Winning The Fight Against Prostate Cancer: A Patient's Journey

The treatment for prostate cancer has evolved. 

It is not only about treatment but also about caring for the well-being of the patient even after the treatment. With a step-by-step care path, patients with prostate cancer can now enjoy better treatment and support for recovery. In this issue, we also bring you a real-life account of a prostate cancer patient's journey to recovery.

Having prostate cancer can put a strain in a patient's outlook towards life, both physically and emotionally. A patient will be concerned about his change in lifestyle, the treatment and its potential outcomes.

With new advances in medical technology evolving towards minimally invasive methods of treatment, most prostate cancer patients who get appropriate treatment early go on to live active and productive lives. Today, the focus of care has extended beyond just good cancer control, but also managing quality of life issues that come along with the disease and treatment. It is with this aim that Tan Tock Seng Hospital (TTSH) has developed its multi-disciplinary approach of care which provides patients with holistic support to cope with the challenges of being diagnosed with cancer, seeking treatment and to achieve even better outcome in recovery.

Today, the focus of care has extended beyond just good cancer control, but also managing quality of life issues that come along with the disease and treatment. Robotic prostatectomy offers numerous benefits over traditional open surgery, including effective cancer control, shorter hospital stay, significantly lesser pain, lesser blood loss and fewer blood transfusions.

PROSTATE CANCER

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate – the gland that contributes fluid to semen. Although experts do not know exactly what causes prostate cancer, certain risk factors such as being over the age of 65, and family history of prostate cancer can put an individual at a greater risk of developing this disease.

TREATMENT OPTIONS

When prostate cancer is assessed to be localised within the prostate gland, there are essentially three treatment options available to a patient, that is surgical removal of the cancerous prostate (radical prostatectomy), radiation therapy and active surveillance.

It is reassuring to know that prostate cancer is a very treatable condition. Here in TTSH, Urologists will advise on the options available and develop an individualised treatment plan for the patient as well as explain what to expect before, during and after treatment. The appropriate treatment choice depends on many things, such as age, the stage and grade of the cancer, surgical fitness and any other health problems the patient may have.

SURGICAL INTERVENTION

In the case of a surgical removal, the surgery can be performed via an open, laparoscopic or robotic approach. Increasingly, patients are seeking robotic prostatectomy just like in the United States of America.

Robotic prostatectomy is performed with a surgical system, which is designed to provide surgeons with enhanced capabilities, including latest high-definition 3D vision and a magnified view. The system translates the surgeon's hand movements into smaller, more precise movements of tiny instruments inside a patient's body.

Though it is often called a "robot", the system cannot act on its own. Instead, the surgery is performed entirely by a trained surgeon.

The technology allows the surgeon to perform complex procedures through just a few tiny openings. As a result, a patient may be able to get back to his normal activities faster – without the long recovery process that usually follows after an open surgery. For qualified candidates, robotic prostatectomy offers numerous benefits over traditional open surgery, including effective cancer control, shorter hospital stay, significantly lesser pain, lesser blood loss and fewer blood transfusions. This surgery approach has been used successfully worldwide in hundreds of thousands of procedures to date.

A MULTI-DISCIPLINARY APPROACH

Coming to terms with the cancer diagnosis can be a depressing and anxious experience for the patient. Through TTSH's team-based approach with a step-by-step multi-disciplinary care path, we hope to help prostate cancer patients address their concerns and put them at ease.

For example, after the Urologist has discussed treatment options and counselled a patient who wants prostate cancer surgery, a nurse clinician will have a counselling session with the patient to help reinforce his understanding about the surgery and also introduce the importance of Pelvic Floor Exercise as part of post-surgery rehabilitation. A patient information booklet which covers pre-, during and post-operative care is also given to all prostate cancer patients with clear instructions during the counselling session. Implementation of the inpatient care path further reinforces the treatment process so that the prostate cancer patient receives evidence-based clinical care in a timely manner. The result is better treatment outcomes which improve the patients' journey and experience.

Men may not be comfortable talking about their condition and emotions. To give them an outlet to share and get supportfrom people going through prostate cancer treatment, TTSH initiated a prostate cancer support group in 2011.

We believe that the best way of coping with any issues and challenges is to keep the lines of communication open.

CONCLUSION

To get the best outcome out of healthcare services, it is increasingly recognised that a team-care approach provides the synergy to do so. TTSH's experience with prostate cancer treatment and surgery has shown us that a multi-disciplinary approach can help ease patients' anxiety, improve the patients' ability to access appropriate information, and ensure that patients receive the best appropriate treatment at the right time.

Written by Dr Chong Yew Lam (link to profile) 

Dr Chong Yew Lam is the Head and Consultant of the Department of Urology, and Assistant Chairman Medical Board (Clinical Development) at Tan Tock Seng Hospital. Dr Chong completed his fellowship training in Endourology and Minimally Invasive Urologic Oncology at the Thomas Jefferson University Hospital in Philadelphia, USA. His specialty interests are in the application of minimally invasive surgical techniques in the management of urinary stone disease and urologic cancers. 


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