You Have Plenty Of Time To Make Decisions
Making good decisions is the most difficult part of having breast cancer. You will feel pressed for time to learn everything and start your treatment as soon as possible. Time is usually on your side. You must work with your team to learn everything about your cancer and treatment options. We created the Breast Cancer School for Patients to quickly teach you to be your own expert in breast cancer. You will make better decisions being your own best advocate.
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Testing Options For Prostate Cancer
There is no one age for prostate cancer testing, but the American Cancer Society makes recommendations about prostate cancer screenings. According to the ACS, patients in any of these groups should consider asking their doctor about testing:
- Men age 50 or older who have an average risk of prostate cancer and a life expectancy of at least 10 more years
- Men age 45 or older with a high risk, including African-American men and those with a first-degree relative who had prostate cancer before age 65
- Men age 40 or older who have a higher risk, such as more than one first-degree relative diagnosed with prostate cancer at an early age
Why Is It Important To Know The Risk Level Of Your Cancer
Knowing whether your cancer is low-risk, medium-risk, or high-risk is important when you are making treatment choices.
The risk level of your cancer is based on the results from your tests and exams, such as the PSA test, digital rectal exam, and prostate biopsy.
- Low-risk means that the cancer isn’t likely to grow right away. There is a chance it may grow so slowly that it never causes symptoms.
- Medium-risk means that the cancer is more likely to grow. Most people will likely need treatment with radiation therapy or surgery.
- High-risk means that the cancer will most likely grow right away. People will likely need treatment with radiation therapy or surgery.
Your doctor can help you understand your test results and the risk level of your cancer. Then you can compare your treatment options and make the choice that seems best to you.
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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.
- In most cases, you will have to go home still wearing the catheter. You will be taught how to care for it.
What Is A Robotic Prostatectomy
Robotic prostatectomy, or robotic-assisted laparoscopic radical prostatectomy, is the complete surgical removal of the prostate, seminal vesicles, and vas deferens for the treatment of prostate cancer. Compared with the traditional open operation, the procedure is performed through small incisions using the daVinci Surgical System.
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Eligard Vs Lupron Depot: Which Is More Effective Against Prostate Cancer
There isnt much research available comparing these medications directly. But we can look at how well each medication lowers testosterone levels.
The goal with medications like leuprolide is to lower testosterone levels below 50 ng/dL. In Eligards clinical trials, over 94% of participants achieved this goal within about a month of their first injection. Similarly, about 94% of people in Lupron Depots clinical trials reached the goal level within the first month.
What Is Localized Prostate Cancer
Prostate cancer is the abnormal growth of cells in the prostate gland. Localized prostate cancer has not spread outside the gland. Early prostate cancer usually doesn’t cause symptoms.
Most cases of prostate cancer occur after age 65. If your father, brother, or son has had prostate cancer, your risk is higher than average.
African Americans have the highest rates of both prostate cancer and deaths from it.
About 12 out of 100 men in the U.S. will get prostate cancer.footnote 5 But most people who are diagnosed with prostate cancer don’t die from prostate cancer.
Unlike many other cancers, prostate cancer is usually slow-growing. When prostate cancer is found earlybefore it has spread outside the glandit may be cured with radiation or surgery.
Prostate cancer that has grown beyond the prostate is called advanced prostate cancer. Treatment choices are different for that stage of cancer.
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What The Results Showed
After five years, there were no significant differences in survival associated with any of the selected treatments. Just one man in the favorable risk category died from prostate cancer during the study, and there were eight deaths from the disease in the unfavorable risk group.
Many men in the study had initial problems with sexual, bowel, urinary, and hormonal functioning. Brachytherapy caused more irritative urinary problems during the initial six months than the other treatments, but then those symptoms steadily improved. Brachytherapy and EBRT were associated with minor bowel symptoms such as urgency, bleeding, frequency, and pain that resolved within a year in men from both risk groups.
Dr. Marc Garnick, Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, agreed the study provides a valuable resource that adds to existing information. Yet he cautioned against brachytherapy, warning that this particular treatment in some cases has long-term urinary side effects that can significantly alter a patients quality of life. I do not routinely recommend brachytherapy, Garnick said. This is especially true in patients with a pre-existing history of urinary tract infections or prostatitis.
About the Author
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
How Soon After Prostate Cancer Diagnosis Should Surgery Be Done : Freedomfighters For America
Learn about detection, diagnostic approaches, treatment options and. Radiation therapy , often with adt, is an option for men in this group. Find out more from the experts at webmd. Is still being carried out into when it should be used after surgery. Prostate biopsy is often done using a thin needle thatâs inserted .
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Side Effects Of Prostate Cancer Treatment
The side effects of treatment vary depending on several factors, and they can be distressing. You should talk through options and concerns with your doctor before deciding which treatment to use for your prostate cancer.
Some common side effects of types of treatment include:
- Surgery many men will have temporary urinary incontinence . Almost all men will have a change to their sexual function and most men will have erectile dysfunction .
- Radiotherapy a small number of men will have bowel problems. Between 40 and 80 per cent of men who have radiotherapy will experience immediate or delayed erectile dysfunction.
- Brachytherapy erectile dysfunction and bowel problems can occur. Some men may experience painful urination and irritation of the bladder for several months after therapy. Urinary incontinence is not usually a problem.
- Hormone therapy side effects may include erectile dysfunction, tiredness, mood changes, hot flushes and loss of sex drive.
Coping with some of these side effects can be very difficult. It is important that you discuss possible side effects with your specialist before treatment.
Survival And Time To Surgery
A 2016 study published in JAMA Oncology looked at data from over 115,000 people via the National Cancer Database . This study included people age 18 and older who were cared for at Commission on Cancer-accredited cancer centers across the United States.
All of the people had early stage breast cancer with surgery as their first treatment. They then looked at wait times to surgery and survival rates at five different intervals: a wait of less than 30 days, a wait time of 31 to 60 days, a wait time of 61 to 90 days, a wait time of 91 to 120 days, and a wait time of 121 to 180 days.
They found that for each 30-day interval of delay, survival rates decreased for people with stage I and stage II breast cancer. The conclusion was that although time is needed to discuss treatment options and prepare, earlier surgery is better.
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Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will work with you to develop a specific treatment plan based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
Loss Of Bladder Control
You can expect to have some light dribbling or trouble controlling your bladder for some weeks to months after a radical prostatectomy. This is known as urinary incontinence or urinary leakage. You can use continence pads to manage urinary leakage. Bladder control usually improves in a few weeks and will continue to improve for up to a year after the surgery. In the long term, some people will continue to have some light dribbling. Some people may consider having an operation to fix urinary incontinence. In rare cases, people have no control over their bladder. For help managing these problems, see Urinary problems.
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Open Rp Versus Robotic
The ability to perform robotic-assisted laparoscopic RP was first described in 2000. Over the past decade, RALRP has gained widespread acceptance and now is the dominant approach to RP in the United States. Many attribute the adoption of the RALRP to marketing as opposed to any objective outcomes data showing superiority over the open approach.
All of the intermediate- and long-term HRQOL outcomes reported in the literature are limited to open RP. The question is, are these findings relevant to RALRP?
Unfortunately, there are no randomized studies comparing HRQOL outcomes following open versus robotic RP. The majority of studies comparing HRQOL outcomes between the two techniques are flawed in design. First, the level of experience of surgeons performing the two techniques and their patient volume are often not comparable. In addition, validated instruments for capturing outcomes are usually not employed. Surgeons are sometimes involved in the data acquisition, entry, and interpretation, which can introduce bias. There are several studies that have examined large administrative databases, which often mitigate bias, but the quality of outcome measures is subject to criticism. A few studies stand out as objective and worthy of comment.
Barocas and colleagues compared men undergoing open and RALRP and failed to show any advantages of either approach for preventing biochemical recurrence.
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Side Effects Of Prostate Surgery
The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.
Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:
- Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
- Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
- Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
- Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.
After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.
There are several options for treating erectile dysfunction:
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Surgery For Prostate Cancer
Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland.
The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles.
Will My Treatment Be Paid For By Insurance
Cancer treatment is expensive. After a prostate cancer diagnosis, request a full description of your medical benefits from your insurance provider. Bring that with you to your first appointment. During your first visit youll spend some time with the Virginia Oncology Associatespatient benefits specialist. They will know how to help you with gaps in coverage for prescriptions or other concerns that many patients have related to paying for cancer treatment.
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Side Effects From Hormone Therapy
Hormone therapy for prostate cancer, known as androgen deprivation therapy , suppresses production of testosterone. ADT can cause several side effects. These include fatigue, hot flashes, decreased bone density, ED, depressed mood, decreased sex drive, weight gain, heart risks, breast growth and cognitive decline.
The severity and length of side effects depend on how long treatment lasts. âIf a man has only six months of treatment, their level of testosterone rises again, and theyâll go back to feeling like themselves,â Calvaresi said.
Often, mood changes in men on ADT are caused by other side effects such as weight gain and hot flashes. âIf we can manage those other side effects, then often that improves mood,â she said. Following a healthy diet and exercising regularly often helps to decrease fatigue, prevent weight gain and improve overall mood. Before beginning hormone therapy, you should discuss the effects of ADT with your doctor, and talk about how you can change your exercise and eating habits to help head off side effects before they occur.
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.
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Tips For Talking With Your Partner
Feeling less of a desire to have sex or having trouble getting an erection may affect your relationship. Try to be as open with your partner as you can. Here are some tips:
- Bring your partner with you to doctors visits. Being part of the conversation may help them understand what youre experiencing.
- Listen to your partners concerns, too. Remember that this issue affects both of you.
- See a therapist or a sex therapist to help you work out any issues that are affecting your sex life.
- If sex is a problem right now, its possible to fulfill each other sexually in other ways. Cuddling, kissing, and caressing can also be pleasurable.
Can You Still Have An Erection If Your Prostate Is Removed
Yes, it is possible as the prostate gland does not play any direct role in erectile function or testosterone production. Erectile dysfunction after prostatectomy is mainly due to local inflammation and nerve injury.
How severe one would have prostate surgery-related issues would depend on the kind of surgery one had.
For example, if one had a minimally invasive surgery for partial prostate removal, the chances are slim that nerves involved in erection might be damaged.
Nevertheless, these nerves may not function well for a few months due to local inflammation. However, most men can expect to reach their prior erection quality in 3 months in such cases.
There are greater chances of nerve damage when it comes to radical prostatectomy because of localized prostate cancer than there are greater chances of nerve damage. 60% of men can expect their erectile function to reach the prior-to-surgery level within 3 months.
Regretfully, the road to recovery for the rest of 40% is prolonged. They might need months and even years of treatment. Some may need regular treatment for erectile dysfunction for the rest of their life after prostate removal.
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