Robotic Prostatectomy Surgery and Robotic Radiosurgery – What’s the Difference?

There’s a lot of buzz about robotics in all areas of medicine. Couple that with new advances and the ever changing world of branded medical tools and procedures and there’s bound to be confusion about what’s what. As we continue to read more about Prostate Cancer Awareness month, I want to offer some clarity on two similarly named, though vastly different, prostate cancer treatment options – robotic prostatectomy surgery and robotic radiosurgery.

First, robotic radical prostatectomy involves the use of surgeon-guided micro-surgical instruments and high-resolution cameras to aid in the non-invasive removal of the cancerous prostate. I believe this technique gives me, and my patients, the best of both worlds. I can draw on my vast traditional and laparoscopic surgical experience and marry it with the technological advantages of the robot – enhanced vision, precise dexterity and full mobility – to remove the prostate with as little trauma to the patient as possible. In doing so, my patients achieve a 97% cure rate.

What’s more, I have the benefit of getting in there and really seeing what’s going on with the cancer. Unfortunately, pre-surgery cancer staging tests don’t really tell the whole story. Many times, we biopsy a cancerous prostate after surgery and find out that the cancer was actually far more advanced than earlier testing indicated. Without surgery, I might never know this and a patient might choose a less aggressive, less complete form of treatment.

Robotic radiosurgery, on the other hand, involves no cutting and is not surgery – it is radiation.

Branded as CyberKnife by Accuray, a radiation oncology company, radiosurgery is an FDA-approved treatment that involves a series of 1-5 procedures on different days. Also non-invasive, it targets radiation at the cancerous tissue and is believed to spare the non-cancerous surrounding tissue. One prostate cancer study involving radiosurgery patients indicated a promising 93 percent non-recurrence rate after 5 years; however, data is very limited for this relatively new procedure.

There are two things I’d like to caution you about with regard to radiosurgery. One, this procedure uses the data from CT scans to target the right location, size and shape of the prostate cancer. As I said earlier, pre-surgery cancer testing has limitations. Two, and this is important for all types of radiation, a patient’s ability to have prostatectomy surgery after radiation is severely limited. Of course the hope is that the cancer never returns, but if it does, radiation patients will require either more radiation or alternative treatments. The peace of mind that comes from a robotic radical prostatectomy will likely not be an option.