Ihor S. Sawczuk, M.D. PROFESSOR & CHAIRMAN UROLOGY TOURO UNIVERSITY COLLEGE OF MEDICINE ADJUNCT PROFESSOR OF UROLOGY COLLEGE OF PHYSICIANS & SURGEONS.

Ihor S. Sawczuk, M.D.PROFESSOR & CHAIRMAN UROLOGYTOURO UNIVERSITY COLLEGE OF MEDICINEADJUNCT PROFESSOR OF UROLOGYCOLLEGE OF PHYSICIANS & SURGEONSCOLUMBIA UNIVERSITY

Prostate Cancer Treatment: Prostate Cancer Treatment: What’s Best for You?What’s Best for You?

Surgical OptionsSurgical Options

Prostate Cancer - 2009A Common Cancer 234,460 new cases, mortality- 27,350

How Significant Is Prostate Cancer?• In the USA, 234,460 men will be

diagnosed with prostate cancer. – That is one man diagnosed every 3 minutes

• Prostate cancer deaths are estimated at 27,350. – That is one death every 18 minutes

Source: Cancer Facts and Figures - American Cancer Society

External Beam Radiation

New TechnologyCryotherapy Watchful Waiting

Open Surgery

Robotic Surgery

Approach To Prostate Cancer: A Multidisciplinary & Individualized Approach

~ 235,000 New Cases of Prostate Cancer

Prostate Cancer: 2009 Statistics

Watchful Waitingor Other55,000

Radiation (EBRT, Brachy)90,000

Prostatectomy90,000

Prostate Cancer: Active Surveillance

Quality of Life: Continence / Erectile Dysfunction

Molecular-Based: Imaging / Staging / Analysis

SURGERY INSURGERY INTHE NEWTHE NEW

MILLENNIUMMILLENNIUM

ROBOTROBOTASSISTEDASSISTEDSURGERYSURGERY

SURGERY INSURGERY INTHE NEWTHE NEW

MILLENNIUMMILLENNIUM

FDA FDA APPROVED APPROVED INTUITIVE’SINTUITIVE’SDA VINCIDA VINCISURGICALSURGICALROBOTROBOT

~ 90,000 Radical Prostatectomies/Year

U.S. Radical Prostatectomy Market

39.5%

0.5%

60%

24.5%

75%

0.5%

2008 2009 Projected

Open

Robotic

Laparoscopic

39.5%

60%

• Stereoscopic 3-D vision

• 75% better resolution

• Endowrist technology

• Six degrees of freedom

• Tremor filtering

• Movement scaling

DA VINCI™ SYSTEM: ADVANTAGES

Surgeon and Patient Positioning

ULTRASOUND GUIDED ULTRASOUND GUIDED CRYOABLATIONCRYOABLATION

FOCAL / WHOLE GLAND

Clinical Trials: Novel TechnologyClinical Trials: Novel Technology

TEAM Members Beyond Physicians

Social Worker

NurseAssistivePersonnel

Patient and Family

Clinical Research Associate

Important OthersSpecialists

Physician

Helps patients navigate through healthcare system

Source: Crighton, Frances, RN. “Management Strategies for Prostate Cancer Patients – The Role of Allied Health Professionals.” Slide 4. Presented July 27, 2006.