Caring For The Incision
You will be able to take a shower the second day after your surgery. You may continue to have some discharge at the drain site for three to five days. Once you leave the hospital, the key words on caring for the drain site and incisions are clean and dry. Showering once a day and gently patting the area with a clean towel should be sufficient.
After Prostate Surgery Will The Prostate Continue To Grow Or Will It Stop After The Surgery
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What Factors Determine The Likelihood Of Recurrence
Several signs can point to a prostate cancer that has come back or spread, including:
- Lymph node involvement. Men who have cancer cells in the lymph nodes in the pelvic region may be more likely to have a recurrence.
- Tumor size. In general, the larger the tumor, the greater the chance of recurrence.
- Gleason score. The higher the grade, the greater the chance of recurrence. Your doctor can tell you your score when the biopsy results come back from the laboratory.
- Stage. The stage of a cancer is one of the most important factors for selecting treatment options, as well as for predicting future outlook of the cancer.
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How Does My Doctor Choose A Treatment
Once you know that your cancer has returned, you and your doctor will choose a treatment. A few factors go into making the decision, including:
- Which type of treatment you had before
- How aggressive your cancer is
- Whether, and where, it has spread
- How much time has passed since your first treatment
- How quickly your PSA level is rising
- Your overall health
Talking With Your Doctor
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
- Family doctors and internists
- Physician assistants and nurse practitioners
- Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
- Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
- Radiation oncologists, who use radiation therapy to treat cancer
- Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
- Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
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Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
How To Handle A Relapse After Treatment For Prostate Cancer
Am I going to die? This is the first question a patient usually asks me when a follow-up blood test reveals that his prostate-specific antigen level has risen after he has already undergone treatment for prostate cancer . The fear is understandable: When PSA levels rise to a certain threshold after prostate cancer treatment, the patient has suffered what is known technically as a biochemical recurrence, sometimes also referred to as a biochemical relapse or stage D1.5 disease. Whatever term is used, it means that prostate cancer remains within the prostate after radiation therapy, that it survived outside the excised area after radical prostatectomy, or that it has reappeared in metastatic form in other tissues and organs. In most cases the cancer remains at a microscopic level, and many years will pass before any physical evidence of it is detectable on a clinical exam or any abnormalities are seen on a bone scan or CT scan.
Thats usually of small comfort to the patient whose PSA has risen. Its emotionally traumatic to go through treatment for prostate cancer, thinking it is cured, and then learn that it might have come back. For many men, its as if theyre dealing with another diagnosis of cancer, except this time its much worse because there is less likelihood of getting cured. A mans confidence and sense of safety may be shattered, especially because the popular misconception is that when prostate cancer recurs, it is deadly.
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Does Penis Length Recover After Prostate Removal
By Andrew M. Seaman, Reuters Health
5 Min Read
– After prostate removal for cancer, men sometimes complain to their doctors that their penis shrank, but a new study from Japan suggests they should not lose hope.
Following men for up to two years after surgery, researchers found the patients penises were shortest a few days after their procedures. Penis lengths generally returned to normal after one year, however.
The studys lead author said the research was started after encountering a few patients complaining of penis shortening after prostate removal, which is known medically as a radical prostatectomy.
Past reports mentioned shortened penises after prostate removal, but the results were a bit different, said Dr. Yoshifumi Kadono, of Kanazawa University Graduate School of Medicine Science.
Therefore, we started our study to obtain our data, he told Reuters Health.
For the new study, the researchers measured the penis lengths of 102 men before having their prostates removed and then at 10 days after surgery and again one, three, six, nine, 12, 18 and 24 months later.
The mens stretched penis lengths were shortest 10 days after surgery, when measurements were an average of about 1.99 centimeters shorter than before prostate removal.
The researchers wanted to know what caused the shortening and if any particular variable, such as the size of a mans prostate gland, would predict which men would experience this effect.
Follow Up Treatment For Recurrent Prostate Cancer
When diagnosed with recurrent prostate cancer, its important to begin treatment as soon as possible. If you did not have a prostatectomy before, your doctor will likely recommend one now. This is important as recurrent prostate cancer is more aggressive and can result in the cancer spreading to lymph nodes and bone if not addressed quickly. In certain cases, when the only sign of recurrent cancer is an increased PSA level, your doctor may recommend a combination of radiation therapy, hormone therapy, chemotherapy, or a combination of treatment efforts.
If your prostate cancer has returned after undergoing hormone therapy, your body may no longer be responding to the hormones. If this is the case, it means one of two situations:
- Castrate-Resistant Prostate Cancer this is when your prostate cancer is still growing, regardless of the effect of hormone therapy on testosterone. CRPC may still respond to other types of hormone therapy.
- Hormone-Refractory Prostate Cancer this is when the prostate cancer is no longer able to be helped by any form of hormone therapy.
Regardless of if youve been diagnosed with prostate cancer, are experiencing recurrent prostate cancer, or are simply trying to take better care of your urologic care, working with a trusted urologist is essential. Always follow your doctors recommendations and dont hesitate to ask any questions you may have. During your treatment plan, along the way.
What Are My Treatment Options
Recurrent prostate cancer treatment is called second-line or salvage therapy. Treatments aim to do one of two things: get rid of your cancer or slow it down .
Curative treatments include:
- Radiation therapy. It uses high-energy X-ray beams to kill cancer cells. The radiation can come from a machine outside your body, which is called external beam radiation. Or you can get radiation through tiny seeds or a tube placed into your prostate, which is called brachytherapy.
- Cryotherapy. This treatment uses extreme cold to kill cancer cells.
- Surgery. Radical prostatectomy removes your prostate and some of the tissue around it.
Control treatments include:
- Hormone therapy. It lowers the amount of the hormone testosterone in your body, or blocks it from getting to your cancer cells. Testosterone fuels the growth of prostate cancer.
- Chemotherapy. This treatment uses strong medicines to kill cancer cells.
How Common Is Recurrence Of Prostate Cancer
According to the American Cancer Society, nearly 100% of men with low- to intermediate-grade prostate cancer can expect to live at least five years after the initial diagnosis. Since many men who get prostate cancer are already elderly, they are more likely to die from causes other than the cancer.
More than 90% of the time prostate cancer is discovered while it is either confined to the prostate gland or has spread beyond the prostate only to a small degree, referred to as regional spread.
Among the less than 10% of men whose prostate cancers have already spread to distant parts of the body at the time of diagnosis, about 30% are expected to survive at least five years.
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What Is A Prostatectomy
A common surgical approach to prostatectomy includes making a surgicalincision and removing the prostate gland . This may beaccomplished with either of two methods, the retropubic or suprapubicincision , or a perineum incision .
Prior to having a prostatectomy, it’s often necessary to have aprostate biopsy. Please see this procedure for additional information.
Risk Of A Change In Penis Size Versus Risk Of No Surgery
While any decrease in penis size can be alarming, a prostatectomy is done as a life-saving surgery. Prostate cancer can be fatal and treatment substantially lowers the risk of death. Many people who are treated for prostate cancer go on to live for many years.
Talk to your surgeon and your oncologist about your individual risk of serious and minor complications, as well your expected chance of a cure and your estimated lifespan after the procedure, Your doctors will also tell you what to expect in the weeks, months, and years following your surgery.
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Using Medication To Reduce Symptoms
Are There Different Types Of Hormone Therapy For Prostate Cancer
Yes. There are several different ways to block the secretion of testosterone, including the surgical removal of the testes, drugs known as LHRH agonists, and drugs called LHRH antagonists. These are considered standard hormone therapy. Another class of medications that can be used in combination with standard hormone therapy is called antiandrogens.
In the past decade, newer medicines called androgen directed therapies have been approved for certain states of advanced prostate cancer.
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Do I Need Additional Treatment After Prostate Surgery
After surgery, one of the most important questions to ask is whether you may benefit from additional therapy, such as adjuvant radiation . The decision to use radiation to lower your risk of recurrence and dying from prostate cancer after surgery is based on whether the cancer has spread to your seminal vesicles, whether there were positive margins, and whether the cancer spread beyond the prostate capsule. In addition, it is important to allow time to recover your urinary function before considering radiation therapy after surgery, as radiation to this region increases the risk of urinary strictures, leakage, and high urination frequency.Many, but not all men, often can safely avoid adjuvant radiation therapy, and closely monitor their PSA to determine if they will need early salvage radiation therapy .
Do Laser Treatments Have Any Advantages Over Turp
As well as the standard approaches such as TURP, there are a number of other surgical techniques. They mainly differ in terms of the instruments and sources of energy used to remove or destroy the prostate tissue. Most of the other techniques are carried out using laser beams. Like in TURP, the instruments are inserted into the urethra and guided to the prostate.
The laser treatments include:
- Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med 1995 332: 75-79.
IQWiG health information is written with the aim of helpingpeople understand the advantages and disadvantages of the main treatment options and healthcare services.
Because IQWiG is a German institute, some of the information provided here is specific to theGerman health care system. The suitability of any of the described options in an individualcase can be determined by talking to a doctor. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by ateam ofhealth care professionals, scientists and editors, and reviewed by external experts. You canfind a detailed description of how our health information is produced and updated inour methods.
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Treating Benign Prostate Enlargement
Treatment for an enlarged prostate will depend on how severe your symptoms are.
If you have mild symptoms, you do not usually need immediate treatment. Your doctor will agree with you if and when you need more check-ups.
You’ll probably be advised to make lifestyle changes, such as:
- drinking less alcohol, caffeine and fizzy drinks
- limiting your intake of artificial sweeteners
- exercising regularly
- drinking less in the evening
Medicine to reduce the size of the prostate and relax your bladder may be recommended to treat moderate to severe symptoms of an enlarged prostate.
Surgery is usually only recommended for moderate to severe symptoms that have not responded to medicine.
Possible Cancer Protection From Prostate Drugs
Early research suggested that 5-alpha-reductase inhibitors , a class of drugs used to treat prostate enlargement, might increase the risk of developing more aggressive prostate cancer. However, newer studies have found that not only do the drugs appear to pose no extra risk, they may even protect against prostate cancer.
For instance, research from the Prostate Cancer Prevention Trial study in 2013 showed that taking the 5-ARI finasteride for seven years could lower the chance of getting low-grade prostate cancer by 25% among men ages 55 and older. A follow-up study of almost 9,500 men, published in the Nov. 1, 2018, issue of the Journal of the National Cancer Institute, also showed that finasteride lowered the risk by a similar amount , and found the protective effect lasted for at least 16 years.
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Caring For The Catheter
You will be discharged with a Foley catheter, a tube that continuously drains urine from your bladder into a bag and that you will use for seven to 10 days. Before you leave the hospital, your nurse will teach you how to empty and care for your catheter and drainage bag. The catheter works with gravity and should be draining urine at all times, so you have to keep the drainage bag below your bladder at all times, even when you shower. If your urine is not draining, lower the bag and check the connection for kinks or loops. Loops can cause an air lock that prevents drainage. You can also try emptying the bag. Then try briefly disconnecting the catheter from the clear plastic tubing to allow a little air into the system. Your nurse will show you how to do this before your discharge.
To prevent infection, you must keep your catheter clean. This section explains how to clean the catheter, the area around the catheter and the drainage bag. It also explains how to apply your leg bag and secure the catheter to your leg.
We will provide most of the supplies you need to care for your catheter. They include:
- Blue clamp
- StatLock Foley catheter securement device
- Shaving supplies
You should empty the catheter bag when it’s half full. This helps prevent air locks from developing in the tubing.
To apply the leg bag: