Sunday, May 15, 2011

Roswell Park Surgeon Performs Nigeria’s First Known Radical Prostatectomy

Imagine learning that you have prostate cancer and need to undergo a radical prostatectomy — but in order to have the surgery, you’ll have to travel to India or England. That’s the reality for prostate cancer patients in Nigeria, and it puts the treatment out of reach for the vast majority of men who need it. But things are beginning to change, and it all started in an operating room at Shawsand Medical Centre in Port Harcourt, Nigeria.

That’s where Willie Underwood III, MD, MPH, MSci, of the Department of Urology at Roswell Park Cancer Institute (RPCI), recently performed the country’s first documented radical prostatectomy. At his own expense, and on his own time, Dr. Underwood traveled to Port Harcourt in late February at the request of the Nigerian Urologic Society and IVUmed, an international nonprofit organization that works to improve urological care around the world through projects that reflect its motto, “Teach one, reach many.”
An IVUmed board member for several years, Dr. Underwood put that motto into practice as he performed the prostatectomy with two Nigerian surgeons assisting by his side. By the end of his visit, his Nigerian colleagues were ready to do the procedure themselves and are now teaching other surgeons in turn.

The number of Nigerian surgeons trained for radical prostatectomy will start to grow exponentially in November 2011 when Dr. Underwood returns to Port Harcourt with other volunteer surgeons he has recruited. In a multi-phase process, the Nigerian surgeons will assist and observe, then perform the surgery themselves with an American surgeon assisting, and then go it alone with an American surgeon available for consultation. “By the time we’re done, they’ll feel comfortable doing these cases [independently],” says Dr. Underwood.

Providing specialized surgical training is just part of IVUmed’s broader goal of improving care for Nigerian patients with urologic cancers. During his visit, Dr. Underwood met with some 30 Nigerian surgeons to provide advice on such matters as designing an efficient system for diagnosing and treating prostate cancer in a country with limited resources and medical facilities.

Research is another focus of the IVUmed initiative. “Cancer has not been well studied in the African population,” notes Dr. Underwood, so plans are underway for the creation of a tissue repository that will provide information “to begin to build the knowledge and understanding of cancer in West Africa.” The repository will link Nigerian surgeons and institutions with researchers in the United States.

Dr. Underwood developed great respect for his Nigerian colleagues as he worked side-by-side with them. “They’re extremely well trained; I was amazed by their talent,” he says. “Their training is so broad.”

After returning to RPCI, he learned from them that the patient on whom he operated is doing well. “We’ve had a great outcome with this case,” he says. For prostate cancer patients in Nigeria, that’s the beginning of hope

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