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Prostate Cancer Surgery

When surgery becomes an option for prostate cancer,Risks and benefits of prostate cancer surgery,The favorable criteria for prostate cancer surgery

The latest edition of the Oxford Handbook of Clinical Medicine notes prostate cancer to be the second most common form of cancer among men. Sure, nobody would want to encounter those trying stages of cancer but what are the available options when it actually strikes? What is prostate cancer surgery? Why isn’t surgery advised to all those who have prostate cancer? What are the risks and benefits involved in prostate cancer surgery? Some bare facts that follow should provide a better insight to the know-how of prostate cancer surgery.
Prostate cancer surgery is suggested to be one of the options for men who are diagnosed with clinically localized prostate cancer. In this surgery, the entire prostate gland and the surrounding seminal vesicles are removed. If the cancer is still in its early stages, i.e., If the tumor is found to be still inside the prostate, the prostate cancer surgery or/and radiation therapy are common treatment options, depending upon other medical parameters of the patient. Tumors which have grown beyond the edge of the prostate cannot be cured with prostate cancer surgery.

Prostate cancer surgery can be performed either with an incision made in the abdomen known as radical retropubic prostatectomy, or through an incision made in the perineum (area between the scrotum and the anus) known as radical perineal prostatectomy. Sometimes, prostate cancer surgery is also done by laproscopy whereby specially designed telescopes are passed through small incisions in the body. This is known to be a relatively new procedure for prostate cancer.
Prostate cancer surgery can provide accurate information on how advanced the cancer is. After the complete removal of the gland, the pathologist can get the exact Prostate Specific Antigen (PSA) reading that helps determine the recurrence of cancer, or determine whether any additional treatment such as radiation must be given in order to hinder the spread of cancer.

This is the reason why the lymph nodes surrounding prostate gland are also removed in a prostate cancer surgery. Removal of lymph nodes ensures to check whether cancer has been spread to lymph nodes. Removal of lymph nodes is definite for those who suffer a moderate or high risk of the cancer spreading to the pelvic lymph nodes. Usually patients with PSA reading of more than 15ng/ml or high grade cancers are suggested to go in for pelvic lymph nodes removal.
This surgery, under careful guidance of a physician is known to be safe with very remote chances of life threatening complications. Even if it does not remove all the cancer, some doctors feel it is good to reduce the load of cancer cells in the body. Recurrence of cancer is easy to detect with prostate cancer surgery. It is learnt that with careful monitoring of PSA tests, prostate cancer surgery allows very low risk of local recurrence of 5 years.

All this, surgeons insist, is just one of the many options. Although prostate cancer surgery is actually the preferred choice for surgeons due to such diagnostic reasons, the surgery is mostly performed on patients who are in very good health and have a good life expectancy, beyond a minimum 10 years. This is because with the increase in age, there is increased risk of urinary incontinence (no control over passing urine) and impotence (inability to achieve or maintain an erection). Therefore it is very important to for the patient to talk to the surgeon about the possible complications before he is wheeled in for the surgery.

The patient could risk losing a lot of blood during a prostate cancer surgery. Before surgery, it is advised that the patient could save 2 units of his own blood as he might go in for a transfusion later. A few tests like blood tests, transrectal ultrasound, prostate biopsy, and sometimes a bone scan, CT scan or an MRI of the abdomen and the pelvis region is done to ascertain certain clinical parameters of the disease.

Studies suggest that patients are likely to regain bladder control within two weeks to several weeks after surgery. There may not be severe pain in the area but a catheter is placed for a few weeks till the patient regains bladder control. About 35 per cent of men who have undergone prostate cancer surgery are known to have occasional incontinence.

Impotency or sexual dysfunction can be avoided if the surgeon avoids cutting the nerve (in the case of early stage small tumors). This may not be possible if the tumor is large. Therefore the age and degree of sexual function of the patient are important pre-surgery factors. Studies also suggest that post-prostate cancer surgery there may be erection not firm enough for an intercourse up to six months. If the patient is under 50 years of age, then there are more chances of normal sexual function. But if the patient is more than 70 years of age, then there are bigger chances of sexual dysfunction.
This is another reason why some aged patients (life expectancy less than 10 years) choose to receive no therapy at all in the hope that the cancer cells would spread very slowly, thereby avoid the side effects that come with the surgery. This, they call watchful waiting, done with frequent PSA testing.

There are risks and benefits of various treatment regimens in treating prostate cancer, including surgery. Based on the patient’s age, health, personal values and wishes, it is, however, a careful and intelligent decision that the patient must take in consultation with the surgeon in treating prostate cancer.
Published: 2008-02-03
Author: Paawana Poonacha Cariappa

About the author or the publisher
Byline articles for publications,PR content for corporates, syndicated articles for bigwigs, rhymes and short stories for children, and poetry for the like-minded...taking forward over 10 years experience as journalist/writer, presently working as Content Head for a Mumbai-based communications firm. You can view my bylines as "Paawana Poonacha" or "Paawana Poonacha Cariappa".

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