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Is Surgery The Best Option For Prostate Cancer

Staging Of Prostate Cancer

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Doctors will use the results of your prostate examination, biopsy and scans to identify the “stage” of your prostate cancer .

The stage of the cancer will determine which types of treatments will be necessary.

If prostate cancer is diagnosed at an early stage, the chances of survival are generally good.

Is Surgery Best Option For Prostate Cancer

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How To Compare Radiation Vs Surgery For Prostate Cancer

Research from the ProtecT trial shows us that radiation and surgery are good options, with the caveat that the specifics of your personal health condition could make one more advisable than the other. If thats not the case, rest assured that youre not at risk of making a terrible decision: Radiation and surgery are both solid options.

How to evaluate radiation vs. surgery comes down to understanding the disease and the research on treatment outcomes, getting a thorough understanding of your specific situation and then deciding which pathway you feel is right for you.

Also Check: What’s The Survival Rate For Prostate Cancer

Remission And The Chance Of Recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.

Observation Through Active Surveillance

Infographics: Prostate Cancer Treatment in Europe

Focusing on quality of life, Chicago Prostate Cancer Center tailors treatment to maximize each patients health outcomes. At the Center, men who choose to follow the observation path, also called Active Surveillance, receive periodic evaluation for prostate cancer risk based on: prostate specific antigen blood test results, detection of abnormal prostate upon digital rectal exam, current and past health considerations, family history of prostate or other cancers, as well as other factors.

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Comparison Of Curative Treatments

Active surveillance, radiation therapy, and surgery all have advantages and disadvantages .13,2427 A randomized controlled trial of 1,643 men in Great Britain compared active surveillance, radical prostatectomy, and external beam radiation therapy for treatment of clinically localized prostate cancer over a median of 10 years.24 There were 17 prostate cancerspecific deaths overall: eight in the active-surveillance group , five in the radical prostatectomy group , and four in the EBRT group . There were no significant differences among groups in prostate cancerspecific mortality or all-cause mortality. Surgery and radiation therapy were associated with lower incidences of disease progression than active surveillance. No trials have compared treatment outcomes by race or ethnicity.

Summary of Curative Treatment Options for Localized Prostate Cancer

Radical prostatectomy

EBRT = external beam radiation therapy.

Information from references 13, and 24 through 27.

Summary of Curative Treatment Options for Localized Prostate Cancer

Radical prostatectomy

EBRT = external beam radiation therapy.

Information from references 13, and 24 through 27.

Treating Advanced Prostate Cancer

If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

  • hormone treatment
  • chemotherapy

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

Also Check: What Does Grade 4 Prostate Cancer Mean

Recovery From Radical Prostatectomy

Typical hospital stays following radical prostatectomy are one to two days. You will need to use a catheter to help drain your bladder for one to two weeks after surgery. Regardless of the surgical approach, you should expect to be walking soon after your procedure. Walking helps speed up your recovery and reduces your risk of developing complications. Recovery from prostate cancer usually involves a process of regaining continence and potency .

  • Incontinence:Prostate surgery may affect your ability to control urine, resulting in leakage or dribbling of urine. Normal bladder control returns for many patients within several months. In rare cases, patients may remain permanently incontinent.

  • Impotence: The nerves that control erection, which run on either side of the prostate, are very delicate and can take time to recover. Full erectile recovery can take up to two years. While recovering, men may benefit from using oral medications , injection therapy, vacuum devices and penile implants. The nerves controlling the sensation of orgasm are not affected by prostate surgery. However, for some men, orgasm may decrease in intensity or become nonexistent. The degree of erectile dysfunction relates to the cancer burden, how many nerves were removed, the patients ability to have an erection before surgery and the patients age.

Robotic Prostate Surgery | Q& A

Comparing Side Effects Of The Various Treatments

Surgical Options for Prostate Cancer Patients

Multiple studies have been published that compare the side effects of the 3 standard treatment options. The best of these studies are Health Related Quality Of Life studies , in which patients answer questionnaires that are validated by expert panels. Multiple HRQOL studies have been performed with the 3 standard treatment options. Unfortunately, none of these studies are randomized, thus patients in the surgical arms are typically younger and healthier before treatment than those in the EBRT or brachytherapy arms. This is because many patients that are not candidates for surgery are still good candidates for EBRT or brachytherapy. So, the average age and health of the surgically treated patient is more favorable than the average age and health EBRT or brachytherapy patient. Multiple studies prove that younger, healthier patients recover from virtually any type of treatment better than older, sicker patients. So, all these studies have a built-in bias favoring the surgically treated patients.

** Peyronies Disease: Curvature of the penis is an abnormal bend in the penis that occurs during erection. Symptoms: Bend in the penis with erection Narrowing of the penis with erection.

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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

Prostate Cancer: Surgery Best Option

Study Shows 10-Year Prostate Cancer Survival Best When Patients Choose Surgery

In early prostate cancer, cancer cells haven’t spread beyond the prostate. There are several different treatment options: surgical removal of the prostate , external-beam radiation therapy, implantation of radioactive seeds , freezing the tumor , hormone therapy, and watchful waiting.

Choosing a treatment for prostate cancer isn’t easy. Each treatment has a different set of benefits and a different set of risks. But there’s a growing body of evidence showing that men who opt for surgery may have better odds of long-term survival.

The latest piece of this evidence comes from Geneva University researchers Christine Bouchardy, MD, MPH Elisabetta Rapiti, MD, MPH and colleagues. They analyzed data on all 844 prostate cancer patients diagnosed with early prostate cancer from 1989 through 1998 in Geneva, Switzerland.

The bottom line: Men who underwent surgery were 2.3 times less likely to die of prostate cancer than men treated with external radiation. Why did surgery seem to work better?

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What Are Your Treatment Options For An Enlarged Prostate

Call Us 212-731-6000. Minimally invasive ablation for prostate cancer is a relatively new and evolving treatment option for prostate cancer at NYU Langone’s Perlmutter Cancer Center. It uses radiofrequency, high-intensity focused ultrasound , or cryotherapy to ablate, or destroy, part or all of the prostate. However, during prostate treatment, the muscles surrounding the prostate can become gradually weakened, Non-Surgical Devices that May Help. While there few surgical options that are truly effective, there is a multitude of non-medical devices available over the counter. A recent Internet search yielded multiple products designed to help. When surgical margins are positive, several studies show that immediate radiation to the prostate fossa will lower relapse rates and may slightly improve 10-year survival rates. However, since only 50% of men will relapse, waiting for evidence of a PSA rise before starting radiation may be a reasonable alternative Although non-surgical options, such as pelvic floor muscle exercises , can hasten continence recovery, patients who remain incontinent at one-year post-procedure, or have severe incontinence at six months, may elect to undergo surgicaltreatment

Surgery For Prostate Cancer

Side Effects Of Removing Prostate

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.

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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.

Most Common Options For Treating Prostate Cancer

Prostate cancer treatments have come a long way in a very short amount of time, allowing men to choose from a wide variety of treatments tailored to their specific situation. Learn more about some of the most common options for treating prostate cancer.

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If you or a loved one has been diagnosed with prostate cancer, its important to research all of your treatment options. What worked for a friend may not be right for you, and you should choose a treatment that will provide you with the best outcome and quality of life.

Most cancers are graded from stage 1 to 4 in level of severity, but prostate cancer uses a different system called the Gleason score. In the Gleason system, prostate cancer is graded using numbers from 1 to 5. Often, prostate cancer has sections with different grades, so those grades are added together to calculate the Gleason score. The highest number on the Gleason score is 10. Your Gleason score helps determine what treatment options are possible.

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Restore Your Prostate Health

A new non-surgical treatment for low-risk prostate cancer can effectively kill cancer cells while preserving healthy tissue, reports a new phase III clinical trial in 413 patients. The research. BPH, also known as an enlarged prostate, affects as many as half of men by age 60. Symptoms include urinary frequency, urgency, urination at night that disrupts sleep and incomplete bladder emptying. Now, for the first time in Southern Arizona, physicians at Banner – UMC are offering a new, non-surgical outpatient procedure — prostate. Until recently, treatments for BPH were limited to medications such as alpha blockers and 5-alpha-reductase inhibitors or surgical procedures such as transurethral resection of the prostate . In TURP, a surgical instrument is inserted into the tip of the penis and then used to trim and remove excess.

Physical Emotional And Social Effects Of Cancer

Prostate Cancer Options Surgery versus Radiation

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.

Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.

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Treatment By Stage Of Prostate Cancer

Different treatments may be recommended for each stage of prostate cancer. Your doctor will recommend a specific treatment plan for you 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.

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