Surgical Treatments for Prostate Cancer

The prostate cancer is the most common the second most deadly and grows slowly for a long time without showing symptoms.

The prostate is a gland in the male reproductive system that produces and stores seminal fluid which contains the sperm necessary for procreation. Seminal fluid is released by the sexual organ during ejaculation as a component of semen. It is estimated that prostate cancer will be present in one in six men at some point in their lives.

In most cases the prostate cancer grows very slowly and persists for a long time without causing significant symptoms but when it spreads (metastasizes) outside the prostate cancer cells are found in nearby lymph nodes. If the cancer has reached these nodes it means that cancer cells may have spread to other body organs such as bone bladder or rectum.

The current option of treatment for prostate cancer depends on the state of it and so far has expanded. For tumors that are still within the prostate radiation therapy (x-ray attack cancer cells) and a surgery called radical prostatectomy are common treatment options. Generally tumors that have grown beyond the prostate cannot be cured with either radiation or surgery but can be treated with hormones that cause tumor growth was slower.

Prostate Cancer Surgery

Decisions about prostate cancer involve many factors and can also bring its consequences. Before making these decisions it is important to spend some extra time to seek a second opinion. For instance going to another physician qualified to review the diagnosis and treatment options.

It must take into account that if the cancer causes no symptoms it grows very slowly is very small and is confined to a small area of the prostate may be recommended to maintain a expectant (wait and see) because in certain circumstances this may be the best option. This treatment is generally reserved for men over 80 years. Because prostate cancer often grows very slowly if the patient is older or has other serious diseases it is necessary to treat prostate cancer.

The radical prostatectomy is the surgery performed with the intent to cure prostate cancer but traditionally only applies to men under 70 years. It is most often performed when the cancer has not exceeded the limits of the prostate gland (stage T1 or T2). Currently radical prostatectomy is subdivided into two types:

Retropubic radical prostatectomy: In this surgery the urologist makes an incision in the lower abdomen from the navel to the pubic bone (suprapubic or half infraumbilical laparotomy). Retropubic radical prostatectomy is the operation most commonly performed by most surgeon’s urologists.

Perineal radical prostatectomy: In this surgery the urologist makes an incision in the perineum. This procedure is performed less frequently because the nerves of erection can not easily identifiable and can not be removed lymph nodes. But this operation is of short duration less blood loss and allows for easier vesicourethral anastomosis which may be appropriate if the patient is unwilling to maintain sexual potency or not require removal of lymph nodes. Also be done if there are other conditions that hamper the conduct retropubic surgery.

Perineal prostatectomy takes less time than the retropubic. After surgery the patient must remain in the hospital at least 3 days and can probably resume their work from 3 to 5 weeks after surgery.

It is highly recommended that the patient donate your own blood before radical surgery in case they were needed during surgery. After surgery the patient should wear a urinary catheter or bladder (a catheter or tube that is inserted through the urethra of the penis to the bladder to empty).

In addition to radical prostatectomy there are other surgeries that can be applied depending on the status of prostate cancer:

Transurethral resection of the prostate (TURP): The urologist removes part of the prostate that is found around the urethra if the patient has severe voiding syndrome and not a candidate for curative surgery. The RTU is used most often to treat BPH (benign prostatic hyperplasia). This operation is not necessary to cut into the skin. We introduce an instrument called a resectoscope through the tip of the penis into the urethra to the level of the prostate. Once there the electricity that passes through a metal arc cuts and vaporizes the tissue.

Cryosurgery for prostate cancer: One of the newest treatments for prostate cancer is precisely the freezing of the organ. Now this procedure is becoming popular thanks to a new technology that allows more securely. Cryosurgery or freezing at low temperatures in a tissue in order to destroy it is a less invasive alternative to radiation and surgery and has fewer complications less risk of impotence and incontinence bleeding and therefore no reduction in the need of blood transfusions and quicker recovery. The patient did not have to use a tube (or catheter to urinate) for 12 or 14 days in the radical surgery but in 2 to 3 days will be removed.

There are some risks of surgery in the prostate that partially dependent on the overall health of the patient and prior experience of the surgical team. Among the most serious risk is a low risk of myocardial infarction stroke deep vein thrombosis and surgical wound infection. Because the prostate is surrounded by many blood vessels the risk of postoperative bleeding. In extremely rare cases some patients have died from complications of this operation.

Prostate surgery can also cause some side effects long term as urinary incontinence (no control over that escapes the urine) or sexual impotence erectile dysfunction (inability to have erections sufficient for vaginal penetration).

This Blog is for reference only and in no way should replace the diagnosis and advice from a specialist.