Ashutosh K. Tewari, MD, chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine, director, Department of Urology, Mount Sinai, discusses the factors to consider when deciding on a robotic radical prostatectomy​ for a patient with prostate cancer.

When considering a radical prostatectomy for patients with prostate cancer, factors relating to the tumor, surgery, and the patient all impact the decision, Tewari says. An ideal candidate for surgery would be a patient whose cancer is intermediate or high risk, yet still confined to the prostate, Tewari adds. The tumor’s location relative to surrounding nerves needs to be considered, Tewari notes. Cancer located near nerves adds more risk to surgery since the nerves around the prostate control erectile function, Tewari explains. Muscles around the prostate control urinary function, and those muscles should not be involved with the cancer if considering surgery, Tewari says.

Regarding patient-related factors, time of cancer discovery, advancement of disease, and location of the tumor need to be considered, Tewari continues. A patient’s physical fitness could also play a role, since the amount fatty tissue surrounding the area could impact the surgical outcome, Tewari adds.

Overall, these factors all impact surgical outcomes, and they must be addressed when making a decision with a patient, Tewari concludes.

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Ashutosh K. Tewari, MD, discusses the factors to consider when deciding on a robotic radical prostatectomy​ for a patient with prostate cancer.

Dr. Tewari on the Factors to Consider for Robotic Radical Prostatectomy in Prostate Cancer

Ashutosh K. Tewari, MD, chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine, director, Department of Urology, Mount Sinai, discusses the benefits of robotic radical prostatectom​y in prostate cancer.

Robotic radical prostatectomies allow for a minimally invasive, cosmetically favorable surgical treatment for patients with prostate cancer, Tewari says. The approach is associated with minimal pain, less bleeding, and a faster recovery time compared with traditional radical prostatectomy, Tewari explains. Moreover, the robotic approach provides additional magnification during the procedure, which allows for a more precise procedure that delicatelyhandles nerves, Tewari says. In turn, patients have a better chance of preserving sexual function and urinary control, Tewari adds.

Ultimately, the benefits of robotic radical prostatectomy include early recovery, less pain, less bleeding, improved cancer control, and improved bodily function recovery, Tewari concludes.

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Ashutosh K. Tewari, MD, discusses the benefits of robotic radical prostatectom​y in prostate cancer. 


Dr. Tewari on the Benefits of Robotic Radical Prostatectom​y​ in Prostate Cancer 

Ashutosh K. Tewari, MD, chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine, director, Department of Urology, Mount Sinai, discusses some of the key differences between racial subgroups in prostate cancer.

In Black men, prostate cancer tends to be more metastasized compared with other racial groups, says Tewari. However, this disease presentation may lend some leverageable characteristics with regard to therapeutic strategies, Tewari explains.

For example, because Black men tend to have more immunologically inflamed disease, vaccines and immunotherapy may be more beneficial treatment options in this population vs other racial groups, Tewari says. Additionally, certain enzymes responsible for DNA damage repair tend to be more present in some men vs others and could be targeted by agents, such as PARP inhibitors.

As such, identifying unique disease characteristics in Black men with prostate cancer could provide critical insight into optimizing therapeutic opportunities, concludes Tewari.

Ashutosh K. Tewari, MD, discusses some of the key differences between racial subgroups in prostate cancer.  



Dr. Tewari on Key Differences Between Racial Subgroups in Prostate Cancer 

Ashutosh K. Tewari, MD, chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine, director, Department of Urology, Mount Sinai, discusses the hallmarks of cancer among Black men with prostate cancer.

Cancer cells can overcome normal growth control mechanisms and demonstrate constitutive proliferation, Tewari explains. Although all prostate cancer cells do this, the mechanisms by which cells overcome normal growth mechanisms may differ between racial groups, Tewari says.

Similarly, other hallmarks of cancer, such as invasive disease properties, metabolic reprogramming, and metastasis, may vary between Black men and other racial groups, Tewari explains. Tumor energy management is also different because Black men with prostate cancer may have more vessel–dense tumors with inflammation, which can result in aggressive cancers, concludes Tewari.

Ashutosh K. Tewari, MD, discusses the hallmarks of cancer among Black men with prostate cancer.  



Dr. Tewari on the Hallmarks of Cancer in Black Men With Prostate Cancer 

Ashutosh K. Tewari, MD, chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine, director, Department of Urology, Mount Sinai, discusses the potential benefits of a mobile MRI unit in prostate cancer.

To bridge the gap in racial disparities in prostate cancer, education, development of trust, and implementation of state-of-the-art clinical investigations and therapeutic interventions are needed, says Tewari.

In February 2021, the Milton and Carroll Petrie Department of Urology at Mount Sinai received a $3.8 million donation from Robert F. Smith to launch the Robert F. Smith Mobile MRI Unit to support African American patients with prostate cancer, explains Tewari. The mobile unit allows providers to bring MRI technology to local hospitals, clinics, and churches to streamline prostate cancer screening, detection, and management in this patient population, concludes Tewari.

Ashutosh K. Tewari, MD, director, Department of Urology, Mount Sinai, discusses the potential benefits of a mobile MRI unit in prostate cancer.  



Ashutosh K. Tewari, MD

Articles

Dr. Tewari on the Factors to Consider for Robotic Radical Prostatectomy in Prostate Cancer

Dr. Tewari on the Benefits of Robotic Radical Prostatectomy in Prostate Cancer

Dr. Tewari on Key Differences Between Racial Subgroups in Prostate Cancer

Dr. Tewari on the Hallmarks of Cancer in Black Men With Prostate Cancer

Dr. Tewari on the Potential Benefits of a Mobile MRI Unit in Prostate Cancer

Ashutosh K. Tewari, MD

Articles

Dr. Tewari on the Factors to Consider for Robotic Radical Prostatectomy in Prostate Cancer

Dr. Tewari on the Benefits of Robotic Radical Prostatectom​y​ in Prostate Cancer

Dr. Tewari on Key Differences Between Racial Subgroups in Prostate Cancer

Dr. Tewari on the Hallmarks of Cancer in Black Men With Prostate Cancer

Dr. Tewari on the Potential Benefits of a Mobile MRI Unit in Prostate Cancer

Dr. Tewari on the Benefits of Robotic Radical Prostatectomy in Prostate Cancer