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da Vinci Surgery with Dr. Mark LaFave, Urologist

Dr. Mark LaFave graduated from the Wake Forest School of Medicine in June 1988. After completing a general surgical internship and a year of general surgical residency at Letterman Army Medical School in Presidio, California, he went on to a urological residency at the Pennsylvania State University/Hershey Medical Center. He completed his chief residency in 1995. Dr. LaFave is certified by the American Board of Urology and is an active member of The American Urological Association as well as The Southeast Section, AUA.

He has special interest in urologic cancer, incontinence and reconstructive urology.

I thought prostate cancer was a cancer found only in older men. I’m only 45, but my wife is insisting I have the PSA blood test now. Do I really need to?

— Bill M., Goldsboro

Yes and no. The age to start prostate cancer screening is controversial.

African-American men or men with a family history of prostate cancer should begin screening at age 45 because they are at higher risk for developing the disease. In fact, they are six times more likely to develop the disease than the general population, and often develop it earlier in life.

Most other men can probably start screening safely at age 50 unless they are symptomatic. It is extremely important to understand that prostate disease is generally a very slow growing cancer.

It has been suggested by some groups that prostate cancer is not a “dangerous or life-threatening cancer”.

Actually, over 30,000 men die from the disease in the U.S. each year. It is the second leading cause of cancer-related deaths in men.

Again, if you are 45 and have a family history of prostate cancer, or if you are African-American, start your yearly screening (PSA blood test and digital rectal exam) now. Otherwise, begin your exams at age 50 and improve your chances of living a long, full life.

Is it true that the having a robotic prostatectomy vs. the traditional open surgery will reduce the chance of impotence?

— Henry W., Mount Olive

Thank you for your candidness. One of the potential advancements made possible by da Vinci robotic-assisted prostatectomy is that it magnifies the surgical field so that nerve-sparing techniques may be more successful, and reconstruction of the urethra is more precise.

This should translate into much better clinical results while offering comparable surgical control of the cancer.

  • Keep fires in their
    proper place by
    using a fireplace
    screen to keep
    sparks from flying
    out of the fireplace.
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