Provenge vs. Robotic Prostatectomy
NEW YORK, July 18, 2011 /PRNewswire/ — Just one year after the FDA approved Provenge, an immunotherapy for treating advanced prostate cancer, Medicare announced that they will continue to pay in full for Provenge when used in accordance with label indications. Provenge, unlike traditional hormone or chemotherapy treatments, uses a patient’s own cells to fight the cancer, thereby extending the life of the patient. Dr. David Samadi, Vice Chairman, Department of Urology, and Chief Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, sees the value in drugs such as Provenge for certain patients, but believes there’s a more direct way for most patients to tackle prostate cancer diagnosis.
Provenge works by in-lab training of a patient’s own immune system cells to fight the protein that surrounds prostate cancer. During treatment the patient undergoes a series of three procedures; each time cells are removed, trained and reintroduced in the patient in hopes that the body will attack the cancer like an infection. Testing indicates that Provenge can slow the progress of prostate cancer, thereby extending a patient’s life. Though the side effects are minimal, the expense is not; Provenge therapy costs approximately $93,000 per patient. “Provenge is seeing good results,” comments Dr. Samadi, “but this is a late game effort.” Provenge is being used on advanced prostate cancer patients who either don’t respond to hormone therapy or are experiencing the return of their prostate cancer. “When newly-diagnosed prostate cancer patients meet with me I urge them to make treatment decisions now that will serve them long into the future,” says Dr. Samadi. “I don’t want my patients, down the road, to be looking at options that will buy them a year or two. I want them to make choices now that will help them move beyond prostate cancer.”
When treating prostate cancer patients, some specialists recommend a “watchful waiting” course of action. Dr. Samadi firmly believes this methodology does not best serve most patients. As a skilled surgeon, Dr. Samadi is able to perform robotic prostatectomy procedures to remove the prostate and all signs of cancer surrounding it, eliminating the waiting and life-long worry. He has performed over 3,300 successful robotic prostate surgeries and his patients have a cure rate of 97 percent.
“Watchful waiting can be risky business,” cautions Dr. Samadi. “Prostate cancer patients can spend their lives returning for testing, worrying of growth or spread, and then dealing with treatment after treatment when the cancer advances. I want more for my patients.” For some, the wait-and-see method leads to a life of repeat treatments, drug hopping, and less-than-ideal survival outcomes. “The key to eradicating prostate cancer is to start early,” stresses Dr. Samadi. “Test early, remove early.”
In fact, studies indicate that in post-surgery biopsies many patients’ prostate cancer was actually far more advanced than initial staging tests indicated. “The fact remains that until the cancerous prostate is removed and tested, it’s impossible to know the exact location and staging of the cancer. Removing it altogether is the way to go.”
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