Ihor S. Sawczuk, M.D. PROFESSOR & CHAIRMAN UROLOGY TOURO UNIVERSITY COLLEGE OF MEDICINE ADJUNCT PROFESSOR OF UROLOGY COLLEGE OF PHYSICIANS & SURGEONS COLUMBIA UNIVERSITY Prostate Cancer Treatment: What’s Best for You? Surgical Options

Prostate Cancer A Common Cancer 234,460 new cases, mortality- 27,350

How Significant Is Prostate Cancer? In the USA, 234,460 men will be diagnosed with prostate cancer. –That is one man diagnosed every 3 minutes Prostate cancer deaths are estimated at 27,350. –That is one death every 18 minutes Source: Cancer Facts and Figures - American Cancer Society

External Beam Radiation New Technology Cryotherapy Watchful Waiting Open Surgery Robotic Surgery Approach To Prostate Cancer: A Multidisciplinary & Individualized Approach

~ 235,000 New Cases of Prostate Cancer Prostate Cancer: 2009 Statistics Watchful Waiting or Other 55,000 Radiation (EBRT, Brachy) 90,000 Prostatectomy 90,000

Prostate Cancer: Active Surveillance

Quality of Life: Continence / Erectile Dysfunction

Molecular-Based: Imaging / Staging / Analysis

SURGERY IN THE NEW MILLENNIUM ROBOTASSISTEDSURGERY

FDA APPROVED INTUITIVE’S DA VINCI SURGICALROBOT

~ 90,000 Radical Prostatectomies/Year U.S. Radical Prostatectomy Market 39.5 % 0.5 % 60% 24.5 % 75 % 0.5 % Projected Open Robotic Laparoscopic 39.5 % 60%

Stereoscopic 3-D vision 75% better resolution Endowrist technology Six degrees of freedom Tremor filtering Movement scaling DA VINCI ™ SYSTEM: ADVANTAGES

Surgeon and Patient Positioning

ULTRASOUND GUIDED CRYOABLATION FOCAL / WHOLE GLAND

Clinical Trials: Novel Technology

TEAM Members Beyond Physicians Social Worker Nurse Assistive Personnel Patient and Family Clinical Research Associate Important Others Specialists Physician Helps patients navigate through healthcare system Source: Crighton, Frances, RN. “Management Strategies for Prostate Cancer Patients – The Role of Allied Health Professionals.” Slide 4. Presented July 27, 2006.