Treating Prostate Cancer That Doesnt Go Away Or Comes Back After Treatment
If your prostate-specific antigen blood level shows that your prostate cancer has not been cured or has come back after the initial treatment, further treatment can often still be helpful. Follow-up treatment will depend on where the cancer is thought to be and what treatment youve already had. Imaging tests such as CT, MRI, or bone scans may be done to get a better idea about where the cancer is.
What Is Prostate Removal
A prostatectomy is a surgical procedure for the partial or complete removal of the prostate, which is a small gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum in men. The prostate supplies part of the seminal fluid , which mixes with sperm from the testes. Sperm needs this fluid to travel and survive for reproduction.
What Are The Types Of Prostate Surgery For Benign Prostatic Hyperplasia
Several minimally invasive surgeries may be used for benign prostatic hyperplasia. These include:
GreenLight laser: Photoselective vaporization of the prostate is a treatment that vaporizes prostate tissue to create a channel in the urethra for free urination. This is surgical treatment performed in the operating room under general anesthesia.
Plasma button electrovaporization: Prostate tissue is removed using low temperature plasma energy. Tissue is vaporized. This is an operating room-based therapy and requires an anesthetic.
Water vapor therapy : Water vapor is directly delivered to the prostate tissue. Over a 3-month period the tissue is destroyed and reabsorbed by the body. This is an office-based therapy and is performed under a local nerve block.
UroLift®: A mechanical approach that places implants to pin the lateral prostate lobes out of the way to reduce obstruction. This is an office-based procedure performed under a local nerve block.
Prostatic artery embolization: This approach uses catheters to deliver agents that block blood flow to the prostatic artery to reduce symptoms of BPH by shrinking tissue. This prostate procedure uses local anesthesia and doesnt require a hospital stay.
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Can You Live Without A Prostate
You can live without a prostate, though there are some side-effects.
The prostate is removed to prevent the spread of prostate cancer, while it might also be removed because it has enlarged through normal ageing and is putting pressure on the uretha .
A prostatectomy is the removal of all or part of a prostate, with the most common procedure being the transurethral resection of the prostate .
Laser prostatectomies are also performed which is the least invasive type of removal.
Providing Your Medical History
At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?
As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.
If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.
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How Fast Will I Become Totally Continent After Prostate Surgery
During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.
The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.
It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.
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What Happens To The Prostate After Radiation
The entire prostate gland is radiated when we treat the cancer. The prostate normally produces some of the fluid in the ejaculation. Radiation therapy has the side effect of damaging the glands in the prostate, so a lot less fluid is produced. The ejaculation may be dry or nearly dry. In addition, you will probably be sterile after radiation, but this is not 100% guaranteed and should not be relied upon as a form of birth control. You can still usually have erections because the nerves and blood vessels that go to the penis are not as damaged as the prostate gland.
The prostate gland will end up having a lot of scar tissue. It will shrink in size to about half its original weight within a couple years after finishing radiation. The urethra passes through the canter of the prostate gland like the hole of a doughnut. Sometimes this passage can widen, other times it can shrink after radiation. In summary, the prostate gland is heavily damaged from radiation and does not work normally afterwards.
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How Is Urinary Incontinence After Prostate Surgery Treated
If you find youre having issues with mild to moderate leakage after surgery, your healthcare provider might suggest starting with noninvasive therapies like medications or physical therapy exercises for the pelvic floor muscles. These treatments may also cut down on the number of times that you have to get up each night to pee.
These methods can sometimes help men who have mild to moderate leakage. Men who have persistent leakage or a more severe problem may need surgery if they do not want to continue to use pads.
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What Is A Radical Prostatectomy
Surgery to remove the prostate is called a radical prostatectomy. Before the operation, the surgeon will explain what will happen and tell you about the possible side effects. They may also tell you about other treatments that may help in your situation, such as radiotherapy.
The aim of the surgery is to remove all of the cancer cells. It is usually only done when the cancer is contained within the prostate and has not spread to the surrounding area.
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Can Prostate Be Removed What Happens After Survival Rate
Since the prostate can cause so many problems in mens health, can the prostate be removed? The answer is yes. Heres what happens after and the survival rate.
If you are looking to reduce your chances of developing prostate cancer, this procedure can help you do just that!
Keep reading to learn more about how to remove your prostate.
Immediately After A Prostatectomy
- You will stay in hospital for two to five days.
- Nurses will monitor your vital signs.
- Your pain will be managed with medication.
- You may be given antibiotics to reduce the risk of infection.
- You may have a drip inserted into your arm or hand for a few days.
- You will most likely have a drain tube out of your abdomen that will be removed in the first day or two after the surgery.
- You will be fitted with a small tube in your penis. The catheter drains urine into an attached bottle or bag. This catheter will be removed about one to three weeks after the operation. Your surgeon will tell you when it can be removed.
- In most cases, you will have to go home still wearing the catheter. You will be taught how to care for it.
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Types Of Radical Prostatectomy
There are three main types of radical prostatectomy:
- Retropubic. In this procedure, the surgeon uses an incision in the lower abdomen to remove the prostate and the lymph nodes for examination. This procedure allows for a nerve-sparing approach, which can lower but not totally eliminate the risk of impotence following surgery. In the nerve-sparing approach, the surgeon tries to preserve one or both of the small nerve bundles needed for unassisted erections. However, if the cancer has spread to the nerves, this approach may not be advised.
- Laparoscopic. In this recently developed procedure, the prostate is removed in a fashion similar to a retropubic prostatectomy, but the procedure is performed through five very small incisions using lighted, magnified scopes and cameras. The prostate specimen is then removed in a small bag through one of the incisions, which is expanded to 2 to 3 cm to allow specimen removal.Potential benefits of this procedure are less pain and earlier return to full activities. Nerve-sparing methods and lymph node dissections can be performed with this technique as well.
- Perineal. In this procedure, the prostate is removed through an incision in the skin between the scrotum and anus. The lymph nodes can’t be removed through this incision. If the lymph nodes need to be examined, removal can be done through a small abdominal incision or by a laparoscopic procedure. A nerve-sparing approach can be performed perineally.
Life After Prostate Cancer Treatment
Adjusting to life after prostate cancer treatment can take time. For some men, the emotional impact of what they have been through may not hit them until they have finished treatment. For others, working through the physical side effects is their immediate focus.
Although prostate cancer treatment can be lifesaving, it can also take a toll on the body. This can result in a disruption to normal urinary, bowel and sexual function.
Whether you have surgery, radiation or hormone therapy, you are likely to have side effects.
Its important to talk with your health care provider about these side effects before you start treatment, so you can learn about the range of options to treat them, says Anne Calvaresi, DNP, CRNP, RNFA, Urology Nurse Practitioner at the Kimmel Cancer Center, Thomas Jefferson University in Philadelphia.
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Advantages And Disadvantages Of Prostate Surgery
Advantages
- Surgery will completely remove the cancer if it is only in the prostate gland.
- The prostate can be removed and be fully analysed and staged in the laboratory.
- The success of the treatment can be easily assessed by PSA testing.
- If the PSA were to rise after surgery you would still be able to get other treatments like radiotherapy or hormone treatment.
Disadvantages
It involves a general anaesthetic and the usual risks you would expect with surgery, like the risk of bleeding, infection and blood clots.
- You will have to stay in hospital for a few days.
- You may get side-effects afterwards like problems with erections and urinary incontinence.
- You will not be able to father children after the surgery, as the prostate, which normally makes some of the fluid needed for semen to be made, has been removed.
- Recovery takes around 6 weeks.
What The Research Shows About Radiation Vs Surgery
The ProtecT trial was a 10-year, randomized clinical study designed to compare radical prostatectomy, external-beam radiotherapy and active surveillance for the treatment of localized prostate cancer.
The results, published in 2016, showed that the rate of disease progression among men assigned to radiotherapy or radical prostatectomy was less than half the rate among men assigned to active monitoring. However, there was no significant difference in survival at the median 10-year mark for radiation therapy, surgery or active surveillance.
If youre interested in directly comparing treatment outcomes by treatment method and risk group , the Prostate Cancer Free Foundation provides an interactive graph on its website with information from data obtained from over 100,000 prostate cancer patients over a 15-year period.
As discussed earlier in the sections on the side effects of radiation therapy and surgery, the researchers conducting the ProtecT trial also looked at side effects and quality-of-life issues and found that the three major side effects of these two treatment options that affect quality of life after prostate cancer treatment are urinary incontinence, sexual dysfunction and bowel health.
The trial found that urinary leakage and erectile dysfunction were more common after surgery than after radiation therapy. Gastrointestinal bowel problems were more common after radiation therapy.
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Can I Have An Orgasm Without An Erection
Yes. An erection is not necessary for orgasm or ejaculation. Even if a man cannot have an erection or can only get or keep a partial erection, with the right sexual stimulation you can experience an orgasm. Your orgasm has little to do with your prostate gland. As long as you have normal skin sensation, you can have an orgasm.
Why The Procedure Is Performed
An enlarged prostate can make it hard for you to urinate. You may also get urinary tract infections. Removing all, or part, of the prostate gland can make these symptoms better. Before you have surgery, your doctor may tell you changes you can make in how you eat or drink. You may also try some medicines.
Prostate removal may be recommended if you:
- Cannot completely empty your bladder
- Have repeat urinary tract infections
- Have bleeding from your prostate
- Have bladder stones with your enlarged prostate
- Urinate very slowly
- Took medicines, and they did not help your symptoms or you no longer want to take them
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What Is The Outlook For Men Who Have Benign Prostatic Hyperplasia Surgery
Benign prostatic hyperplasia surgery has a very high success rate. However, for the best results from treatment, you should seek medical help at the earliest signs of a problem. Also, talk with a doctor if you are experiencing symptoms of BPH after surgery.
There is no evidence that BPH increases the risk of developing prostate cancer. However, the symptoms of BPH and prostate cancer are similar. The American Urological Association and the American Cancer Society recommend annual prostate screenings for men ages 55 to 69. Men at high risk such as African-American men and men with a family history of prostate cancer should begin screening at age 40.
What Is The Prostate Gland
The prostate gland is about the size of a walnut and surrounds the neck ofa man’s bladder and urethrathe tube that carries urine from the bladder.It’s partly muscular and partly glandular, with ducts opening into theprostatic portion of the urethra. It’s made up of three lobes, a centerlobe with one lobe on each side.
As part of the male reproductive system, the prostate gland’s primaryfunction is to secrete a slightly alkaline fluid that forms part of theseminal fluid , a fluid that carries sperm. During male climax, the muscular glands of the prostate help to propel the prostatefluid, in addition to sperm that was produced in the testicles, into theurethra. The semen then travels through the tip of the penis duringejaculation.
Researchers don’t know all the functions of the prostate gland. However,the prostate gland plays an important role in both sexual and urinaryfunction. It’s common for the prostate gland to become enlarged as a manages, and it’s also likely for a man to encounter some type of prostateproblem in his lifetime.
Many common problems that don’t require a radical prostatectomy areassociated with the prostate gland. These problems may occur in men of allages and include:
Cancer of the prostate is a common and serious health concern. According tothe American Cancer Society, prostate cancer is the most common form ofcancer in men older than age 50, and the third leading cause of death fromcancer.
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Known Side Effects Of A Radical Prostatectomy
So, what happens to a man when he has his prostate removed? There is a multitude of effects that occur to men after they have had prostate removal surgery.
The procedure is major pelvic surgery, and, as such, it carries along with it many potential risks. In addition to the immediate effects of the surgery, the removal of the prostate causes long-term side effects that are generally permanent.
Until recently, these side effects about what happens to a man when he has his prostate removed have not been relatively well-classified.
Most side effects are those reported by urologists that are performing the surgery. This reporting has been, in past years, rather poorly detailed and sparse due to the surgeons not anxious to publicize the failures of a procedure, they have attached a gold standard label.
The most reported side effects are erectile dysfunction and urinary incontinence.
Unfortunately, even though doctors have filed reports, the bias of the doctors filing them is questionable.
For example, one report details one of the significant side effects, postoperative erectile dysfunction, occurs between 14 and 90 percent of patients. This is a relatively wide range.
Based on my many years of practice, it is a very optimistic estimate. And it is likely provided by urologists who either do not want to admit their procedure causes such harm or deny the side effects and results.