Paul Wright didn’t have any of the usual symptoms of an enlarged prostate, which can signal prostate cancer. Fortunately, his doctor detected an elevated PSA, or prostate specific antigen, level in his blood during his annual physical examination, and referred him to Dr. Mark Kellerman, who performed a prostatectomy on Nov. 17.

Now, nearly nine months after surgery, the 58-year-old Des Moines resident is optimistic a blood test later this month will show he remains cancer-free.

Prostate cancer, the second-leading cause of cancer deaths in men, will become more common as the Baby Boomer generation ages. Fortunately, the potential for early detection and successful treatment for this type of cancer have improved dramatically as well, say doctors.

The number of men diagnosed with prostate cancer in the United States is expected to increase by 40 percent over the next 10 years, from approximately 230,000 cases a year to more than 300,000. Furthermore, it’s predicted that the number of deaths from prostate cancer could rise from 30,000 to 50,000 per year.

The earlier prostate cancer is diagnosed, the greater the chances for recovery. And for those who require surgery, a robotically assisted procedure available at Iowa Methodist Medical Center is making recovery easier, said Kellerman, a urologist with the Iowa Clinic.

Kellerman and another Iowa Clinic surgeon, Dr. Richard Glowacki, have performed a total of 20 prostatectomies over the past 10 months, Wright’s among them, using the million-dollar da Vinci robot at Iowa Methodist. The robot, acquired by Iowa Health in 2004 and also used for cardiac surgery, provides the surgeon with a magnified, three-dimensional view of inside the body. It also has “wristed” instruments that can mimic the surgeon’s precise hand and wrist movements as he operates on delicate tissues.

“I think the da Vinci system in particular is allowing surgeons to perform operations like this with more ease and with more precision,” Kellerman said. “The average blood loss for the robotic surgery is one-sixth to one-seventh of a regular surgery, and we’ve had no transfusions needed for the ones we’ve done so far. We’re also able, because of the excellent visualization, to do a better job of splicing out the nerves to prevent urinary incontinence.”

Another advantage over conventional surgery is that approximately 75 percent of patients operated on with the robotic system can leave the hospital the next day, compared to an average three-night stay for those undergoing conventional surgery.

Because a prostatectomy is a delicate and complex procedure, using laparoscopic techniques with hand-held instruments is tricky, and the two-dimensional view that’s projected onto a screen is limited. In some parts of the country, the use of robotic surgery has already become the standard for prostate surgery, Kellerman said.

“The traditional open surgery has some advantages, but for my patients, if I’m going to take out the prostate, this is how I do it,” he said.

Though Iowa Health currently has the only such robotic capability for prostate surgery in Central Iowa, Mercy Medical Center – Des Moines is considering acquiring a system such as the da Vinci for both urological and cardiac procedures, said Kay Matthews, Mercy’s administrator of perioperative services.

The need for prostate screening can begin as early as age 40.

“We encourage all men to be screened at age 45,” said Dr. Jay Rosenberger, a physician with Iowa Health Physicians and Clinics. “However, for men who have a family history of prostate cancer or who are at high risk such as African American men, we recommend they get screened at age 40. Establishing a PSA baseline and monitoring any changes annually is the best way to ‘know your PSA’ and have the information to manage your health.”

SUPPORT GROUP MEETS MONTHLY

A support group for men who have been diagnosed with prostate cancer, as well as those who have had prostate surgery, meets monthly at the John Stoddard Cancer Center on the Iowa Methodist Medical Center campus.

The group, called “Us Too,” regularly has about 20 to 25 attendees, said Kathy Hunnicutt, the cancer center’s outreach coordinator.

“A lot of times support groups are aimed toward women, but men also need support for themselves and their families,” said Hunnicutt. One of about 300 chapters worldwide, the support group has provided speakers, information and counseling to prostate cancer survivors for the past 13 years.

The group meets the fourth Tuesday of each month at 5:30 p.m. in the fourth floor conference room of the cancer center. The next meeting is scheduled for Tuesday, Sept. 27. For more information, visit www.ustoo.org, or www.johnstoddardcancer.org.