Loss Of Bladder Control
You may have some light dribbling or trouble controlling your bladder after a radical prostatectomy. This is known as urinary incontinence or urinary leakage. You may need to use a pad to manage urinary leakage for some days or weeks after the operation. Bladder control usually improves in a few weeks but it can take up to a year after the surgery. For about 5% of people, incontinence is ongoing and may need an operation to fix. In rare cases, incontinence may be permanent.
For help managing these problems, see Urinary problems.
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The Success Rate Of Prostate Surgery
Survival rates can tell you how many people with the same type and stage of cancer are still alive 5 years after being diagnosed. For example, if you have stage 3 colon cancer, there is a 66% chance that 5 years later, you will be alive. But the rates cannot tell you how long you will live. However, they may help give you an idea of how likely your treatment will be successful.
Survival rates are estimates. They are based on data from many people who have had cancer before. These numbers might be confusing because they dont tell you what will happen, but they can help doctors decide treatments. Talk with your doctor to see if these statistics apply to you because they know about your situation.
A relative survival rate tells how likely a person is to survive a particular type of cancer. I.e., if the 5-year close survival rate for prostate cancer is 90%, it means that men who have this type of cancer are about 90% as likely as other men to live a minimum of 5 years after being diagnosed with the disease.
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Living With Prostate Cancer
From the moment you are diagnosed with prostate cancer, its important to make mindful decisions about your diet and lifestyle. Your everyday choices are vital to the success of your treatment and your recovery from the disease, and its a great way to take back some of the control that cancer and its treatment may have had on your life. Additionally, there is growing scientific evidence that suggests healthy diet and lifestyle practices may actually slow the growth and progression of prostate cancer.
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How Is A Prostatectomy Performed
The type of surgical procedure depends on the condition being treated . In both cases, the prostate gland is removed and in the case of cancer, surrounding tissue and some lymph nodes may also be removed. Our surgeons reattach the tube to the bladder and may leave a drain in the abdomen to remove extra fluids after surgery.
The doctors of The Urology Specialists of Maryland will help patients determine what type of prostatectomy is best suited for your conditions.
Was The Surgery Successful
The prostate gland will be examined under a microscope in the laboratory after it has been removed. The doctor will check the grade of the cancer cells again. and check that the edges of the prostate are clear of cancer, called ‘checking the margins’.
Negative margins: No cancer cells.Positive margins: Cancer cells found at the edge of the prostate.
These tests are used to predict your response to the treatment along with PSA checks. Your PSA level should drop within weeks of surgery.
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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.
When To Call Your Doctor Or Nurse
Its important to tell your doctor or nurse if:
- your bladder feels full or your catheter isnt draining urine
- your catheter leaks or falls out
- your urine contains blood clots, turns cloudy, dark or red, or has a strong smell
- you have a fever
- you feel sick or vomit
- you get cramps in your stomach area that will not go away
- you get pain or swelling in the muscles in your lower legs.
Your doctor or nurse will let you know if you should go to the hospital.
Prostatectomy: What To Expect During Surgery And Recovery
If youve been diagnosed withprostate cancer, your doctor will consider many factors before recommending the besttreatment. For many men, that may mean a prostatectomy. In this surgery,doctors remove the entire prostate.
The Johns Hopkins Hospital performs more of these procedures than almostanywhere else in the world. One of the most common questions they hear frompatients: What should I expect after surgery?
Johns Hopkins urologistMohamad Allaf, M.D., explains the surgery and recovery.
Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
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How You Might Feel
Being diagnosed with prostate cancer can be stressful. It is natural to have a wide variety of emotions after the diagnosis and during treatment, including anger, fear anxiety, sadness and resentment. These feelings may become stronger over time as you adjust to the physical side effects of treatment.
Everyone has their own ways of coping with their emotions. There is no right or wrong way. It is important to give yourself and those around you time to deal with the emotions that cancer can cause. For support, call Cancer Council 13 11 20.
If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.
If you think you may be depressed or feel that your emotions are affecting your day-to-day life, talk to your GP. Counselling or medication even for a short time may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may also run a counselling program in your area.
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What You Need To Know About Prostate Surgery
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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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.
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Robotic Prostate Surgery Details
Using the advanced surgical system, miniaturized robotic instruments are passed through several small keyhole incisions in the patients abdomen to allow the surgeon to remove the prostate and nearby tissues with great precision. This is much less invasive than a conventional radical retropubic prostatectomy, which involves an abdominal incision that extends from the belly button to the pubic bone.
During robotic-assisted radical prostatectomy, a three-dimensional endoscope and image processing equipment are used to provide a magnified view of delicate structures surrounding the prostate gland , allowing optimal preservation of these vital structures. The prostate is eventually removed through one of the keyhole incisions.
For most of the surgery, the surgeon is seated at a computer console and manipulates tiny wristed instruments that offer a range of motion far greater than the human wrist. The surgery is performed without the surgeon’s hands entering the patients body cavity.
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Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
Open Or Laparoscopic Radical Prostatectomy
In the more traditional approach to prostatectomy, called anopen prostatectomy, the surgeon operates through a single long skin incision to remove the prostate and nearby tissues. This type of surgery is done less often than in the past.
In a laparoscopic prostatectomy, the surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate. The surgeon either holds the tools directly, or uses a control panel to precisely move robotic arms that hold the tools. This approach to prostatectomy has become more common in recent years. If done by experienced surgeons, the laparoscopic radical prostatectomy can give results similar to the open approach.
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Difficulty Getting An Erection
Impotence is more likely to happen if you are older. Nerve sparing surgery and robotic surgery may reduce the risk for some men. Speak to your doctor before you have surgery to get an idea of your risk of problems afterwards.
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
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What Should People Know About The Potential Complications Or Side Effects From A Radical Prostatectomy
A radical prostatectomy is very complex and requires a high level of technical precision. The prostate is surrounded by nerves and structures that are important to normal urinary and sexual function. Men who have this procedure are understandably concerned about the possibility of complications that affect longer-term quality-of-life issues. These can include urinary control, also called urinary continence, and changes in sexual function.
Over the past few decades, technical refinements have dramatically reduced the number of complications with this surgery. At MSK, weve found ways to use the results of imaging tests when planning a surgery. Then we can avoid injuring important structures, which minimizes the risk of incontinence and maximizes the chance of maintaining sexual function. We continue to look for ways to further minimize the risk of side effects.
Studies have shown that patients of surgeons who regularly perform radical prostatectomies have fewer complications on average than those who do these surgeries less often. I myself have performed more than 3,000 radical prostatectomies. The other MSK surgeons also have vast experience in this procedure.
Its always a balance between removing the cancer and trying to preserve function. The balance is different for each person because each cancer is different. People need to ask questions and be clear about their expectations.
Advantages And Disadvantages Of Prostate Surgery
- Surgery will completely remove the cancer if it is only in the prostate gland.
- The prostate can be removed and be fully analysed and staged in the laboratory.
- The success of the treatment can be easily assessed by PSA testing.
- If the PSA were to rise after surgery you would still be able to get other treatments like radiotherapy or hormone treatment.
It involves a general anaesthetic and the usual risks you would expect with surgery, like the risk of bleeding, infection and blood clots.
- You will have to stay in hospital for a few days.
- You may get side-effects afterwards like problems with erections and urinary incontinence.
- Recovery takes around 6 weeks.
Life After Prostate Removal
For many men with prostate cancer, prostate removal is never needed because the cancer is often slow-growing and managed with non-surgical treatments. But, if the cancer has grown beyond the prostate, the oncologist may recommend prostate removal surgery, also called a prostatectomy. If you are going to have prostate removal surgery, this information can help you in your discussion with the doctors.
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Keeping Up With Appointments And Screenings
Attending your doctors appointments after youve entered remission is very important. If you need to skip an appointment, you should make another appointment as soon as possible.
Use these appointments as a time to discuss any concerns you may have with your doctor. Your doctor can also conduct tests to check for the cancers return during these appointments.
Two tests to detect recurrent prostate cancer include a digital rectal exam and a PSA blood test. During a DRE, your doctor will insert a finger into your rectum. If your doctor detects something unusual, theyll likely ask for additional follow-up tests. These tests may include bone scans and imaging studies, such as an ultrasound or MRI.
Men often experience side effects from their prostate cancer treatments. Some of these side effects may be immediate and temporary. Others may take several weeks or months to show up and never fully disappear.
Common side effects from prostate cancer treatment include:
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The Purpose Of Prostate Surgery
Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.
It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.
Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:
Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.
The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.
Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.