According to the CDC, aside from non-melanoma skin cancer, prostate cancer is the most common cancer among men in the United States. It is also one of the leading causes of cancer death among men of all races and Hispanic origin populations.
In this segment, Khurshid Guru, MD., explains how each Roswell Park Comprehensive Cancer Center patient receives a customized treatment and post-treatment plan; and ongoing communication between Roswell Park and the patient's primary care physician continues long after treatment ends. This is why Roswell Park Comprehensive Cancer Center is the best choice for prostate cancer treatment.
Selected Podcast
The Latest Advances in Prostate Cancer Treatment
Featured Speaker:
Learn more about Khurshid Guru, MD
Khurshid Guru, MD
Khurshid Guru, MD, was appointed Director of Robotic Surgery at Roswell Park Comprehensive Cancer Center in October 2005. Dr. Guru completed his residency training in Urologic Surgery (2005) and a Robotic Surgery Fellowship (2004) at the Vattikuti Urology Institute, Henry Ford Health System, MI.Learn more about Khurshid Guru, MD
Transcription:
The Latest Advances in Prostate Cancer Treatment
Bill Klaproth (Host): According to the American Cancer Institute, prostate cancer is the third leading cause of cancer death in American men behind lung cancer and colorectal cancer. However, the good news is, with the proper early detection, care and treatment, most men diagnosed with prostate cancer don’t die from it, and here to tell us more is Dr. Khurshid Guru, Chair, Department of Urology and the Director of Robotic Surgery at Roswell Park Comprehensive Cancer Center. Dr. Guru, thank you for your time. So, let's start with this. What are the prostate cancer risk factors for men?
Dr. Khurshid Guru, MD (Guest): So, thanks for having us, Bill. Well, you know, prostate cancer is a little different from other cancers where there are common risk factors here. There have been multiple studies which have been conducted on risk factors. Some studies – there is no exact cause for this which has been identified clearly. There are some studies which looked at, you know, saturated fats, eating, diet, dietary habits, but there is nothing exactly known for this kind of a causative risk factor.
Bill: And what about hereditary makeup? Does that have anything…
Dr. Guru: Yes.
Bill: …to do with it?
Dr. Guru: There is definitely a component of that, and that’s kind of an interplay when we talk about patients and their family histories, and we have to kind of keep it in our mind when we are dealing with this. Yes, there is a component for that.
Bill: And can you tell us about the importance of screening and early detection?
Dr. Guru: Oh, this is kind of the name of the whole thing about prostate cancer and for, you know, for any cancer, but especially for prostate, because if you screen early and detect early, the options are multiple, and you know, in a lot of cancers, we do not have a lot of options, and they're limited. But in prostate cancer, if you're detected early and you know, you have kind of done everything timely, your options are multiple, and they kind of can still make you, you know, live your quality of life and the full extent of your – everything intact with a few bumps ahead and there in the road, but you are able to do everything you want and with a full life expectancy, but the condition is that you detect things early, and you kind of pick things, and you follow through on things. For example, we have like active surveillance where we watch patients, and we don’t have to do anything, and they still have their full quality of life. We have radical prostatectomy which kind of has tremendously kind of improved over the last few decades, and the results are very good.
We also have radiation which has kind of improved over the years, and the technology has gotten better. So the side effects have become less and less. So, these options, all these options – and even for metastatic disease, there are good medications out there. So, we are able to kind of fight this cancer well, and give our patients a better chance of living their life the way they should.
Bill: Well, that is very good news, and what symptoms should men be on the look out for?
Dr. Guru: Well, because this is a cancer which should be detected early on, I think one of the most important things is screening, and the problem with having symptoms is that it either indicates that there's advanced disease if it's related to cancer, or you have common outliers which are like regular benign enlargement of prostate which is a normal thing with aging. So, people have these symptoms, and they’re more related to kind of benign aging, but I think there is no bigger symptoms. You know, years ago, symptoms were a big issue. Now, we detect a lot of these things with screening which is like the PSA screening.
Bill: So, very important, and you mentioned radical prostatectomy before. Can you tell us more about the robotic surgery for radical prostatectomy at Roswell Park Cancer Institute?
Dr. Guru: Sure, I mean, you know, it is obviously one of the key options in treatment of local prostate cancer, which is localized, and the ideal thing is that surgery comes in with a few side effects which are very, very important in quality of life for patients. One is urinary incontinence and second is sexual dysfunction. So, when you remove the prostate, the nerves for sexual function are very close to the prostate, and the nerves and the function of the urinary sphincter lie in approximation of both the bladder as well. As the sphincter being next to the prostate, it is very important that they are preserved well, and the surgery’s very delicate and done well for us to kind of regain these functions of urinary control as well as sexual function. So, for that purpose, in the last 12 years, we have at Roswell Park engaged in delivering a robot-assisted approach to prostate surgery. This approach has really, really kind of made a difference because, you know, you can see narrow spaces, and you can dissect tissue with the kind of precision and are very delicate in saving the nerves and also preserving urinary function. So, this is a big improvement over probably 10, 15 years back.
Bill: So, it sounds like the radical prostatectomy is a very effective way to treat prostate cancer.
Dr. Guru: Yes. It is one of the good – one of the very good options we have.
Bill: And can you tell us about the survival rates and outcomes at Roswell Park Cancer Institute?
Dr. Guru: Well, survivor outcomes are excellent. We basically measure in above the national averages, and we have, for localized cancers, our outcomes are as good. In fact, we are soon going to come out with our Roswell’s Outcome book, which will also include the prostatectomy outcomes, and they are definitely excellent, and you can see that by stage by stage.
Bill: And we hear a lot about clinical trials all the time. How important is it for people to participate in clinical trials?
Dr. Guru: It's very important. The reason it's very important, Bill, is because at the end of the day, treating cancer is not just one option. Treating cancer is multiple options. From active surveillance, especially in the case of prostate cancer, to all the way advanced cancers of the prostate which are aggressive, and they’re sometimes, you know, very aggressive that they need multiple treatments, and they can spread, and we need treatments which are, you know, only available in dedicated cancer institutes or institutes which have the capability of doing clinical trials, and clinical trials take something which has not become yet the standard of care, but, you know, provide new opportunities for these patients, but also have them under a keen observation and very stringent guidelines to make sure that we, you know, to make sure that it is safe for the patients and the results and monitor and the patients get the best out of it while we also are advancing science and trying newer things. These are only available for us in certain settings, and Roswell is one of those settings where national cancer clinical trials are available here, and we are one of the few centers in the country which has almost every trial opportunity – to open a trial and do it well – and we have the team, and we have researchers, and we have, you know, kind of the support to deliver this kind of care for patients, and it's very important for overall care of patients with prostate cancer.
Bill: And, Dr. Guru, could you talk just a little bit more about that when it comes to prostate care and surgery – what sets Roswell Park Cancer Institute apart?
Dr. Guru: Well, so, Bill, the most important thing in surgery anymore is not just the surgeon. I think it's the team. It’s the place you get it done. It’s the support you have and if you look at Roswell, over 12 years, we have become a major robotic surgery institute where we have delivered cutting-edge, novel techniques. We have been the leaders in training people from all over the world. Our guidelines are accepted across the globe, and our patient outcomes are very, very good in this term. So, if you have to go to a place where there is a need for surgery, you want to go to a place where the surgeons are experts, the nursing and the support team has done this for a long time, and they're able to support you, and they're able to do what kind – if you want them to do for you – where they, as a team together, make the best results for you. That’s one aspect of it.
The second aspect of it is also that cancer, as you know, goes through phases, and sometimes, localized therapy-like surgery doesn’t work out, and then you need other options, and for that other option, if you have a team which kind of can work with their colleagues at Roswell who basically are under one roof, offering the whole gamut from active surveillance to advanced treatment, it's easier for the patient to have care and communication, support, resources at one place.
Bill: Well, Dr. Guru, the team aspect sounds so important in the fight against prostate cancer, and it sounds like you're making critical advances in the fight against prostate cancer. Thank you so much for your time today and talking with us. For more information, you can visit roswellpark.org. That's roswellpark.org. You're listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I'm Bill Klaproth. Thanks for listening.
The Latest Advances in Prostate Cancer Treatment
Bill Klaproth (Host): According to the American Cancer Institute, prostate cancer is the third leading cause of cancer death in American men behind lung cancer and colorectal cancer. However, the good news is, with the proper early detection, care and treatment, most men diagnosed with prostate cancer don’t die from it, and here to tell us more is Dr. Khurshid Guru, Chair, Department of Urology and the Director of Robotic Surgery at Roswell Park Comprehensive Cancer Center. Dr. Guru, thank you for your time. So, let's start with this. What are the prostate cancer risk factors for men?
Dr. Khurshid Guru, MD (Guest): So, thanks for having us, Bill. Well, you know, prostate cancer is a little different from other cancers where there are common risk factors here. There have been multiple studies which have been conducted on risk factors. Some studies – there is no exact cause for this which has been identified clearly. There are some studies which looked at, you know, saturated fats, eating, diet, dietary habits, but there is nothing exactly known for this kind of a causative risk factor.
Bill: And what about hereditary makeup? Does that have anything…
Dr. Guru: Yes.
Bill: …to do with it?
Dr. Guru: There is definitely a component of that, and that’s kind of an interplay when we talk about patients and their family histories, and we have to kind of keep it in our mind when we are dealing with this. Yes, there is a component for that.
Bill: And can you tell us about the importance of screening and early detection?
Dr. Guru: Oh, this is kind of the name of the whole thing about prostate cancer and for, you know, for any cancer, but especially for prostate, because if you screen early and detect early, the options are multiple, and you know, in a lot of cancers, we do not have a lot of options, and they're limited. But in prostate cancer, if you're detected early and you know, you have kind of done everything timely, your options are multiple, and they kind of can still make you, you know, live your quality of life and the full extent of your – everything intact with a few bumps ahead and there in the road, but you are able to do everything you want and with a full life expectancy, but the condition is that you detect things early, and you kind of pick things, and you follow through on things. For example, we have like active surveillance where we watch patients, and we don’t have to do anything, and they still have their full quality of life. We have radical prostatectomy which kind of has tremendously kind of improved over the last few decades, and the results are very good.
We also have radiation which has kind of improved over the years, and the technology has gotten better. So the side effects have become less and less. So, these options, all these options – and even for metastatic disease, there are good medications out there. So, we are able to kind of fight this cancer well, and give our patients a better chance of living their life the way they should.
Bill: Well, that is very good news, and what symptoms should men be on the look out for?
Dr. Guru: Well, because this is a cancer which should be detected early on, I think one of the most important things is screening, and the problem with having symptoms is that it either indicates that there's advanced disease if it's related to cancer, or you have common outliers which are like regular benign enlargement of prostate which is a normal thing with aging. So, people have these symptoms, and they’re more related to kind of benign aging, but I think there is no bigger symptoms. You know, years ago, symptoms were a big issue. Now, we detect a lot of these things with screening which is like the PSA screening.
Bill: So, very important, and you mentioned radical prostatectomy before. Can you tell us more about the robotic surgery for radical prostatectomy at Roswell Park Cancer Institute?
Dr. Guru: Sure, I mean, you know, it is obviously one of the key options in treatment of local prostate cancer, which is localized, and the ideal thing is that surgery comes in with a few side effects which are very, very important in quality of life for patients. One is urinary incontinence and second is sexual dysfunction. So, when you remove the prostate, the nerves for sexual function are very close to the prostate, and the nerves and the function of the urinary sphincter lie in approximation of both the bladder as well. As the sphincter being next to the prostate, it is very important that they are preserved well, and the surgery’s very delicate and done well for us to kind of regain these functions of urinary control as well as sexual function. So, for that purpose, in the last 12 years, we have at Roswell Park engaged in delivering a robot-assisted approach to prostate surgery. This approach has really, really kind of made a difference because, you know, you can see narrow spaces, and you can dissect tissue with the kind of precision and are very delicate in saving the nerves and also preserving urinary function. So, this is a big improvement over probably 10, 15 years back.
Bill: So, it sounds like the radical prostatectomy is a very effective way to treat prostate cancer.
Dr. Guru: Yes. It is one of the good – one of the very good options we have.
Bill: And can you tell us about the survival rates and outcomes at Roswell Park Cancer Institute?
Dr. Guru: Well, survivor outcomes are excellent. We basically measure in above the national averages, and we have, for localized cancers, our outcomes are as good. In fact, we are soon going to come out with our Roswell’s Outcome book, which will also include the prostatectomy outcomes, and they are definitely excellent, and you can see that by stage by stage.
Bill: And we hear a lot about clinical trials all the time. How important is it for people to participate in clinical trials?
Dr. Guru: It's very important. The reason it's very important, Bill, is because at the end of the day, treating cancer is not just one option. Treating cancer is multiple options. From active surveillance, especially in the case of prostate cancer, to all the way advanced cancers of the prostate which are aggressive, and they’re sometimes, you know, very aggressive that they need multiple treatments, and they can spread, and we need treatments which are, you know, only available in dedicated cancer institutes or institutes which have the capability of doing clinical trials, and clinical trials take something which has not become yet the standard of care, but, you know, provide new opportunities for these patients, but also have them under a keen observation and very stringent guidelines to make sure that we, you know, to make sure that it is safe for the patients and the results and monitor and the patients get the best out of it while we also are advancing science and trying newer things. These are only available for us in certain settings, and Roswell is one of those settings where national cancer clinical trials are available here, and we are one of the few centers in the country which has almost every trial opportunity – to open a trial and do it well – and we have the team, and we have researchers, and we have, you know, kind of the support to deliver this kind of care for patients, and it's very important for overall care of patients with prostate cancer.
Bill: And, Dr. Guru, could you talk just a little bit more about that when it comes to prostate care and surgery – what sets Roswell Park Cancer Institute apart?
Dr. Guru: Well, so, Bill, the most important thing in surgery anymore is not just the surgeon. I think it's the team. It’s the place you get it done. It’s the support you have and if you look at Roswell, over 12 years, we have become a major robotic surgery institute where we have delivered cutting-edge, novel techniques. We have been the leaders in training people from all over the world. Our guidelines are accepted across the globe, and our patient outcomes are very, very good in this term. So, if you have to go to a place where there is a need for surgery, you want to go to a place where the surgeons are experts, the nursing and the support team has done this for a long time, and they're able to support you, and they're able to do what kind – if you want them to do for you – where they, as a team together, make the best results for you. That’s one aspect of it.
The second aspect of it is also that cancer, as you know, goes through phases, and sometimes, localized therapy-like surgery doesn’t work out, and then you need other options, and for that other option, if you have a team which kind of can work with their colleagues at Roswell who basically are under one roof, offering the whole gamut from active surveillance to advanced treatment, it's easier for the patient to have care and communication, support, resources at one place.
Bill: Well, Dr. Guru, the team aspect sounds so important in the fight against prostate cancer, and it sounds like you're making critical advances in the fight against prostate cancer. Thank you so much for your time today and talking with us. For more information, you can visit roswellpark.org. That's roswellpark.org. You're listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I'm Bill Klaproth. Thanks for listening.