Dr. Tewari on the Factors to Consider for Robotic Radical Prostatectomy in Prostate Cancer

Ashutosh K. Tewari, MD, chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine, director, Department of Urology, Mount Sinai, discusses the factors to consider when deciding on a robotic radical prostatectomy​ for a patient with prostate cancer.

When considering a radical prostatectomy for patients with prostate cancer, factors relating to the tumor, surgery, and the patient all impact the decision, Tewari says. An ideal candidate for surgery would be a patient whose cancer is intermediate or high risk, yet still confined to the prostate, Tewari adds. The tumor’s location relative to surrounding nerves needs to be considered, Tewari notes. Cancer located near nerves adds more risk to surgery since the nerves around the prostate control erectile function, Tewari explains. Muscles around the prostate control urinary function, and those muscles should not be involved with the cancer if considering surgery, Tewari says.

Regarding patient-related factors, time of cancer discovery, advancement of disease, and location of the tumor need to be considered, Tewari continues. A patient’s physical fitness could also play a role, since the amount fatty tissue surrounding the area could impact the surgical outcome, Tewari adds.

Overall, these factors all impact surgical outcomes, and they must be addressed when making a decision with a patient, Tewari concludes.