I would like to thank James Mtume and Bob Pickett for having me on their show today.
We had an excellent discussion with several points that Id like to summarize. I will also be taking questions from their listeners that can be emailed to
[email protected]
The broadcast can be heard on a series of MP3 files archived on my website.
1) African-American males are more likely to develop prostate cancer and die from prostate cancer than other races. The reasons are multifactorial, but genetics plays a role, as does environmental factors such as diet, but there is also a socio-economic role.
2) Most men should get screened with bloodwork (PSA) and a rectal exam done with a doctors finger.
The age to get screened in the absence of symptoms should be 40-45 for African Americans. Prostate cancer is silent and does not cause symptoms in the early stages.
3) We discussed the care of people that are incarcerated and it should be the same as people that are not. While I was at Indiana University, we took care of prisoners in the urology clinic and provided the same care that would be received at any other urologists office.
4) Patients without insurance is a problem. I am familiar with free screening programs, but people without insurance are less likely to seek care and will be less likely to afford the care if diagnosed with a significant problem. I didn’t have a good answer for this problem.
5) We discussed how robotic surgery works and different hospitals in the tri-state area that perform it. A list of physicians who perform it can be found at davinciprostatectomy.com.
The most important benefits of robotics is the decrease in blood loss. I have performed 108 robotic prostatectomies without transfusing a patient and do not have patients donate blood. The hospital stay is 1 night and patients are often back to work within 2 weeks, although this is not always the case.
6) We fielded some questions from the audience, with one listener pointing out that friends of his and himself have had a diminished quality of life after surgery. This is an important point and my best advice is to have an informed discussion about side effects from surgery and for doctors to offer care of the side effects from surgery.
I am hopeful that the quality of life long term will improve with urologists becoming adept at robotic surgery. Studies will need to be done to see if this is true.
I will try to make my blog available to answer questions and to provide a starting point for further discussions about prostate cancer, its treatments, and side effects from surgery.