BLUE HORIZON ROBOT APPEAL

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1 Please support Prostate Scotland s Blue Horizon Robot Appeal to bring robotically-assisted prostate cancer surgery to Scotland. Together we can help tackle prostate cancer.

2 Foreword from the Patron of Prostate Scotland introduction As Patron of Prostate Scotland I am delighted that Prostate Scotland has launched the Blue Horizon Robot Appeal for robotically assisted prostatic surgery in Scotland. This is a vital initiative to ensure that men with prostate cancer have access to the latest surgical treatment in Scotland. Currently there is no robotic surgery for prostate cancer in Scotland and men need to travel to England or abroad for treatment. Prostate Cancer is the most common cancer in men in Scotland and the incidence of prostate cancer is increasing. I am delighted by the progress that has led to twice as many men surviving prostate cancer as compared to only two decades ago. However, we can and must do more to ensure that even more men survive it and with the best outcome. There is more that we need to do by way of early diagnosis and to ensure that men have access to the latest tested and effective treatments. That is why I believe that this appeal for a robot to support prostate cancer treatment in Scotland is so important. Scotland has been home to so much in the way of medical advances and people can be justly proud of our doctors and health service. The addition of robot-assisted surgery for prostate cancer will be a significant step forward. I hope that you will be able to support the appeal and help ensure that we take another step forward in the battle against prostate cancer and disease. Sir Tom Farmer CVO CBE KCSG DL The Blue Horizon Robot Appeal has been launched by Prostate Scotland, Scotland s prostate disease charity, to raise 1.5 million to purchase a robot to provide roboticallyassisted prostate surgery for the first time in Scotland. This appeal will enable men with prostate cancer living in Scotland to have access to the latest appropriate surgical treatment, without having to travel outwith Scotland. Prostate cancer is the most common cancer in men in Scotland, one in eleven men have a lifetime risk of suffering from prostate cancer 7,118 men in Scotland died from prostate cancer between 2000 and 2009 i Over 22,662 men were newly diagnosed with prostate cancer between 2000 and 2009 ii Survival rates of prostate cancer are at 80%, having doubled in the past 20 years iii The incidence of prostate cancer is set to grow by up to 48% over the next ten years according to recent projections by the NHS iv Minimal access and robot-assisted prostatic surgery now accounts for nearly half of all prostate cancer surgery in the UK, and is also widely available in Europe and the United States, but robot assisted surgery is not available in Scotland. The Blue Horizon Robot Appeal will provide a robot for a service of excellence in Scotland. This will be an NHS service in a geographical area making it easy to reach for patients and staff. We are working with the NHS in Scotland to agree the most appropriate location for the robot. The addition of robotassisted surgery for prostate cancer will be a significant step forward 2 3

3 Tackling prostate cancer and the benefits of robotically assisted surgery Although prostate cancer is the most common cancer in men in Scotland, early diagnosis can often lead to successful treatment and cure. In Scotland there are a number of treatments available for prostate cancer, including surgery, radiotherapy, brachytherapy and hormone treatment. One of the main treatments for early prostate cancer is surgery and currently around 400 operations to remove the prostate are undertaken in Scotland each year v. Increasingly these operations are performed by keyhole (laparoscopic) surgery which was introduced into Scotland at the Western General Hospital in Edinburgh. Keyhole surgery is now also available in Aberdeen Royal Infirmary, Ninewells in Dundee, the Raigmore in Inverness, Monklands in Lanarkshire and will soon be available in Glasgow. Robotically assisted surgery is performed by a surgeon operating a robot, utilising keyhole technology. During the procedure the surgeon sits close to the patient, remotely operating the four surgical arms of the robot from a console. The surgeon views the operation through a video monitor. Robotics allow a level of surgical precision that is not available in standard keyhole surgery, making complex manoeuvres easier to perform and consequently facilitating dissection whilst making reconstructive actions such as suturing easier to perform. Over the past few years robotic assisted surgery for prostate cancer has become a common method of choice in England, much of Europe and the United States - where over 70% of all prostate cancer surgery is now undertaken robotically. We believe that every man who needs to have his prostate removed because of cancer, should have the option of having it done laparoscopically. This type of operation has been available in Edinburgh for several years and proved to be a very successful treatment. It has now become apparent, from work elsewhere, that a robotic procedure in many cases considerably enhances the outcome. If Prostate Scotland can provide a robot for the NHS in a suitable location, then men throughout Scotland will have a much better chance of obtaining optimal results from laparoscopy. Edinburgh & Lothians Prostate Cancer Support Group With prostate cancer being the most common cancer in men in Scotland and with a likely increase in incidence over the coming ten years - it is important that men with prostate cancer in Scotland have the opportunity to access the latest treatment option of robotically assisted surgery and I am therefore supporting the Prostate Scotland Blue Horizon Robot Appeal. Stephen Bird from Forth Valley 4 5

4 TACKLING PROSTATE CANCER AND THE BENEFITS OF ROBOTICALLY ASSISTED SURGERY A recent Health Technology Assessment Study for the National Institute for Health Research vi concluded that: the outcomes were generally better for robotic than for laparoscopic surgery for major adverse events and importantly for positive margin rates. This may lead to better cancer-related outcomes and fewer episodes of adjuvant radiotherapy for localised recurrence. It also concluded that: use of robotic prostatectomy may be associated with improved overall survival. vii Current evidence viii for prostatic robotic surgery suggests that compared with open surgery it leads to: Less blood loss during operations and fewer transfusions A shorter length of hospital stay Faster recovery time Greater recovery of urinary continence Better surgical margins Less pain Less scarring There is also evidence that patients treated in high volume centres where there is both greater individual surgeon experience, and overall institutional experience of a surgical procedure can expect a better surgical outcome, with fewer complications and shorter hospital stay. The consensus appears to be that safe and cost-effective introduction of robotic technology for prostate cancer requires a critical mass with at least 150 procedures and highly trained surgeons and operators with experience. This is what the Blue Horizon Robot Appeal, in partnership with the NHS, is aiming for in Scotland. I truly believe that it is a quantum leap forward As a surgeon with considerable experience in pure (conventional) laparoscopic surgery, and who has also had the opportunity to use the da Vinci robot in another expert centre, I have no doubt that it will lead to improved outcomes in Scottish patients undergoing prostate cancer surgery. I truly believe that it is a quantum leap forward. Ian Dunn - Consultant Urological Surgeon, Lanarkshire We obtained our first da Vinci surgical robot in 2005 and since then have performed over 1,100 robot assisted laparoscopic prostatectomies. The da Vinci system has made a huge difference to our ability to do the operation well. Our blood transfusion rates are below 1%, our average length of stay is 24 hours, and the cancer related outcomes have improved markedly. With increasing use of the robot we have seen better continence rates and better recovery of erectile function. I think there is little doubt that this is the way forward with this type of surgery. Professor David Neal, Professor of Surgical Oncology at the University of Cambridge and Clinical Director of Surgical Oncology 6 7

5 HOW YOU CAN HELP THE The Blue Horizon Robot Appeal needs to raise 1.5m to cover the capital cost of a robot for prostate cancer. Please support this appeal and help us bring the horizon closer by: Making a donation towards our appeal Donating towards key aspects of the equipment Mentioning the appeal to friends, work colleagues and family and encouraging them to support it All donations will be recorded in the Blue Horizon Book of thanks. Getting your firm or business to support the appeal We will recognise donors in the following ways: Saltire Blue supporters Those donating more than 10,000. Saltire Blue supporters will be invited to the opening of the robotic unit and will be invited to appeal receptions, as well as having their name displayed on the Saltire Blue section of the Blue Horizon board in the hospital where the equipment will be sited and a Saltire Blue Certificate of thanks. Blue Riband supporters Those donating between 5000 and 10,000. Blue Riband supporters will be invited to appeal receptions and have their name displayed on the Blue Riband section of the Blue Horizon board in the hospital where the equipment will be sited and a Blue Riband Certificate of thanks. 8 Turquoise Blue supporters In our work we are inspired by the dignity of men with prostate cancer and disease, by the commitment of the doctors and nurses treating them and by the hugely encouraging increase in the number of men surviving prostate cancer. Together we can bring the horizon closer Our aim through this appeal is to ensure that men with prostate cancer in Scotland have access to the latest and most up-to-date method of surgery for prostate cancer. Those donating between 1000 and Turquoise Blue supporters will have their name on the Turquoise Blue section of the Blue Horizon board in the hospital where the equipment will be sited and a Turquoise Blue Certificate of thanks. Indigo Blue supporters Those donating between 250 up to 1,000 will be sent a Indigo Blue Certificate of thanks. Together we can bring the horizon closer and see even more men in Scotland surviving prostate cancer, for men across the country to have access to the latest and most appropriate care and treatments available, as well as information and support. We know from our daily contact and engagement with men with prostate cancer and disease how important this is to them and their families. Robert Wilson Chairman of Prostate Scotland Sky Blue supporters Those supporters donating up to 250 will receive a special letter of thanks. 9

6 The introduction of robot assisted radical prostatectomy will help ensure that men undergoing surgery for prostate cancer surgery in Scotland benefit from the latest technological advances in minimal access surgery and have their care delivered in a high volume centre of excellence. There is clear and strong evidence that having surgery performed in a high volume centre, with a dedicated team of very experienced surgeons offering a minimal access surgical approach is the optimum way to deliver this important treatment for prostate cancer. PROF ALAN MCNEILL CONSULTANT UROLOGICAL SURGEON AND PROSTATE SCOTLAND TRUSTEE I am backing the Prostate Scotland Blue Horizon Robot Appeal as it will be great if men in Scotland with prostate cancer are able to benefit from the latest robot assisted surgical treatment to help kick prostate cancer into touch. Chris Paterson Scotland rugby legend With one man in eleven in Scotland likely to get prostate cancer it is going to take a team effort to beat prostate cancer. I am supporting Prostate Scotland s Blue Horizon Robot Appeal which has the goal of enabling access in Scotland to the latest treatment for prostate cancer with robot-assisted surgery. Craig Levein - Football Manager the optimum way to deliver this important treatment I am supporting the Blue Horizon Robot Appeal to get robot assisted surgery for prostate cancer in Scotland. Ever since I presented a video about prostate cancer I have been a firm advocate for early diagnosis and treatment of prostate cancer as I have seen and heard examples of it helping save lives. However we need to do more to beat prostate cancer by also ensuring that men have access to the latest effective treatments and the Blue Horizon Robot Appeal to get robotic surgery in Scotland is a key step in this battle. Grant Stott Broadcaster and actor 10 11

7 Mr Chris Anderson Consultant Urological Surgeon St George s Hospital London, who has been performing robot assisted prostate surgery for five years and whose unit undertakes over 150 robot assisted operations per year: The effect on post-operative hospital stay associated with the introduction of our Robotic programme was profound with 43% of our cases being discharged the next day. I immediately noticed that my patients had less pain following a robot assisted procedure compared to conventional laparoscopy. I believe that the reduced movement (fulcrum effect) at the port sites when using the da Vinci system causes less post-operative pain which facilitates faster recovery and discharge from hospital. less pain following a robot assisted procedure DR MUSTAFA MULLA. SCOTTISH PATIENT WHO TRAVELLED TO LONDON TO UNDERGO ROBOTICALLY ASSISTED PROSTATE SURGERY. It is important for men in Scotland to have all of the treatment options available to them. My experience of robotically assisted surgery was excellent, my recovery was quick and I am very pleased with the results. I would like to see this treatment available in Scotland so other men, and their families, do not have to travel. the difference... is startling Prof Jens Uwe Stolzenburg Professor and Chairman of Urology at the University Hospital Leipzig and Head of the International Training Centre of Urological Laparoscopy: I had performed a vast number of laparoscopic prostatectomies over a decade, using a technique devised by me and learned by many other dedicated surgeons around the world. Having moved to robot-assisted surgery over the last two years, I can say that the difference, in terms of comfort, ergonomics, and vision, is startling even for me. I am convinced that every major centre offering high volume prostate cancer surgery should have a surgical robot in the best interests of their patients

8 PROSTATE SCOTLAND Prostate Scotland is Scotland s prostate disease charity set up in 2006 to tackle prostate disease and to raise awareness. We were established by people with direct experience or knowledge of prostate disease as well as some of the country s leading experts in the field. We are: Informing Providing information and advice to men and their families Developing and providing information leaflets, booklets, posters and videos on prostate health and diseases Giving talks and presentations to groups, workforces and teams Taking forward a Workplace initiative to provide information to staff about prostate disease Supporting Providing an award winning state of the art interactive website Producing regular newsletters, information and advice i See Scottish Cancer Registry and Cancer in Scotland, Information Services Division NHS National Services Scotland September 2011 ii ibid iii Cancer in Scotland: ISD, NHS National Services Scotland, September 2011 iv Cancer in Scotland: ISD, NHS National Services Scotland, September 2011 Projections of Cancer incidence in Scotland to 2020 Samuel Odoro, Roger Black, David Brewster NHS National Services for Scotland ISD 2010 v See SCAN Annual report 2009 and 2010, and WoSCAN Annual report 2010 vi Systematic review and economic modelling of the relative clinical benefit and cost effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer C. Ramsay, R Pickard, C Robertson, A Close L Vale, et al Health Technology Assessment 2012: Vol 16 No 41 pp 89 vii Ibid pp. iv viii See Sigismund Leddy, Lenvay and Satava - Open Access Surgery 2010: , Meta-analysis of perioperative outcome and complications after robot-assisted radical prostatectomy Novarra G, Ficcara V. Stoltzenburg JU et al- European Urology 2012 September: 62(3) Health Technology Assessment of robot-assisted surgery in selected surgical procedures, Health Information and Quality Authority 2012, Republic of Ireland Photo Credits: Intuitive Surgical St George s Hospital NHS Trust Clive Boothby Synaptik Hamish Campbell Advancing Raising awareness through initiatives and campaigns Working with and lobbying government and NHS to ensure that prostate issues are high on the agenda Collaborating with other organisations to further work on prostate issues Researching into future treatment and services needs for men in Scotland with prostate disease 14

9 To contact us or make a donation Prostate Scotland, 6 Hill Street, Edinburgh EH2 3JZ Tel: info@prostatescotland.org.uk Prostate Scotland is a charity registered in Scotland (SC037494). Prostate Scotland is a company registered in Scotland (SC ).