Dr. Chang on the Evolution of Surgical Techniques in Prostate Cancer

Sam S. Chang, MD, MBA, professor, Department of Urology, Patricia and Rodes Hart Endowed Chair of Urologic Surgery, Vanderbilt University Medical Center, discusses the evolution of surgical techniques in prostate cancer.

In prostate cancer, surgery has shifted toward the use of robotic approaches. Now, the question is whether the field should focus on focal therapy versus continued whole-gland treatment, such as whole-gland radiation or radical prostatectomy, says Chang. If oncologic outcomes are the same with less-invasive focal therapies, patients could be spared unnecessary adverse events.

In terms of surgical radical prostatectomy, subtle changes have been made, such as using a single port. There is also a move toward retzius-sparing surgery, which is done in an attempt to improve continence rates, explains Chang. The procedure has resulted in encouraging results with regard to early urinary control and early continence. Moreover, these changes have the potential to improve quality of life, concludes Chang.