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    The Art of High Tech Healing

    Eisenhower’s First da Vinci Prostatectomy Patient Shares His Story

    While approximately one in six men will be diagnosed with prostate cancer, only one in 35 will die of the disease—less than three percent. The overall five-year survival rate for prostate cancer is virtually 100 percent. After 10 years it is 92 percent, and the 15-year survival rate is 70 percent. Advances in screening and treatment techniques have resulted in prostate cancer being detected early—when the cancer is still localized and has not spread beyond the prostate gland—and treated effectively.

    Prostate cancer does not usually produce noticeable symptoms in its early stages, so early detection happens thanks to effective screening. For most men, prostate cancer is first detected during a routine screening such as a prostate-specific antigen (PSA) test or a digital rectal exam.

    That was the case for Indio resident Alfonso Alejandre, 62, a retired agricultural worker who has lived in the Coachella Valley for more than 20 years. Alfonso had the PSA screening, which is a simple blood test, during a check-up with his primary care physician. The test reading was high, and Alfonso’s physician referred him to a local urologist.

    “I did some research and spoke to friends in the community, and they recommended I call Eisenhower,” Alfonso says. “I was very lucky, because I was referred to Dr.Walsh.”

    Lance Walsh, MD is a urologist at the Arnold Palmer Prostate Center at the Eisenhower Lucy Curci Center. After examining Alfonso and running additional tests, Dr.Walsh scheduled a biopsy of Alfonso’s prostate gland. The biopsy was abnormal—Alfonso needed to be treated for prostate cancer. He was immediately assigned to a team that included not only Dr.Walsh, but also medical oncologists and radiation oncologists, to determine the best course of treatment.

    Dr.Walsh specializes in minimally-invasive surgical approaches to treating prostate cancer. “If a patient’s biopsy shows cancer, our next step is to determine whether it is localized within the prostate,” says Dr. Walsh. “If it appears that the cancer has not spread, then the patient is a good candidate for one of the new, minimally invasive procedures we offer at Eisenhower.”

    Dr.Walsh determined that Alfonso’s cancer had not spread, and that surgical removal of the prostate gland —a prostatectomy—was the best option. “Our approach depends on several factors in addition to the size and location of the tumor,” Dr.Walsh explains.“How old is the patient, is he otherwise healthy, is he cleared for surgery by a cardiologist? Alfonso is only 62. And except for back pain, he had no other health issues. Since his tumor was contained within the prostate, he was a perfect candidate for surgery.”

    Alfonso did not know it at the time, but he became an Eisenhower pioneer, the first patient to receive a prostatectomy utilizing the Arnold Palmer Prostate Center’s new daVinci® Surgical System.

    [PHOTO dir="assets/news/story/Spring2009Pg38.JPG" align="Center" caption="Lance Walsh, MD at the daVinci console just prior to Alejandre’s surgery." width="585"]

    “We are the only facility in the Coachella Valley that offers the daVinci procedure,” says Dr.Walsh. “For patients, it means a shorter hospital stay, less pain, less risk of infection, less scarring and fewer side effects. Because the procedure minimizes any impact on the healthy tissues that surround the prostate, using the daVinci usually means a much faster recovery and a quicker return to normal activities.”

    “I have used the daVinci in private practice, but was very excited to launch the technology here at Eisenhower, where it is accessible to many more patients.”
    —Lance Walsh, MD

    Prostatectomy patients have a higher and longer survival rate than those who receive radiation or other treatments. Surgery also has a lower risk of long-term complications than radiation. The da Vinci prostatectomy is a robotic-assisted surgical procedure that allows surgeons to perform very complex and delicate procedures through a very small incision. The surgeon controls a computerized system that translates his or her hand movements into extremely precise “micro movements” that significantly minimize impact on the organs, tissues and nerve endings that surround the prostate. According to Dr.Walsh, studies show the daVinci procedure results in excellent patient outcomes in cancer control, urinary continence and maintenance of sexual function.

    “Alfonso was an excellent candidate for the procedure,” explains Dr.Walsh. “I have used the daVinci in private practice, but was very excited to launch the technology here at Eisenhower, where it is accessible to many more patients.”

    Dr.Walsh performed the surgery on Alfonso on November 6, 2008.“He stayed with us overnight,” says Walsh, “and then we sent him home the next day with a catheter. Any pain issues were resolved once we removed the catheter.”

    Alfonso confirms that the procedure was relatively simple. He has been careful during his recovery not to strain the surgical area through heavy lifting or too much work around the house, but he has had no complications and has resumed his normal activities. I only had to take pain medication twice after I came home,” he says.

    Alfonso returns to Eisenhower every few weeks for post-surgical follow up. The news has been all good. Dr. Walsh says his PSA levels are undetectable, and pathology tests show the cancer cells were completely removed with the prostate. Alfonso needs to continue with regular screenings, but thanks to his successful surgery, he has the peace of mind to once again enjoy his time with his wife of 36 years, Adelita. The couple have three children and a granddaughter in the area, and after years of hard work, Alfonso enjoys nothing more than spending time with his family, reading and taking walks in the neighborhood.

    “Dr.Walsh says that because my prostate cancer was detected early, I was able to have the new surgery,” Alfonso says. “Now, I tell my friends, my family, that they should see their doctor and get the PSA test. I am grateful to Eisenhower for treating me right away, and I am proud that I was their first da Vinci patient.”

    Dr.Walsh reiterates Alfonso’s advice.

    “Alfonso is a great ambassador for us—he is the perfect example of how men can minimize their risks by getting regular screenings,”Dr. Walsh says. “Men over 50 should get an annual PSA screening and a digital rectal exam. However, if there is a history of prostate cancer in the family, they should really start by age 40 or 45. When we catch prostate cancer early, our success rate is remarkable.”