A major study of patient satisfaction and regret following open prostatectomy and robot-assisted laparoscopic prostatectomy provides some important lessons for surgeons …

… and opens up the debate about  alternative prostate cancer care

The research, recently published in the European Journal of Urology, shows 19 per cent of patients regretted their treatment choice and patients who had robot-assisted surgery were most likely to be dissatisfied.

The authors suggest the regret is “possibly because of higher expectation of an ‘innovative procedure’”.

Their conclusion is one for all urological surgeons to note.

“We suggest that urologists carefully portray the risks and benefits of new technologies during preoperative counselling to minimise regret and maximise satisfaction.”

In recent years, the treatment of prostate cancer has been a rapidly developing field, providing patients with a  wide range of different cancer care choices .

Brachytherapy and HIFU offer non-surgical options and for those who want surgery, there are open, laparoscopic and nerve-sparring options, depending upon your diagnosis and treatment provider.

At the same time, patients are becoming increasingly proactive, using the internet to research and consider the different  prostate cancer treatment options themselves, as well as the traditional consultation with the urologist.

Increased choice is without doubt a positive benefit for patients, but as urology centres – both private and NHS – seek to attract patients, we have a responsibility to carefully counsel them about the advantages and disadvantages of treatments.
There is a distinctive risk when a procedure is perceived to be new and especially “innovative”. The media will always be interested in the next “pioneering operation”, particularly one which involves robots.

A newspaper article will tend to portray the new procedure as an immaculate solution, which corrects all the risk and disadvantages of other procedures.
As surgeons, we have a responsibility to provide patients with a more sober and informative picture, acknowledging limitations as well as benefits.

The patient satisfaction study was based on the responses of 400 men who had undergone retropubic radical prostatectomy (RRP) or robot-assisted laparoscopic radical prostatectomy between 2000 and 2007 in the US.

The report’s authors also examined patients urinary domain scores, hormonal domain scores and found scores were independently linked with regret.

It is still early days for robotic surgery in the UK. In prostate cancer surgery, there are currently six Da Vinci robotic machines in the UK, compared with 350 in America.

There is no current evidence that robotic surgery provides better outcomes for patients, in terms of urinary symptoms, post operative sexual function or post-operative risks and complications. It seems certain that robotic surgery will increase within the UK during the next decade, with NHS and private centres purchasing the Da Vinci machines.

This will provide even more choice for patients, which is in principle, a positive development.

It is however vital that patients are given accurate and comprehensive information to enable them to make an informed choice, rather than simply being over-sold on a new product.

By: Alan Doherty

Article Directory: http://www.articledashboard.com

Alan Doherty is a Consultant Urologist and Medical Director of The Birmingham Prostate Clinic. A centre of excellence for Prostate Cancer Treatment.

Here are some related posts about prostate cancer treatment options

Prostate Cancer – Causes And Treatment

The treatment options for organ-confined prostate cancer or locally advanced prostate cancer usually include surgery, radiation therapy , hormonal therapy, cryotherapy, combinations of some of these treatments, and watchful waiting. 

Chemotherapy  Treating Prostate Cancer

It is really up to the patient and his doctors to decide whether on balance the advantages outweigh the risks. D.Valerian is a freelance writer interested in items such as prostate cancer treatment 

Preventing Prostate Cancer

In addition, this report discusses the strides made in prostate cancer prevention, and why this cancer in particular should be a target for prevention, rather than treatment. 

Prostate Cancer Treatment Options

Radical prostatectomy is one of the most invasive prostate cancer treatment options. This procedure will remove the prostate and the affected lymph nodes. This is to prevent the spread of cancer cells from reaching other parts 

Prostrate Cancer Awareness Campaign

Many people are now agreed on the need for a broader prostate cancer awareness campaign and images that create more consciousness in the fight against the disease and the against the ignorance about the disease.

New Prostate Cancer Treatment Options Prostate Cancer Support

The most common therapies for prostate cancer are surgical removal of the entire prostate gland, radiation treatment, and hormonal therapy.

Technorati Tags: cancer, care, choices, cure, davinci, diagnosis, non-surgical, options, prostate, prostatectomy, robotic, surgery, treatment, urologist, urology