Does a Robotic Cystectomy Offer a Superior Outcome to Open Cystectomy?

Currently, the standard of care worldwide for the treatment of patients who have cancer invading the bladder muscle (muscle invasive bladder cancer) is chemotherapy followed by surgery. In men, the surgery is called radical cystoprostatectomy (removal of the bladder, prostate, and the seminal vesicles). In women, the surgery is called anterior pelvic exentration (removal of bladder, uterus, ovaries, and part of the vagina which can sometimes be avoided). In addition, a critical part of the surgery in both men and women is removing the lymph nodes within the pelvis.

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The Cancer Related Benefits of Brussel Sprouts (Recipe Included!)

Brussel sprouts have a history of under appreciation, being boiled or steamed to an olive colored mush and strongly eliciting smells of sulfur. Over the past few years, however, they’ve taken a turn in the eyes of the public and have become a favorite of foodies, bloggers, and some of the best restaurants in NYC. This is good news for the health minded and flavor-seeking alike!

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“Incidentalomas” + – Concerns about Overdiagnosing and Overtreating Cancer

The Wall Street Journal article noted “Removing the word ‘cancer’ from the terminology used for many slow-growing lesions in the breast, prostate, lung, skin and other body areas could ease patients’ fears and reduce the inclination of doctors to treat them aggressively, says a panel of experts advising the National Cancer Institute.”

“…new diagnostic technology is finding ever smaller abnormalities that are unlikely to be lethal, but are being labeled cancer and treated as if they were. The result: billions of dollars in unnecessary surgery, radiation and chemotherapy.”

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“Robot versus Surgeon: No Clear Winner”

An article in Medpage Today noted “Robot-assisted radical prostatectomy (RARP) led to complication rates, readmission rates, and rates of additional cancer therapy similar to those of conventional surgical prostatectomy, a review of almost 6,000 cases showed.”

“First-year reimbursements were greater for patients undergoing robot assisted compared with open radical prostatectomy.”

“Introduced a decade ago, robot-assisted prostatectomy has become the dominant surgical technique for patients with localized prostate cancer. Investigators in some studies have suggested that robotic prostatectomy has driven the overall prostatectomy rate to a level beyond what would have been expected given current demographic and clinical trends.”

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“… Comparing the Quality and Outcomes of Care at Competing Cancer Centers”

“Cancer!” Should you rush to a “major” cancer center?

The Modern Healthcare article noted “When it comes to cancer care, there is a huge disconnect between the possibilities of modern medicine and its day-to-day practice. As last fall’s troubling report from the Institute of Medicine noted, variation in oncology practice is wide; collection of quality and outcomes data is poor; and progress in learning what works best for any particular cancer remains slow and halting.”

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New Research Refutes Long-Held Antiviral Theory

A long-standing belief that mammals use the same potent antiviral molecules deployed by plants and invertebrates is being challenged by researchers at Icahn School of Medicine at Mount Sinai.

Their findings, published in the July 10, 2014, issue of Cell Reports, surprised many scientists who assumed that antiviral RNA Interference (RNAi) exists in humans as a natural result of evolution.

Scientists know that human cells, like cells in every living organism with a nucleus, encode and generate small RNAs, which influence our genetics. It is also known that mammals combat viruses with interferons—proteins manufactured by immune cells in response to pathogens.

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“The Rationale For Most (cancer) Screenings Are Strong If There Is A Good Test…”

“If there is a test but there’s problems with it, I often go over this with a patient and how to decide if it’s necessary.”

Add mammography to the list of cancer screenings where evidence has challenged “best practices.”

Dr. Sanjay Gupta of CNN reported in EveryDay Health that while early cancer detection can save lives, recent studies raise new doubts about the benefits of screening without considering the risks as well.

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“We Are Silently Irradiating Ourselves To Death.”

“… unless we change our current practices, 3 percent to 5 percent of all future cancers may result from exposure to medical imaging.”

CT, MRI, ultrasound, nuclear scan, PET scan – why not? Just to make sure.

An article in the New York Times noted: “ DESPITE great strides in prevention and treatment, cancer rates remain stubbornly high and may soon surpass heart disease as the leading cause of death in the United States. Increasingly, we and many other experts believe that an important culprit may be our own medical practices: Of course, early diagnosis thanks to medical imaging can be lifesaving. But there is distressingly little evidence of better health outcomes associated with the current high rate of scans. There is, however, evidence of its harms.”

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