Urology

Precise Procedure

Area man benefits from revolutionary cancer surgery.

(The following article appeared in the Plattsburgh Press-Republic on January 7, 2003)

By Jeff Meyers, Staff Writer

Robotic technology is being used during urology and cardiac surgeries at Strong Memorial Hospital. The system consists of a robotic arm that performs surgeries using movements that replicate a surgeon's motions.

Dave Comfort has confronted cancer and survived.

The experience did not leave him drained, dejected or terrified, though. It has taught him some important lessons about hope and survival, lessons that he now shares with others.

"They found it during a routine checkup," Comfort said of his doctor's decision to perform a Prostate Specific Antigen (PSA) blood test late last summer that verified an early stage of prostate cancer.

"I had no real symptoms," he added. "This PSA test saves lives. Men need to go have them done. Women who know men need to talk them into going for the test. I can't say how important the test is."

Comfort, 52, started having annual PSA tests several years ago. Although medical experts recommend beginning the tests at age 50, Comfort felt there was no reason to wait.

"There is some controversy that false reports might unnecessarily scare people," said Comfort, who has researched prostate cancer and its impact since he received his diagnosis in November.

The test can detect high levels of PSA for other conditions, such as inflammation of the prostate or an enlarged prostate, that are not cancerous. As a result, some medical circles frown on giving the test too early.

For Comfort, the first-hand experience convinced him.

"I'd rather be scared (from a false reading) than not find out," he said.

Learning that he had a positive test result set the wheels in motion for Comfort, a regional forester for New York State Electric and Gas.

"I started to educate myself," he said. "I got on the Internet and researched my options. I talked to friends who had gone through this. I wanted to know what I should do about it. I wanted to get it fixed. That's what I do for a living."

Through his research, Comfort uncovered a brand new procedure that utilizes laparoscopic surgery to remove the prostate. Although traditional surgery has long been one of the options for dealing with prostate cancer, using smaller incisions and tiny cameras placed inside the body have made laparoscopic surgery an increasingly popular option,

"Laparoscopic prostatectomy was first done in this country in 1992, but it was abandoned because it took too long to perform," said Dr. Jean Joseph of James P. Wilmot Cancer Center at the University of Rochester Medical Center.

"But since then, technology has improved, and we can do the procedure a lot faster," said Joseph, who performed the surgery on Comfort. "We're finding that younger men are being diagnosed with prostate cancer. Therefore, we need to look at ways to get them home faster following the procedure."

Traditional surgery requires a lengthy hospital stay followed by several weeks of recuperation before returning to normal daily activities. With the laparoscopic procedure, patients can return to work within a few weeks.

In fact, Comfort was back at his desk, on a part-time basis, just two weeks after his Dec. 17 surgery date.

"I'm feeling great," he said. "There's still a little discomfort, but everything is going well as long as I take it easy and don't try to do too much."

Prostate cancer is one of the most common cancers men face. In this country, one in 10 men will develop prostate cancer. About 32,000 men die from it annually, and about 180,000 new cases will be diagnosed this year, according to the American Cancer Society.

Treatments for the ailment ranges from doing nothing to treating with radiation or surgery. We discuss with patients the pros and cons for each option," Joseph said. "It is sometimes a slow-moving disease, so if a man of 90 is diagnosed, we may suggest leaving it alone.

"But if a man has a good life-expectancy ahead, we'll want to intervene, either through radiation or surgery.

We are living longer, so it is important to weigh the options and make an educated decision."

For Comfort, the decision was obvious when he first met Joseph, who has been performing the laparoscopic procedure at Rochester since 1998 and is one of only a handful surgeons across the nation to offer the procedure."He has confidence and a strong bedside manner," Comfort said of his initial impression after first meeting Joseph. "I knew I could trust this man. Sure, I was scared as hell going into the surgery, but I was confident because Dr. Joseph and his staff were confident."

Traditional treatment of prostate cancer has often resulted in such side-effects as a impotence and an inability to control urinary functions.

However, using the laparoscopic equipment is much more precise than the standard surgical tools, resulting in less damage to the area surrounding the prostate. Therefore, there have been remarkably fewer side-effects for patients following the laparoscopic procedure.

"It takes skill to learn how to spare nerves that lead to the penis," Joseph said. "As we obtain better techniques and learn how to preserve structures better, you will only see more and more opportunities for this kind of procedure."

For Comfort, the surgery has provided a return to a normal, active life.

"From all initial reports, everything looks good," he said. "Who knows, I still have to have follow up PSA tests, but I'm feeling really good about my chances."

More information on the daVinci Surgical System and the laparoscopic prostatectomy procedure.