbane and Women’s HospitalUrologistDr Nigel Dunglisonsaidthestudy examined surgery outcomes foraround300Australianmenover a two-year period.
“To date, very little research has been done comparinglong-term outcomes of robotic-assisted prostatectomy and open prostatectomy,” Dr Dunglison said.
“Our study showedsimilar resultsfor urinary and erectile function from both the robot-assisted and open surgicalpatientgroupsafter 12 weeks,andthese remained equalat six, 12 and24 months.
“Manypatients experience long-term complicationspost-surgery,including reduced urinary and bowel control, erectile dysfunction and elevated psychological distress.
“Astechnology,surgery, oncology, and radiation advances,we hope this will help improve long-term side effects experienced by prostate cancer survivors to reduce the burden of the disease on those diagnosed.
“This study has given us vital insight into the two surgical options, and will help shape further research going forward.
“Werecommend thatfunding organisations, health care institutions and practitioners embraceminimally invasive technologies, andhighquality trainingisprovidedfor surgeonsto ensure patientsreceivethe bestform ofcare.”
Dr Dunglison said the study indicated men who underwent a robotic prostatectomy had a lower biochemical PSA recurrence after two years, however, the reason for this was not specifically studied and more research isneeded to understand why.
Griffith University’sMenzies Health Institute Queensland DirectorProfessorSuzanne Chambers saidone in fiveparticipantsreported elevated psychological distress 24 months after surgery.
“Unexpectedly,the studyalsoshowed that psychologicaldistressremained high for one in five menthroughout thestudy periodand was not influenced by surgery type,” Professor Chambers said.
A need for improved distress screening and psychological care
“These findings highlight the need for improved distress screening and psychological carelong after treatment ends.
“Issues such as sexual dysfunction, urinary and bowel changes, and even fear of recurrence can all lead to elevated psychological distress.
“For optimal prostate care, there needs to be evidence-based psychological intervention that is responsive to masculinity and related concerns.”
Cancer Council QueenslandCEO Ms Chris McMillansaidprostate cancer was the most common cancerdiagnosed inmen inAustralia.
“Around18,300menare diagnosed with prostate cancer every year inAustralia, and about3200die from the disease,” MsMcMillansaid.
“Prostate cancer is most common in men over the age of 50 and in those who have a family history of prostate, breast or ovarian cancer.
“If men have questions about their individual risk of prostate cancer, we recommend they speak with their GP to discuss risk factors and pros and cons of prostate cancer testing.”
Prostate Cancer Foundation Australia National Chairman, Jim Hughes AM said that PCFA welcomed the study findings and embraced the dissemination of these findings about some of the many different treatment approaches available to men diagnosed with localised prostate cancer in order to support informed decision making.
“There are various other treatments available and men need to be well across their medical choices so that optimal decisions relevant to their personal health circumstances can be made by them in conjunction with their medical advisors,” Mr Hughes said.
The study was funded by Cancer Council Queensland andundertaken by the Department of Urology at Royal Brisbane and Women’s Hospital, Menzies Health Institute Queensland, and University of Queensland Centre for Clinical Research with support from the Urological Society of Australia and New Zealand.
More information about prostate cancer can be found atcancerqld.org.auor via 13 11 20.
