Santa Cruz urologist is among the most recently trained in new technique

The “gold standard” for curative prostate cancer therapy in the United States may be replaced by a new, minimally invasive laparoscopic procedure.
“Prostate cancer is surgically curable when it is caught early,” said Steven Roberts, M.D., a Santa Cruz Medical Clinic urologist. “I believe we get better results with the new laparoscopic technique (laparoscopic radical prostatectomy) because our field of vision is magnified and we can be more precise.“
Following the lead of European doctors, specially trained American urologists are extolling the post-operative benefits for patients, which include equally good preservation of potency and urine control. Other plusses are less pain and blood loss, a quicker recovery and wearing a catheter for a shorter time.
This approach is supplanting “surgery that required men to wear a catheter post-surgically for up to two to three weeks. Besides being uncomfortable, the catheter interfered with their return to normal activity,” Dr. Roberts said.

One Man’s Experience

The third recipient of this laparoscopic technique in Santa Cruz County was Aptos resident Kenneth Files, 57, a heavy truck mechanic for Pacific Gas and Electric for 32 years.
After experiencing rising PSA levels since 1999, Files had a needle biopsy of the prostate gland that came back positive for cancer in November of 2002. His urologist, Elizabeth Newsom, M.D., outlined his choices, mentioning the laparoscopic option and Dr. Roberts’ expertise. He chose this newest technique and underwent surgery on January 13.
“I’m the type of patient who has to coach myself to get through a blood test,” he said, “but the surgery was a non-event. I never had any pain due to the surgery.”
He described a 1 ¼-inch incision below his naval and 4 tiny cuts like paper cuts in his abdomen, all of which were healed within a few weeks. “There was nothing to it,” Files said. “Both Dr. Newsom and Dr. Roberts have a really great bedside manner, Sutter Maternity and Surgery Center is only 20 minutes from home, my wife stayed overnight at the hospital and I was walking a mile within 10 or 12 days.”
He is “extremely pleased” and his prognosis is good.

High Incidence of Prostate Cancer

Prostate cancer has surpassed lung cancer as the number one cancer diagnosis in men, and is the second most common cause of death from any kind of cancer. About 30,000 American men die of prostate cancer every year.
“Prostate cancer can develop without any symptoms and is curable only when it hasn’t spread to other organs, so all men should be examined yearly once they’ve reached age 50,” Dr. Roberts emphasized. “The incidence of prostate cancer is higher in African-American men and men whose family members have had it, so they should get checked earlier.” Screening involves the PSA (prostate-specific antigen) blood test and a digital rectal exam.
The only other curative therapy for prostate cancer is radiation therapy. Brachytherapy, a type of radiation therapy, involves implantation of radiation seeds in the prostate. Urologists team up with a radiation oncologist to perform this procedure.
Removal of cancerous tumors in the kidneys (nephrectomy) is another new urological use for the laparoscopic technique. Dr. Roberts performed one of the first such surgeries in Santa Cruz County in February.
“We advanced from a big, long flank incision that made recovery very painful and necessitated a week-long hospitalization to three small incisions with less post-operative pain, quicker recovery and only a one- to two-day hospital stay,” he explained.
Only urologists who have received training in these laparoscopic techniques are qualified to perform such procedures.

Board certified urologists, Dr. Roberts and Dr. Newsom offer a full spectrum of urologic care including lithotripsy for kidney stones (see Kidney Stone Buster Now at Sutter Maternity & Surgery Center), thermal therapy for benign prostatic enlargement, erectile dysfunction and minimally invasive surgery for incontinence.

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