September 26, 2023

Prostate Cancer Surgeries Among 3 Robotic Procedures to be Funded by Ontario Health

A Decade of Research from St. Joe’s Helped to Lobby for this Change

This summer, Ontario Health announced three types of robotic-assisted surgery now qualify for OHIP funding – among them are robotic-assisted procedures for Prostate Cancer. Until now, robotic surgery in Ontario has only been available thanks in large part to philanthropy.

Affecting 1 in 8 people, Prostate Cancer is the most commonly diagnosed cancer in Canadian men. St. Joe’s is the regional lead for urologic care and prostate cancer surgery, performing over 250 surgeries annually – the vast majority of which are performed robotically.

The Hospital’s robotics surgery program was launched in 2012 after a $5 million donation from the Boris Family brought the da Vinci surgical robot to St. Joe’s. An additional $6.6 million in investments by the family, and over $5 million in gifts from grateful patients and our generous community have continued to fuel the Hospital’s mission to show the benefits of robotic-assisted procedures.

“Every one of the 2,578 robotic-assisted prostatectomies we’ve performed at St. Joe’s over the past 11 years, have been part of research studies documenting that patients undergoing robotic surgery are healing faster, returning to their lives, their jobs and their families sooner – and with fewer complications,” says Dr. Bobby Shayegan, one of the country’s top urologic surgeons and Chief of Surgery at St. Joe’s.

Certainly, that was Michael Foster’s Experience.
After routine bloodwork during an annual physical with his family doctor, St. Catharines resident Michael Foster, found out he had elevated levels of PSA. After a biopsy confirmed that cancer had been detected, he immediately began researching what treatments for prostate cancer diagnosis might look like and which hospitals in the region provided this specialized care.

“I knew that eventually surgery might be needed, and I saw that St. Joe’s was one of only three Hospitals in the province performing prostate cancer surgeries with a surgical robot,” says Michael. “The literature I read indicated robotic surgery was the way to go.”

Michael came under the care of Dr. Shayegan, and was placed on an active screening program where his PSA was monitored every 6 months, paired with biopsies and the occasional MRI’s to monitor what was at first a slow-growing, non-aggressive cancer. After 5 years of relatively stable results, Michael and his wife Ellen had come to feel confident and comfortable attending their regular follow up appointments with Dr. Shayegan. But on May 30, 2023, the date of their 30th wedding anniversary, everything changed.

“We had planned to go to this appointment, obtain the usual update, and then head out for a nice anniversary dinner,” recalls Michael. “But those plans changed the moment that Dr. Shayegan told us my most recent MRI had found an aggressive tumor that would likely require treatment. I decided then that it was time to have the surgery and was fortunate that Dr. Shayegan had a cancellation and was able to schedule me to have a robotic-assisted prostatectomy ten days later.”

To the Operating Room and Back Home in Less than 24 Hours
Michael’s surgery took place at 11:00 a.m. on May 9, 2023. “I was up and walking around by 8:00 p.m. that night. I stayed in the Hospital overnight for observation and was discharged home by 9:00 a.m. the next morning,” says Michael. “I was able to go walking as soon as we returned home and had minimal pain and bleeding. Within 8 weeks I was back to all my normal activities including full rounds of golf while walking the course.”

Not Just Better for Patients – Better for the Healthcare System
In addition to improved patient outcomes, data shows robotic surgery could be more cost-effective for the healthcare system. A study co-authored by Dr. Shayegan and published in the August 2020 edition of the Canadian Urological Association Journal, showed that robotic-assisted prostatectomies are cost-effective when compared to traditional open surgical techniques. Not only do patients spend fewer days in Hospital following their robotic procedure (freeing up valuable bed space and saving healthcare dollars), but there is a lower rate of readmission to Hospital following surgery, which resulted in better cost-effectiveness per patient across quality-adjusted life years.

Dr. Shayegan’s study was part of a body of research that was presented to provincial representatives to help lobby for the recently announced funding for robotic-assisted prostatectomies. In addition to prostatectomies, robotic nephrectomies (for those living with kidney cancer), and hysterectomies (for patients with a high BMI living with endometrial cancer) will also be funded by OHIP.

Why Philanthropy Will Continue to Be Important to the Future of Robotic Surgery
“The three types of surgery approved for OHIP funding are among the most commonly performed robotic procedures, so there’s a lot of great data that’s been generated to support improved patient outcomes. But there are more applications of robotic surgery that are new, and showing great promise but they’re not yet funded.”

Surgeons at St. Joe’s are using the da Vinci XI robot to operate on patients living with cancers of the head, neck, chest, and lungs, and leveraging the MAKO Rio robot to perform robotic-assisted knee replacement surgeries. None of these procedures are funded by OHIP yet, but clinicians and patients alike are citing similar advantages over traditional techniques.

“Since the very beginning, the generosity of the Hamilton community has played a leading role in pushing the boundaries of robotic surgery innovation,” says Dr. Shayegan. “This funding for prostatectomies, nephrectomies, and hysterectomies is great news. But we’re only beginning to understand how robotic surgery could improve care for other cancers and conditions. Philanthropy was the catalyst that allowed us to begin this journey in the promise of robotic-assisted surgeries, and it will continue to play an important role in advancing the care we provide to patients.”