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New Treatment for Prostate Cancer

Recently, radiation oncologists at Virginia Hospital Center began administering Xofigo®, a new treatment for patients with prostate cancer that has metastasized (spread) to the bones and who have failed other treatments. When prostate cancer metastasized to the bone, it can be very painful for the patient and increase the risk of fractures.

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Treatments for Men's Urological Conditions

Our urologists Robert Mordkin, MD, FACS, Andrew Joel, MD, FACS, Gregory Bernstein, MD, FACS and James H. Masterson, MD of Virginia Hospital Center Physician Group — Urology perform many procedures and surgeries to treat the various urological conditions including benign prostate enlargement (BPH), prostate cancer, testicular cancer, and more. To learn about treatments and procedures, click on the links below:

Benign Prostatic Hypertrophy (BPH)

Half of all men over the age of 50 develop enlarged prostate or BPH, a condition that may cause a slow flow of urine, a frequent need to urinate and a feeling that the bladder never completely empties. As a result, sleep may be disrupted and many men avoid traveling or wearing light pants for fear of embarrassment.

Laser Treatment for Enlarged Prostate

Fortunately, treatment for enlarged prostate has become faster and less invasive with a procedure known as GreenLight PVP (photoselective vaporization of the prostate).

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A camera guided laser fiber is inserted into the urethra and threaded to the prostate, where it’s used to destroy excess tissue. Performed under anesthesia on an outpatient basis, this minimally invasive surgery restores urine flow quickly. GreenLight PVP is just one of many revolutionary procedures available at Virginia Hospital Center. For example, laparoscopic procedures, also known as “ keyhole surgeries,” are now being performed in the treatment of many kidney and prostate tumors. In some cases, laparoscopy is combined with cryoablation, a procedure that uses a thin probe to freeze and kill malignant cells while preserving healthy tissue. The incisions with laparoscopic surgery are small, and patients typically go home within a day or two.

In the best cases, advanced urological treatments restore both urinary function and dignity. For patients with bladder cancer, a new bladder can be formed from a piece of small intestine, replacing the need for an external urinary collection bag, notes Robert Mordkin, MD, formerly an Associate Professor of Urology and Director of Laparoscopic Urology at Georgetown University Hospital.

Now head of Virginia Hospital Center’s state-of-the-art urology program, Dr. Mordkin joined by Andrew Joel, MD, also a former faculty member at Georgetown and fellowship trained in laparoscopic surgery.

Prostate Cancer

Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. One in six American men will develop prostate cancer in the course of his lifetime. A little-known fact is that a man is 33% more likely to develop prostate cancer than an American woman is to get breast cancer.

Laparoscopic Prostatectomy

Laparoscopic Prostatectomy is a cutting-edge, minimally invasive surgery to remove a man's prostate gland. This technique involves five small (5-10 millimeter) incisions, one just below the navel and two each on both sides of the lower abdomen. Carbon dioxide is passed into the abdominal cavity through a small tube placed into the incision below the navel to aid visualization. The surgeon than guides the laparoscope, which transmits a picture of the prostate onto a video monitor. Men who undergo this technique have less blood loss, less need for pain medication, shorter hospital stays, quicker return to regular diet and activities, early removal of urethral catheters, and a quicker recovery.

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Who is a Candidate for the Procedure?
The typical patient is a male age 50+ who has been recently diagnosed with organ-confined prostate cancer (meaning cancer that has not yet spread outside the prostate gland).

To hear more on Laparoscopic Prostatectomy, CLICK HERE.

Robotic Radical Prostatectomy

Men have multiple treatment options to consider when faced with a new diagnosis of organ-confined prostate cancer. Of the surgical options available, the fastest growing and most technologically advanced approach is robotic-assisted laparoscopic radical prostatectomy, also called a “da Vinci prostatectomy with nerve sparing.”

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A da Vinci prostatectomy offers removal of the entire prostate gland while attempting to preserve the nerves, muscles and blood vessels that are required for successful urinary control and erectile function. The da Vinci procedure is unique in comparison to traditional surgery in that it is performed using much smaller incisions, 3-D magnified imagery, and small, highly precise instruments. The surgery is typically completed in less than two hours and requires a general anesthetic. The vast majority of patients will be discharged home after only one night in the hospital. They will all have an internal catheter to drain the bladder for 8 or 9 days postoperatively and most will return to full normal activity within 2 to 3 weeks.

CyberKnife® Treatment for Early Stage Prostate Cancer

The Department of Radiation Oncology at Virginia Hospital Center has performed over 1,600 CyberKnife treatments (including over 300 for prostate cancer) — more than any hospital in Northern Virginia.

A research study conducted by the Department of Radiation Oncology at Virginia Hospital Center examined the quality of life and side effects patients experienced after CyberKnife® treatment for prostate cancer over a three-year period. Published in Radiation Oncology, the findings of the study demonstrate that CyberKnife® treatment produces cancer outcomes equivalent to other treatments, while the acute urinary and sexual side effects are minimal and very well tolerated.

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CyberKnife® treatment is an option for early stage prostate cancer patients that delivers highly accurate doses of radiation to the prostate, minimizing unnecessary radiation and damage to surrounding healthy tissue. A non-invasive, painless radiation treatment, CyberKnife® can be an alternative to open surgery and conventional radiation therapy. For prostate cancer, the CyberKnife® treatment requires just five sessions, scheduled over five consecutive days. Each treatment session takes about 30 to 45 minutes.

“For a patient diagnosed with low- and intermediate-risk, organ-confined prostate cancer Virginia Hospital Center offers several options for treatment including active surveillance, surgery, external beam radiation, brachytherapy (radioactive seed implants) and CyberKnife,” says Nadim Nasr, MD, radiation oncologist. “All have comparable effectiveness in terms of PSA control, but all come with side effects and risks. We work with our patients to help them choose which treatment they feel most comfortable with, given their age, risk levels, and potential side effects.”

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Congratulations to Drs. Mordkin, Joel and Bernstein for being named in Washingtonian’s 2017 TOP DOCTORS!

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