Moffitt Momentum eNewsletter | Moffitt Cancer Center

Thanks to innovations in surgical technology, there is a new category of minimally invasive surgery, and we are pleased to announce that Moffitt Cancer Center now offers da Vinci® Robotic Surgery – allowing Moffitt physicians to provide patients with the next evolution in surgical procedures.

The da Vinci® Surgical System provides an enhancement beyond traditional open surgery and conventional laparoscopy, putting the surgeon at the controls of a state-of-the-art robotic platform. The system allows surgeons to perform the most complex and delicate procedures through very small incisions with unmatched precision.

“Our extensive experience with laparoscopy and the addition of robotic technology will provide patients with the most optimal state-of-the-art minimally invasive surgery,” says Julio Pow-Sang, M.D., director of the Moffitt Robotics Program. Dr. Pow-Sang also serves as department chair and program leader of Genitourinary Oncology at Moffitt. “With the use of robotic assisted surgery, the patient undergoes a minimally invasive surgical procedure using a much smaller incision, when compared to open surgery.”

Moffitt acquired its first da Vinci® Surgical System earlier last year, and now a second da Vinci® has been added. Since acquiring its first da Vinci® robotic system, 371 robotic minimally invasive surgical procedures have been performed at Moffitt.

Urologic Surgery:
Typically referred to as robotic surgery for prostate cancer or robotic prostatectomy, this minimally invasive surgery is quickly becoming a popular treatment for removal of the prostate following early diagnosis of prostate cancer. With da Vinci® prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been, according to Dr. Pow-Sang.

Gynecologic Surgery:
For gynecologic oncology patients who are candidates for robotic surgery, the system will offer numerous advantages. With the precision, 3-D vision, and dexterity of robotic technology, Moffitt gynecologic oncologists can offer the benefits of minimally invasive surgery to a greater number of patients with gynecologic cancers. The robotic platform will also allow the surgeon to perform more complex laparoscopic procedures with a greater margin of safety and efficiency, according to Sachin Apte, M.D., member of the Gynecologic Oncology Program, who performs these procedures together with William Roberts, M.D.

Lung Cancer:
The first robotic lung surgery in Tampa Bay recently was performed at Moffitt. Lung surgeries are very complex operations because of the large vessels leading to and from the lungs and heart. Unlike the traditional open-chest method, the da Vinci® system allows surgeons to perform minimally invasive procedures by guiding robotic arms as they make tiny incisions. The new technique promises minimal trauma to the patient and better surgical results, according to Moffitt thoracic surgeon Eric Sommers, M.D. who performed the da Vinci® assisted lung cancer surgery.

Greater Speed, Precision and Safety
Many surgical procedures performed today using standard laparoscopic techniques can be performed with greater speed, precision, and safety using the da Vinci® system. This is because the equipment delivers increased clinical capability while maintaining the same “look” and “feel” of open surgery.

“This system provides an enhancement to both traditional open surgery and conventional laparoscopy, putting us at the controls of a state-of-the-art robotic platform,” Dr. Pow-Sang says. “Our extensive experience with laparoscopy and the addition of robotic technology will provide patients with optimal state-of-the-art minimally invasive surgery.” By enhancing surgical capabilities, the da Vinci® Surgical System offers the potential to improve clinical outcomes and redefine standards of care.

The system cannot be programmed or make its own decisions. Every surgical maneuver is performed with direct input from the surgeon. To operate the equipment, the physician sits at a console viewing a 3-D image of the surgical field. The surgeon’s fingers grasp the master controls below the display, with the hands and wrists naturally positioned relative to his or her eyes. The system translates the surgeon’s hand, wrist and finger movements into precise, real-time movements of special instruments during the surgical procedure.

Research and Education Of Future Surgeons
Dr. Pow-Sang plans to develop educational programs to train the future generations of surgeons in robotic procedures.

“I plan to continue creating an environment in which our surgeons can take robotic surgery to the next level and Moffitt can become one of the premiere robotic surgery institutions in the country,” says Dr. Pow-Sang. “There are additional surgeries that few centers perform that we are now doing at Moffitt, which offers an opportunity for research in outcomes.”

To Find Out More
“Conventional open and laparoscopic surgery remains an important component of cancer treatment here at Moffitt,” says Dr. Pow-Sang. “Not all patients are optimal candidates for surgery, and Moffitt’s physicians help to weigh the risks and benefits to help patients select the best cancer treatment for their individual situation.”

We are dedicated to providing minimally invasive surgery options for the benefit of our patients and their families. If you or someone you know would like to learn more about this new treatment option, please call Cancer Answers at 1-888-MOFFITT.

Moffitt Patient/Family Testimonial:

A Son’s Medical Saga Inspires Parents To Give
By Beth Davey

Craig Shafer doesn’t remember much about the hit-and-run accident near his Bradenton home one sultry night in August 2007. He doesn’t recall being airlifted to a St. Petersburg hospital where he was treated for a head injury. But what the 29-year-old clearly recalled was the urgency in his doctor’s voice during a follow-up visit.
    “You need to see a urologist.”
    Although his head wound was healing, Shafer had complained that he hurt all over. An ultrasound suggested something far different might be causing the young man’s pain.
      The diagnosis was soon confirmed – testicular cancer. And to the dismay of Shafer and his family, he had the faster growing form of the disease called embryonal nonseminoma.
     Shafer fit the profile for testicular cancer patients since the disease occurs most often in men between the ages of 20 and 39. With just over 8,000 cases diagnosed a year nationwide, testicular cancer accounts for only 1 percent of all cancers in men, according to the National Cancer Institute. The good news is that 95 percent of cases can be cured.
    The Shafer family quickly began researching the best place for Shafer to get treatment. Since relocating to Palmetto in 2004 from upstate New York, Shafer’s parents were unfamiliar with cancer facilities in Florida. To their relief, they found Moffitt Cancer Center just a short ride away.
     “I can’t imagine being somewhere else,” Craig Shafer explained. “They know how to handle everything. You can tell. Every facet of treatment is covered. There’s no better consolation for patients who are scared and sick.” He describes Mayer Fishman, M.D., Ph.D., and his nurse Adrienne Cardellini, R.N., as “awesome.” “They’re unbelievably patient and compassionate.”
    About eight weeks into his chemotherapy, the unthinkable happened. Shafer suffered a massive heart attack. A harrowing week in intensive care was followed by three more weeks of hospitalization and rehabilitation.
    Bound and determined to recover, Shafer remembers looking in the mirror in his hospital room every day and repeating, “You’re going to die some day, but not today.”
    One day stretched into weeks, then months, and today Shafer gets a clean bill of health from Dr. Fishman.
    “He’s in a good risk group where 92 percent won’t recur,” he says. “Your best chance to cure the cancer is upfront.”
    Meanwhile, parents Julie and George Shafer have become grateful supporters of the research done at Moffitt Cancer Center.
     “We received a gift from Moffitt Cancer Center first – our son’s life,” says Mrs. Shafer.
    Dr. Fishman notes the importance of charitable giving to continue the cutting-edge immunology research for many types of genitourinary cancers. He also cites Moffitt’s expertise in minimally invasive surgery options, which give patients like Shafer numerous benefits such as the new da Vinci® surgical system for robotic laparoscopic surgery.
   And for Craig Shafer, the medical turmoil of the past eighteen months has strengthened him inside and out.
     “I made a choice that through all this, I was not going to be a victim; I was going to be an example and an inspiration that you can come back…. Life is so precious. I’m more alive today than I’ve ever been.”

Melanoma Quiz:

Moffitt surgeons are performing robotic surgery on patients with all types of genitourinary tumors (including prostate), uterine and other gynecologic, adrenal and early-stage lung cancers.

Cancer Answers:

Q&A: Facts About Robotic Surgery For Prostate Cancer

A: It is a newer approach to perform robotic-assisted laparoscopic prostatectomy (LRP) remotely using a robotic interface (called the da Vinci® system). The surgeon sits at a panel near the operating table and controls robotic arms to perform the operation through several small incisions in the patient's abdomen. Robotic LRP has been in use in the United States since 2003. The machines are expensive, and they are found in a limited number of medical centers across the country. This approach has become more popular in recent years. Key factors for a successful outcome are the skill and experience of the surgeon.

Q: What is the difference between using the robotic versus traditional surgery for prostate cancer?

A: Robotic surgery is done in the same fashion as open surgical removal. The difference is that what originally required a large incision (from the belly button down to the pubic bone), now only requires 4 to 6 small incisions, each about 5 mm-12 mm in length. These incisions allow instruments to pass through ports (a hollow cylinder through which instruments can pass), keeping the surgeon's hands outside the patient.

Symptom Checker: Urinary Problems in Men

According to the National Cancer Institute, a man with prostate cancer may not have any symptoms. For men who do have symptoms, however, the most common symptoms include urinary problems, difficulty having an erection, blood in the urine or semen, as well as frequent pain in the lower back, hips, or upper thighs. Common urinary symptoms include:

Although these symptoms are not always due to cancer, you should tell your doctor if you have any of these symptoms so that the problems can be diagnosed and treated.

Moffitt Morsels – Healthy Recipes For Healthy Living

Apple Spice Bread:

Ingredients:

Cooking spray
2 medium Granny Smith apples (about 2 cups)
3 Tbsp. fresh lemon juice
1 cup all-purpose flour
1 cup whole wheat flour
2 tsp. baking powder
1 1/2 tsp. ground cinnamon
1/2 tsp. allspice
1/4 tsp. salt
3/4 cup packed light brown sugar
3 Tbsp. canola oil
1 egg, lightly beaten
1 tsp. vanilla extract
Pinch of nutmeg (optional)

Instructions:

Preheat oven to 350 degrees. Coat a 9-inch loaf pan with cooking spray. Peel and grate apples. Toss with lemon juice to prevent browning.

In large bowl, combine flours, baking powder, cinnamon, allspice and salt. Mix well. Make well in center and set aside.

In medium bowl, combine apples, brown sugar, canola oil, egg and vanilla. Mix well. Add mixture to dry ingredients and mix until just blended. Transfer batter to prepared pan.

Bake 1 hour, until wooden pick inserted near center comes out almost clean (to preserve moistness). Cool in pan on wire rack, 10 minutes. Remove from pan and cool completely.

Nutritional Information:

Makes 10 servings. Per serving: 206 calories, 38 g carbohydrates, 2 g dietary fiber, 5 g total fat (<1 g saturated fat), 4 g protein, 170 mg sodium.

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Mushroom and Barley Soup:

Ingredients:

1 Tbsp. canola oil, divided
1 medium onion, chopped
2 stalks celery, chopped
1/2 cup pearled barley, rinsed and drained
6 cups fat-free, reduced sodium chicken or vegetable broth, divided
5 cups (about 3/4 lb.) button mushrooms, chopped
2-3 tsp. Worcestershire sauce
3 carrots, peeled and chopped
Salt and freshly ground black pepper, to taste
Cayenne pepper or lite soy sauce, to taste

Instructions:

In large soup pot, heat half of oil over medium heat. Add onion and celery and sauté 3 minutes. Add barley and stir constantly 2 minutes. Add 4 cups broth.

Bring to boil; reduce heat to low and simmer, covered, 40 minutes.

Meanwhile, in nonstick pan, sauté mushrooms in remaining oil over medium-high heat, stirring constantly 6 minutes. Add Worcestershire sauce and stir constantly 1 minute. Remove from heat.

Stir carrots into mushrooms and set aside. After barley has simmered 40 minutes, add mushrooms, carrots and remaining broth. Simmer 30 more minutes, covered.

Season with salt, pepper and cayenne or soy sauce, to taste. When reheating, thin with more broth or water, as desired.

Nutritional Information:

Makes 6 servings. Per serving: 123 calories, 3 g total fat (<1 g saturated fat), 21 g carbohydrates, 5 g protein, 4 g dietary fiber, 632 mg sodium.

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Spicy Pear Chutney:

Ingredients:

3 1/2 cups peeled and diced pears (3 to 4 medium)
2 Tbsp. lemon juice
2 Tbsp. chopped fresh cilantro leaves
1 clove fresh garlic, minced
1/2 cup chopped red onion
1 1/2 tsp. sugar
1/8 tsp. ground red pepper

Instructions:

In a small bowl, combine all ingredients, mixing well. Cover and refrigerate at least 2 hours before serving.

Nutritional Information:

Makes 8 servings. Per serving: 51 calories, 0 g total fat (0 g saturated fat), 13 g carbohydrates, <1 g protein, 2 g dietary fiber, 1 mg sodium.

Recipe Source:
American Institute for Cancer Research

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Moffitt Momentum

Table of Contents

Robotic-Assisted Surgical Procedures Provide Numerous Patient Benefits

Moffitt Patient/Family Testimonial:

Melanoma Quiz:

Cancer Answers:

Q&A: Facts About Robotic Surgery For Prostate Cancer

Symptom Checker: Urinary Problems in Men

Moffitt Morsels – Healthy Recipes For Healthy Living