Treating Prostate Cancer at Beaumont Hospital

Friday, 27 October, 2017

Richard Power is having a busy Monday morning. His clinic is in full swing and, after a weekend spent in the operating theatre in Beaumont Hospital, he admits to being tired. However, fatigue doesn’t prevent him from speaking passionately about the treatment of his patients with prostate cancer.

He explains that, as one of the country’s major cancer treatment centres, Beaumont Hospital has a fantastically well operated Rapid Access Prostate Clinic. Our target is for all patients to be seen within two to three weeks of being referred here by their GP with a query of prostate cancer. Mr Power and his team are reaching this target in well over 90% of cases and this is having a direct impact on the increasing number of patients who are diagnosed at an early stage.

The Rapid Access Prostate Clinics were devised as part of the National Cancer Control Programme’s (NCCP) strategy to reorganise the way cancer care is delivered in Ireland so that survival rates compare with best in class in Europe and the rest of the world. And although Mr Power acknowledges the important work of the Rapid Access Clinics and the hugely positive impact they have had on early detection rates, he feels that the HSE’s resources are being used wholly in the area of detection to the detriment of advanced surgical treatment options.

At present, 85% of radical prostatectomies (removal of the prostate) in the UK and 95% in the USA are performed robotically. Using this system, the surgeon makes very small incisions in the patient’s abdomen and manoeuvres the robot’s arms, which in turn control the cameras and instruments. Robotic surgery has become very popular over the past ten
years due to the smaller incision, shorter post-operative recovery and improved outcomes for patients. However, this equipment is not available in Beaumont Hospital and is only currently available to Irish patients through the private health system.

Mr Power explains, "There are three such robotic systems in the Dublin area alone but sadly, all in private hospitals. The capital outlay for a new dual console, teaching robotic machine that can be used across many specialities to do colorectal, cardio thoracic, gynae oncology and uro oncology will cost about €2.1 million".

"Patients want and deserve access to this service. At the moment, prostate cancer patients who wish to have minimally invasive, rather than open surgery, are looking at long waiting times. There is currently only one surgeon in Beaumont Hospital, Mr Gordon Smith, who can offer minimally invasive radical prostatectomy and this is done by skilled laprascopic surgery and not using robotics.

However, fewer of these operations are being carried out because of surgical fatigue factors and because the minimally invasive robotic surgery has taken over".

He continues, "We should have a mechanism to treat our public patients in the same way that we treat private patients for prostate cancer and that’s a grievance that consultants in all public hospitals will share. I find it very sad and difficult to consult with patients who've been on the internet and researched surgical treatment options. They discover robotic assisted prostatectomy only to then find out that it's unavailable through the public healthcare system. It puts patients in a very difficult situation. I’ve had patients take out Credit Union and family loans to pay for the treatment".

"Robotically assisted surgery is the way forward for treatment of prostate cancer and Beaumont Hospital needs this technology, sooner rather than later. But while we wait for this new technology to become available, our work in early detection continues and our current appeal is to fund a transperineal biopsy machine which will make a huge improvement to the comfort and safety of men having biopsies for prostate cancer".