Laura Crocitto, M.D., wants to give men their lives back.
As a urologic surgeon, Crocitto knows that prostate cancer can threaten not only a man’s life, but his love life, too. Even with the most honed, minimally invasive surgical techniques, a prostatectomy — the removal of the prostate — leaves men at high risk of erectile dysfunction.
But Crocitto believes that advanced, high-tech surgery offered at City of Hope, as well as early intervention with medication, may help more men stay sexually active.
Crocitto is principal investigator on a clinical trial that investigates whether robotic laparoscopic prostatectomy helps preserve erectile function better than standard open surgery. The trial will also evaluate whether patients who use regular, low doses of erectile function drugs soon after surgery return to potency faster than those who do not take the doses regularly.
Surgeons at City of Hope have adopted laparoscopic robotic surgery using the da Vinci Surgical System as their standard technique — preferring it over open surgery and standard laparoscopic surgery.
“We know that robotic surgery provides an improved view of the prostate and surrounding tissues including the nerves. This results in lower blood loss and less chance for injury to the nerves, which are responsible for erections,” Crocitto said.
Crocitto said that early data hint that patients undergoing this surgery return to erectile function quicker than those undergoing regular open prostatectomy. “It has been reported that in patients over 65 years old, 47 out of 100 bilateral nerve-preservation patients experience a return of erectile function at one year following surgery,” Crocitto said. “In patients younger than 60 years old, 76 out of 100 experience a return of erectile function.”
She also noted that urologists typically provide daily Viagra to patients who have undergone prostatectomy. “But there are no large series showing that this improves return of erectile function,” she said.
In this study, patients will be randomly assigned to one of three groups: one will receive daily low-dose Viagra, one receives daily Muse (or a urethral suppository) and the other will receive no daily therapy. All three groups receive three therapeutic doses of Viagra each month.
“It may be important to start rehabilitation as early as possible to increase blood and oxygen flow to the penis, helping to prevent scarring,” Crocitto said. “We hope this study will start to answer that question.”
City of Hope researchers are looking to accrue 220 men for the study. All study related medications are provided to men free of charge.
The study is supported by Pfizer, the maker of Viagra, and Vivus, the maker of Muse. More information is available from Rosa Mejia, ext. 63030, or Paul Kearns, ext. 64235.