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NewYork-Presbyterian Hospital/Weill Cornell Medical Center has established a new Prostate Cancer Institute, dedicated to pursuing aggressive and innovative prostate cancer treatments while providing patient care in a comfortable and compassionate setting. Dr. Ashutosh Tewari, a leading robotic urologic surgeon, has been appointed as its director.

Dr. Tewari is an internationally acclaimed expert on robotic prostatectomy and other minimally invasive robotic surgeries, of which he has performed more than 2,000 in New York. A prolific researcher, he has also written upwards of 200 scientific articles. His clinical interests involve urologic oncology with special emphasis on the care of patients with prostate, bladder and other urological cancers.

"I am proud to have Dr. Tewari lead the Prostate Cancer Institute," says Dr. Peter Schlegel, professor and chairman of urology at Weill Cornell Medical College, and urologist-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "He brings to the Institute his vast experience and numerous innovations in robotic surgery and patient care, as well as cutting-edge research that is helping to advance discoveries in prostate cancer treatments."

Dr. Tewari will continue to serve as director of the recently established LeFrak Center for Robotic Surgery and as director of robotic prostatectomy and prostate cancer–urologic oncology outcomes at NewYork-Presbyterian/Weill Cornell Medical Center. He also directs a fellowship program in robotic prostatectomy and prostate cancer outcomes and is the Ronald P. Lynch Professor of Urologic Oncology and professor of urology and public health at Weill Cornell Medical College.

The new Prostate Cancer Institute will bring together experts in oncology, radiation therapy, minimally invasive surgery, molecular medicine, men's health, urologic oncology, diagnostic radiology, clinical pathology, computational biology, biomedical engineering and sexual recovery. The team will serve patients from diagnosis and treatment to developing strategies for living a healthy life. The Institute will also collaborate with scientists at Cornell University in Ithaca, N.Y., to develop nanotechnologies and innovative imaging approaches aimed at enhancing patient care.

"I feel that it is important to approach medicine from all possible angles in order to provide comprehensive care," says Dr. Tewari. "The Institute will focus on improving surgical techniques and patient comfort and care, while also focusing on clinical research."

Improving Patient Care and Recovery

Dr. Tewari and his team endeavor to improve patient care and recovery through inventive cutting-edge research. He has pioneered several innovations in robotic prostate surgery focused on anatomical reconstruction in order to improve patient recovery, and to restore sexual function and continence.

"Two of the biggest concerns for men faced with prostate cancer surgery is maintaining sexual function and regaining continence following the procedure," explains Dr. Tewari. "We are trying to find new ways to reduce these risks so that men feel more comfortable with the surgery and can make the choice to eliminate their cancer with a lessened fear of side effects."

In 2009, Dr. Tewari was awarded the Clarke Medal for Surgical Innovation by the Royal College of Surgeons of England for developing a "catheter-less" technique and device for prostate cancer surgery. This prestigious award is given to only one surgeon each year. The device eliminates the need of a penile catheter following prostate surgery in certain cases. The "catheter-less" procedure re-routes urine from the bladder through a tube that exits through a small puncture hole in the pubic area. This new alternative avoids the discomfort associated with the use of a penile catheter. Results were published in a recent issue of the British Journal of Urology. (Read more: http://news.med.cornell.edu/wcmc/wcmc_2008/10_02_08.shtml)

Cutting-Edge Research and Personalized Medicine

"Dr. Tewari has been incredibly supportive in helping us establish a translational research program in the area of prostate cancer," says Dr. Mark Rubin, professor of pathology and laboratory medicine, and vice chair for experimental pathology at Weill Cornell Medical College and a pathologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "He goes well beyond the standard contributions of a surgeon and takes great care to understand the science behind the medicine. He uses his experience as a clinician to inform the research studies he is involved in, and considers what the findings mean to patients."

Drs. Rubin and Tewari are currently collaborating on studies that examine the genetic profiles of men with prostate cancer. Using tissue samples from Dr. Tewari's prostate cancer patients, Dr. Rubin's research team uses RNA sequencing to create a genetic fingerprint of tumors with the hope of identifying the molecular traits of aggressive disease for earlier diagnosis.

To date, Dr. Rubin's research has yielded three distinct gene fusions that are found in certain men with prostate cancer. The research team believes that this information may be used to accurately diagnose men with prostate cancer and serve as an alternative to PSA testing. Diagnosing specific gene fusions may also lead to novel and tailored treatments focused on a patient's specific disease. (Read more: http://news.med.cornell.edu/wcmc/wcmc_2009/07_23_09.shtml)

In a separate collaboration with bioengineers from Cornell University in Ithaca, New York, Dr. Tewari is studying the use of the multi-photon laser for real-time cancer detection. The ongoing research is being funded by a National Institutes of Health R01 award, a benchmark for federal funding. This technology may someday be used to detect prostate cancer cells during surgery and prior to receiving results from pathology testing, which can sometimes take several days following the surgical procedure.

"We may be able to tell where the cancer is while operating, so that surgeons don't miss any tissue during the procedure," explains Dr. Tewari. "We hope to show that this device will lower the number of patients who must return for follow-up surgeries in order to remove the remaining cancer, and also to reduce the likelihood of cancer recurrence."

Dr. Tewari and his collaborators published a paper in a recent issue of the Journal of Endourology demonstrating the laser's ability to distinguish nerve tissue from malignant tissue that is targeted for removal. Doing so helps spare nerves responsible for sexual function that could otherwise be damaged during surgery. These findings were awarded a first-place prize for clinical research at the 2009 meeting of the American Urological Association.

In other recent research, Dr. Tewari and his team demonstrated in the journal Urology that African-American patients have nearly a 1.5 times greater risk of death due to prostate cancer than Caucasian patients. When controlling for income and health insurance, however, the risk becomes equal for both groups. The researchers concluded that socioeconomic factors are the primary reason for a higher risk in the male African-American community.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances — including the development of the Pap test for cervical cancer; the synthesis of penicillin; the first successful embryo-biopsy pregnancy and birth in the U.S.; the first clinical trial for gene therapy for Parkinson’s disease; the first indication of bone marrow’s critical role in tumor growth; and, most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. For more information, visit Weill Cornell Medical College.