No Risk Of Abdominal Complications
In a robotic prostatectomy, the prostate area is accessed through the abdominal cavity. During an open prostatectomy, the surgical path is entirely outside the abdomen, eliminating the potential for injury to the abdominal contents. Any surgical complications would be confined entirely to the pelvis.
Dealing With Prostate Cancer
Being diagnosed and living with prostate cancer can change how you feel about life. If you or your loved one is dealing with prostate cancer you may feel scared, stressed or even angry. There is no right way to feel and everyone reacts differently.
Visit our wellbeing hub for information to help support you in looking after your emotional, mental, and physical wellbeing. If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.
What Is A Nomogram
A nomogram is a tool used by doctors to help them and their patients predict the success of a particular treatment or the probability of remaining cancer free after certain treatments.
It uses different features of the cancer like PSA, Gleason grade and stage as well as other prostate biopsy details to make predictions. The predictions are based on the past experiences of many thousands of patients, usually drawn from hospitals based in the USA.
Nomograms can be complicated and are not always reliable. Talk to your doctor if you want to use an online predictive tool to help guide you in your decision making.
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Questions To Ask Your Doctor Radiographer Or Nurse
- Will I have a planning session at a different time to the treatment, or immediately before?
- Will I have external beam radiotherapy or hormone therapy as well?
- What side effects might I get?
- How will we know if the treatment has worked?
- What should my PSA level be after treatment and how often will you test it?
- If my PSA continues to rise, what other treatments are available?
Cost Of Enlarged Prostate Treatment Without Insurance
At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.
At New York Urology Specialists, we offer a flat-fee all-cost-included Rezum procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment. Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles.
At New York Urology Specialists, we offer a flat-fee all-cost-included Urolift procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.
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Is Another Treatment Option Better For Preservation Of Erectile Function
The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.
New Treatment Options For Prostate Cancer
New technologies, scientific advancements and clinical trials continue to develop and test additional and alternative forms of classical treatments. Often, the only way to access these newer treatments and procedures is through a clinical trial. Participating in these carefully controlled research trials is another way to get state-of-the-art care that you might not be able to get otherwise. Still, certain factors may cause ineligibility or personal discomfort with a lesser known treatment plan.
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When Does Turp Have An Edge
TURP procedure is a well established and effective treatment option for men with enlarged prostate and BPH. It is very effective in the treatment of urinary retention in men. While there are other treatment options for BPH including Greenlight laser, HOLEP holmium laser ablation, Urolift, and prostate artery embolization, TURP still has a role due to its effectiveness and versatility.
In my practice, we use TURP, Greenlight Laser, Holmium Laser, and Urolift depending on the patients individual characteristics and preferences.
An important advantage of TURP is that it provides a pathological specimen at the end of the procedure a small piece of the prostate can be retrieved and analyzed by a pathologist under a microscope. This is important in patients who are at increased risk of bladder or prostate cancer. Other procedures such as Greenlight laser evaporate tissue and there is no way of ascertaining that there is no cancer in the tissue.
In general, my recommendation is to perform a TURP procedure in men with elevated PSA when there is a concern about the coexistence of prostate cancer as a possible cause of enlarged prostate.
In patients with a history of bladder cancer or blood in urine and heavy history of smoking, I also advise TURP over other treatment options as TURP provides pathological specimen which can be examined under the microscope to verify the absence of bladder cancer recurrence.
The Main Advantage Of Prostatectomy
This is a very important comment I am gonna make right now. If your cancer ever comes back after surgery, the idea of having a plan B of having low-dose radiation after surgery is feasible. If you start with radiation and cancer comes back, surgery would be very difficult and challenging. So, I want you to know this because not too many people are aware of this.
Again, one more time. If you start with surgery, you still have the radiation as an option. If you start with radiation, surgery would be very difficult because the tissue becomes like a cement attached to the rectum and the surrounding tissues and it would be very difficult to do that operation.
As you get older, because we have removed the prostate with the surgery, you do not have to worry about the old-man disease, an enlarged prostate. With radiation may be some consequences with bleeding from the rectum or bleeding from the bladder. Certainly, in the hands of an experienced radiation oncologist, the results are better. We have superb doctors at St. Francis Hospital. One of my colleagues, Dr. Jay Bosworth, whom I am looking forward to interviewing him at this program, is a fine radiation oncologist and you will have what to learn from him. So, the risks of side-effects in the hands of an experienced radiation oncologist would be less. But there is a small chance of having secondary cancers such as rectal cancer or bladder cancer at some point down the road after radiation.
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Hormone Therapy For Prostate Cancer
Otherwise known as androgen suppression therapy or androgen deprivation therapy , hormone therapy aims to shrink prostate cancers or slow their growth by targeting androgens . There are several treatment types and medications available to lower androgen levels, suppress them or stop them from working. Although hormone therapy may impede the growth of prostate cancer, it does not alone cure it. Nevertheless, it can be effective if used in conjunction with radiation therapy or surgery.
Often Recommended for:
- Slowing growth and shrinking tumors
- Prostate cancer that remains or recurs despite treatment
- Those at higher risk of recurrent prostate cancer after treatment
- Pre-radiation therapy for maximum effectiveness
Side Effects of Hormone Therapy:
Pros & Cons of Hormone Therapy for Prostate Cancer
Pros:
- Helps shrink and inhibit prostate cancer cells
- Potentially effective when used with other treatments
Cons:
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What Determines Erection Recovery After Surgery
The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.
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Radiation Therapy Has Most Side Effects
Prostate cancer is expected to be diagnosed in more than 240,000 men in the United States in 2012, according to the American Cancer Society.
Ciezki and colleagues analyzed data on 137,427 men from National Cancer Institute Medicare data collected between 1991 and 2007.
Of the total, 43% of men were treated with surgery , 44% with external beam radiation therapy, and about 13% with brachytherapy. Researchers looked only at side effects that required a procedure to correct them.
Over a six-year period, on average, 8.8% who had external beam radiation therapy, 6.9% of patients who underwent surgery, and 3.7% who had brachytherapy needed a procedure to fix a therapy-related effect.
A total of 7.1% of patients who received external beam radiation therapy experienced problems such as incontinence or bladder bleeding, compared with 6.7% of those treated with prostatectomy and 3.4% of those treated with brachytherapy.
And 1.7% of EBRT patients had gastrointestinal side effects such as rectal bleeding, compared with 0.1% of prostatectomy patients and 0.3% of brachytherapy patients.
Brachytherapy was the cheapest treatment: $2,557.36 per year. Prostatectomy was slightly more expensive, at $3,205.71, followed by EBRT at $6,412.29.
Diagnostic Advances In Prostate Cancer
Prostate cancer diagnosis is followed by staging of the cancer. If theres no evidence of metastasis of the original prostate tumor, meaning the cancer hasnt spread to other parts of the body, your cancer will also be assigned to a risk stratification group, also known as a risk group. The risk group attempts to predict the likelihood that the disease has spread microscopically outside the prostate. We informally refer to three risk groups: low risk, intermediate risk and high risk, although as many as six different groups exist.
The specific stage and/or risk stratification of your cancer may determine your treatment options. In general:
Depending on your specific diagnosis, you may have two or more good treatment choices that have similar outcomes, and you probably have time to investigate those options.
Recent areas of advancement in oncology may provide a more accurate picture of your specific diagnosis, directing you and your doctor to more appropriate treatment options. Two specific developments include prostate-specific PET scan agents that may allow us to get more accurate imaging than we could before and the results of advanced genomic testing, which may help identify more aggressive cancers that are less suitable for active surveillance.
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Prostate Cancer Treatment Advances: Can They Help You
While the 10-year survival rate for men diagnosed with prostate cancer in the United States is approximately 98 percent, many men face difficult decisions about their treatment options. They worry not only about which treatment may be appropriate in fighting their cancer, but also about the impact treatment may have on their quality of life.
In 90 percent of cases, prostate cancer is diagnosed at the local or regional stage, meaning it hasnt spread beyond the prostate or nearby organs. Men diagnosed with early-stage prostate cancer may have several treatment options with similar outcomes. Men diagnosed with distant cancer, meaning its already spread to other areas of the body, face different treatment decisions. Either way, its normal to feel anxious after a diagnosis and to want to take action right away.
But you may regret rushing into a treatment plan without considering your options carefully. Prostate cancer treatment has common side effects, especially urinary incontinence and erectile dysfunction, that may negatively impact your quality of life. Because prostate cancer often progresses slowly, most men have time to investigate their options.
Whether youre already receiving treatment for prostate cancer, or youre considering new treatment decisions, its worth learning about prostate cancer treatment advances that may affect your choices.
Potentially beneficial advances in prostate cancer treatment include:
Prostate Cancer Treatments Pros And Cons
Studies have shown that great numbers of people died because of different cancer types like prostate cancer. To help patients who are suffering from this condition, experts continue to search for the best treatment option.
If you are suffering from prostate cancer, you always want to undergo an extensive medication. Like others, you also desire to see if prostate cancer treatments work. However, before making any option, you have to know the pros and cons of prostate cancer. To give you some hints, simply take the following facts as your guide:
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Recurrence Risk With Prostate Cancer Surgery Vs Radiation
While many patients fear that radiation is less effective than a prostatectomy, the ten year survival for both treatments is comparable. Age plays a factor in which treatment patients may prefer, as the risk of recurrence is less relevant for older patients, who are more likely to die of other causes before they die of prostate cancer, and may hence prefer radiation due to the lower morbidity. On the other hand, younger patients may prefer surgery in order to minimize the chances of a recurrence.
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Active Surveillance For Prostate Cancer
Active surveillance is a plan to monitor low and some intermediate-risk, localized prostate cancer. If, among other criteria, your cancer has not spread beyond the prostate, is not causing symptoms and does not show signs that it may be aggressive, active surveillance may be an appropriate option for you.
Why would you consider active surveillance over immediate, more aggressive treatment like surgery or radiation therapy? It comes down to carefully weighing risks versus quality of life.
We know that, in most men, prostate cancer grows slowly. In some cases, it may take three to 10 years to reach the point where it needs to be treated. In the meantime, if you can safely postpone treatment, you can avoid the sometimes-immediate and long-term side effects that may have serious consequences on your quality of life.
Having access to some of the advances in prostate cancer treatment discussed earlier in this article may allow you to choose active surveillance with more confidence. For example, if genomic testing predicts that your cancer is not aggressive, and/or a prostate-specific PET scan finds no evidence of cancer cells outside of the prostate, active surveillance may be the right choice for you.
Active surveillance does not mean that we ignore the cancer. If you and your care team decide its an appropriate option for you, your urologist will monitor your disease with regular follow-ups, which may include:
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Ebrt Or External Beam Radiation Therapy
The EBRT is a 10-minute radiation therapy where a single radiation beam treats the affected local area.
Pros
The main reason why most people undertake EBRT because of its painless treatment.
Few healthy cells are also destroyed, as the single beam is used to treat a specific area.
Cons
The patient undertaking EBRT would suffer from loose stools, frequent urination, and bleeding in the rectum area.
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Why The Procedure Is Performed
Radical prostatectomy is most often done when the cancer has not spread beyond the prostate gland. This is called localized prostate cancer.
Your doctor may recommend one treatment for you because of what is known about your type of cancer and your risk factors. Or, your doctor may talk with you about other treatments that could be good for your cancer. These treatments may be used instead of surgery or after surgery has been performed.
Factors to consider when choosing a type of surgery include your age and other medical problems. This surgery is often done on healthy men who are expected to live for 10 or more years after the procedure.
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What To Expect After Surgery
Following surgery, most men spend one to two days in the hospital. Patients typically receive intravenous pain medication during their first day after surgery , then transition to oral pain medications by the second day. Once pain is under control and bowel function has begun to return, the patient is ready for discharge.
What Is A Radical Prostatectomy
Surgery to remove the prostate is called a radical prostatectomy. Before the operation, the surgeon will explain what will happen and tell you about the possible side effects. They may also tell you about other treatments that may help in your situation, such as radiotherapy.
The aim of the surgery is to remove all of the cancer cells. It is usually only done when the cancer is contained within the prostate and has not spread to the surrounding area.
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Surgery Vs Radiation For Early Prostate Cancer
Analysis of 19 studies suggests surgery has an edge in survival, but experts say each case may be different
HealthDay Reporter
TUESDAY, Dec. 15, 2015 — Men with prostate cancer that’s still confined to the organ are more likely to survive if they have surgery rather than radiation therapy, a new Canadian study suggests.
This type of “localized” prostate cancer is the most common form of the disease, accounting for about 80 percent of cases, said a team led by Dr. Robert Nam of the Odette Cancer Centre at Sunnybrook Research Institute in Toronto.
The most common treatments for localized prostate cancer are surgery and radiation therapy.
But which works best to keep the disease at bay?
To find out, Nam’s team looked over data from 19 studies that included a total of nearly 119,000 men with localized prostate cancer.
Findings from 15 of the studies showed that those who received radiation therapy were twice as likely to die from prostate cancer as those who had surgery.
Findings from 10 of the studies also showed that men who had radiation therapy were 50 percent more likely to die sooner of any cause, compared to those who had surgery.
The results of the analysis were published Dec. 14 in the journal European Urology.
But prostate cancer treatment is never a one-size-fits-all matter, he added.
“There are times when radiotherapy may be more appropriate than surgery, so it is important that a patient discusses treatment options with his clinician,” Nam said.
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