What Surgery Is Done For Prostate Cancer

Risks Of Prostate Surgery

The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:

• Reactions to anesthesia
• Blood clots in the legs or lungs
• Damage to nearby organs
• Infections at the surgery site.

Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.

If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.

In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.

Advantages And Disadvantages Of Surgery

What may be important for one person might be less important for someone else. The advantages and disadvantages of surgery may depend on your age, general health and the stage of your cancer.

Advantages

• If the cancer is completely contained inside the prostate, surgery will remove all of the cancer.
• The prostate is looked at under a microscope to give a clearer picture of how aggressive your cancer is, whether it has spread outside your prostate and if you need further treatment.
• Your health professionals can get a good idea of whether your cancer was completely removed during surgery. Your PSA level should drop so low that its not possible to detect it at six to eight weeks after surgery.
• If there are signs that your cancer has come back or wasnt all removed, you may be able to have further treatment.
• Some men find it reassuring to know that their prostate has been physically removed, although you will still need to have follow-up tests to make sure no cancer cells have spread outside the prostate.

Disadvantages

After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body

The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.

The following tests and procedures also may be used in the staging process:

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What Is Prostate Cancer Surgery

Prostate cancer is a cancer that develops in the prostate gland – a small gland placed between the penis and the bladder in men. Prostate is a part of the male reproductive system. It secretes prostate fluid – through the seminal vesicles – that forms a part of semen along with sperms and fluids from other glands.

The seminal vesicles are a pair of smaller glands present on the sides of the prostate. Prostate cancer may spread to the seminal vesicles too.

The surgery for prostate cancer involves removal of the prostate gland, seminal vesicles and a part of the urethra. This procedure is known as radical prostatectomy. The tissues around these glands may also be removed if cancer cells are observed on them. The following types of radical prostatectomy are available:

• Open surgery: A large incision is made to remove the prostate gland and the tissues that may have cancer cells.
• Minimally invasive surgery: The prostate and adjacent cancer cells are accessed with the help of a few small incisions. This surgery may be done manually or with robotic assistance.

What Are The Side Effects

Medical research shows that symptoms of incontinence and impotence are similar for both minimally invasive surgery and traditional surgery. Men usually return to normal urinary function within 3 months.

Because this technique is nerve-sparing, a man’s postoperative ability to have an erection should be comparable to that of traditional surgery. Recent studies have shown no difference between laparoscopic surgery and open surgery called open radical prostatecomy .

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How Is Prostate Cancer Treated

Through a virtual conversation, Nathan can help you get ready to talk to your doctor about treatment options.

Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are

• Expectant management. If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you dont treat the cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways:
• Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen tests and prostate biopsies regularly, and treating the cancer only if it grows or causes symptoms.
• Watchful waiting. No tests are done. Your doctor treats any symptoms when they develop. This is usually recommended for men who are expected to live for 10 more years or less.

Other therapies used in the treatment of prostate cancer that are still under investigation include

Surgically Removing The Prostate Gland

A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.

Like any operation, this surgery carries some risks.

A recent trial showed possible long-term side effects of radical prostatectomy may include an inability to get an erection and urinary incontinence.

Before having any treatment, 67% of men said they could get erections firm enough for intercourse.

When the men who had a radical prostatectomy were asked again after 6 months, this had decreased to 12%. When asked again after 6 years, it had slightly improved to 17%.

For urinary incontinence, 1% of men said they used absorbent pads before having any treatment.

When the men who had a radical prostatectomy were asked again after 6 months, this had increased to 46%. After 6 years, this had improved to 17%.

Out of the men who were actively monitored instead, 4% were using absorbent pads at 6 months and 8% after 6 years.

In extremely rare cases, problems arising after surgery can be fatal.

It’s possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.

After a radical prostatectomy, you’ll no longer ejaculate during sex. This means you will not be able to have a child through sexual intercourse.

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Which Treatments Are Best In Keeping Men In Remission

Here is your opportunity to compare prostate cancer treatments. Over 129,000 patients underwent PSA monitoring after treatment to see which treatments were most effective at keeping the cancer in remission. The charts show which treatments are more likely to leave patients Prostate Cancer Free, for how many years. Share this data, talk with your Doctor, or multiple Doctors and make an informed decision. Select the treatment option, that is best for you.

Compare Prostate Cancer Treatments by gathering information about your own Prostate Cancer Diagnosis. Your Doctor will provide three elements that describe your prostate cancer. Your PSA, Stage and Gleason Score. These three elements help you determine your risk group. Find and select your Risk Group in the table below. This will take you to the comparing prostate cancer treatments page, where you can select different prostate cancer treatments on an interactive chart and graphically see their effectiveness over time.

The treatments included in this study are Prostate Surgery or Prostatectomy, , Brachytherapy or Seeds, High Dose Rate Radiation, HDR, External Beam Radiation Therapy or EBRT, Androgen Deprivation Therapy, ADT, or Hormone Treatment, Proton Therapy, High-Intensity Focused Ultrasound, HIFU, Cryotherapy, Cryo and Hypo-Fractionated External Beam Radiation Therapy. For more advanced prostate cancer, treatments are combined to increase effectiveness.

Radical Prostatectomy Perineal Approach

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Why Is A Prostate Cancer Surgery Done

The surgery for prostate cancer is recommended for the treatment of prostate cancer. Initially, prostate cancer may not show any symptoms. Over time, the following symptoms may be observed:

• Painful ejaculation
• Pain or burning sensation while urinating Read more: Painful urination causes
• Weak flow while urinating
• Bone pain

Types Of Prostate Surgery

There are several ways of removing the prostate keyhole surgery either by hand or robot-assisted, and open surgery.

Although robot-assisted keyhole surgery is the newest technique, the most recent research suggests all three techniques are as good as each other for treating prostate cancer, as long as the surgeon is experienced. They also have similar rates of side effects.

The advantages of keyhole surgery, both by hand and robot-assisted, are that you are likely to lose less blood, have less pain, spend less time in hospital, and heal more quickly than with open surgery.

Keyhole surgery

Keyhole surgery .

• Robot-assisted keyhole surgery Your surgeon makes five or six small cuts in your lower abdomen and a slightly bigger cut near your belly button, and removes the prostate using special surgical tools. These include a thin, lighted tube with a small camera on the tip. The image will appear on a screen so the surgeon can see what theyre doing. Your surgeon controls the tools from a console in the operating room via four or five robotic arms. Although its called robot-assisted, its still a surgeon who does the operation. You may hear the equipment called the da Vinci® Robot.
• Keyhole surgery by hand As with robot-assisted keyhole surgery, the surgeon will make four or five small cuts in your abdomen. But they will hold the surgical tools in their hands, rather than using robotic arms.

Open surgery

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How Common Is Prostate Cancer

About one in nine men will receive a prostate cancer diagnosis during his lifetime. Prostate cancer is second only to skin cancer as the most common cancer affecting males. Close to 200,000 American men receive a diagnosis of prostate cancer every year. There are many successful treatments and some men dont need treatment at all. Still, approximately 33,000 men die from the disease every year.

Prostate Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Prostate

The prostate is agland in the malereproductive system. It lies just below the bladder and in front of the rectum . It is about the size of a walnut and surrounds part of the urethra . The prostate gland makes fluid that is part of the semen.

Prostate cancer is most common in older men. In the U.S., about 1 out of 5 men will be diagnosed with prostate cancer.

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Complications Due To Surgeries:

Urinary incontinence:

This is one of the major side effects of surgical procedures to treat prostate cancer. This is a phenomenon where men cannot control their urine or experience leaking of the urine. Post surgery, men experience a constant urinary incontinence, known as continuous incontinence. There are three major types of urinary incontinence:

• Stress incontinence: This is the leakage of urine when a person sneezes, cough, laughs or exercises. This is caused due to the problems of the valve in the urinary bladder which is responsible to keep the urine in its place. Prostate cancer treatments damage the muscles and nerves of this valve leading to stress incontinence.
• Overflow incontinence: Men with overflow incontinence have a trouble in emptying their bladder. They take a lot of to urinate, after which a they urinate a dribbling stream with little force. This condition is caused due to the blockage or narrowing of the bladder outlet by scar tissue.
• Urge incontinence: Post surgical procedures, the urinary bladder find it difficult to stretch its walls to the urine because of which men get the urge to urinate.

Erectile dysfunction:

Changes in orgasm:

The prostate gland and the seminal vessels are responsible for the secretion of the semen. Removal of these glands affect the ejaculation of the semen. Men experience pleasure during the sensation, but their orgasm remains to be dry. In a very few cases, men experience pain during orgasms.

Loss of fertility:

Lymphedema:

What Happens After Robotic Prostate Surgery

• Robotic prostate surgery operative time is typically 2-4 hours
• Hospital stay is typically 1-2 days
• Our team will be seeing you on a daily basis during your stay in the hospital and will give you detailed after-surgery instructions prior to your discharge home.
• Foley Catheter typically comes out on day 5 after a cystogram
• Jackson Pratt drain comes out around the time of Foley catheter removal depending on your individual circumstances
• No driving for 7 days after prostate surgery
• No other restrictions in physically activities after surgery – just do what you can tolerate
• Aspirin can be restarted when you are back to eating regular meals
• You will be given Viagra upon the removal of the foley catheter. Typically 50mg a night, increasing to 100mg if no response. This is not given to necessarily induce erections, but to help improve the blood supply to your penis. If you have any heart conditions, your internal medicine doctor needs to clear you before taking Viagra.
• The first PSA check after prostate surgery is at 1 month and then 3-6 months thereafter.

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Who Can And Cannot Get A Prostate Cancer Surgery Done

Prostate cancer surgery is beneficial in the treatment of people with prostate cancer, which is either present only in the prostate or has spread to the region just adjacent to the prostate. People undergoing this surgery should also be generally healthy. In some cases, surgery may also help in treating the cancer that may have reoccurred after radiotherapy.

The surgery is generally not recommended in people with significant health conditions, such as heart disease, as the risks of the surgery increase. This surgery is also not recommended in men above the age of 75 years or life expectancy of less than 10 years.

What You Need To Know About Prostate Surgery

• Recovery

What is prostate surgery for?

The prostate is a gland located underneath the bladder, in front of the rectum. It plays an important role in the part of the male reproductive system that produces fluids that carry sperm.

Surgery for partial or complete removal of the prostate is called a prostatectomy. The most common causes for prostate surgery are prostate cancer and an enlarged prostate, or benign prostatic hyperplasia .

Pretreatment education is the first step to making a decisions about your treatment. All types of prostate surgery can be done with general anesthesia, which puts you to sleep, or spinal anesthesia, which numbs the lower half of your body.

Your doctor will recommend a type of anesthesia based on your situation.

The goal of your surgery is to:

• cure your condition
• maintain the ability to have erections
• minimize side effects
• minimize pain before, during, and after surgery

Read on to learn more about the types of surgery, risks, and recovery.

The goal of prostate surgery also depends on your condition. For example, the goal of prostate cancer surgery is to remove cancerous tissue. The goal of BPH surgery is to remove prostate tissue and restore the normal flow of urine.

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Reasons For The Procedure

The goal of radical prostatectomy is to remove all prostate cancer. RP isused when the cancer is believed to be confined to the prostate gland.During the procedure, the prostate gland and some tissue around the gland,including the seminal vesicles, are removed. The seminal vesicles are thetwo sacs that connect to the vas deferens , and secrete semen.Other less common reasons for radical prostatectomy include:

• Inability to completely empty the bladder

• Recurrent bleeding from the prostate

• Bladder stones with prostate enlargement

• Very slow urination

• Increased pressure on the ureters and kidneys from urinary retention

There may be other reasons for your doctor to recommend a prostatectomy.

What Happens After Surgery

You can expect to follow a liquid diet at first and then gradually be able to eat solid foods. When you go home, you will follow a soft diet, which generally means no raw fruits or vegetables. A dietitian can give you more specific guidelines.

Nausea and vomiting are common because the intestines are temporarily disabled during anesthesia and surgery. Your doctor can prescribe medications to relieve these symptoms, which will improve a few days after surgery.

You will be encouraged to get out of bed and walk as much as possible, starting the first day after surgery. You should steadily increase your activity after you go home. For 6 weeks after surgery, you should not lift or push anything over 30 pounds and should not do abdominal exercises such as sit-ups.

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