Good Prostate Cancer Care
Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.
You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.
You should also be told about any clinical trials you may be eligible for.
If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.
Surgery For Prostate Cancer
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.
Radical Prostatectomy Perineal Approach
You’ll be placed in a supine position in which the hips and knees will be fully bent with the legs spread apart and elevated with the feet resting on straps. Stirrups will be placed under your legs for support.
An upside-down, U-shaped incision will be made in the perineal area .
The doctor will try to minimize any trauma to the nerve bundles in the prostate area.
The prostate gland and any abnormal-looking tissue in the surrounding area will be removed.
The seminal vesicles may be removed if there’s concern about abnormal tissue in the vesicles.
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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.
Diet Fluids And Bowel Movements
Constipation is a common side effect of pain medications and surgery. You should have received prescriptions for an oral stool softener and a laxative.
You should start drinking fluids as soon as you are comfortable after surgery, and you can resume your normal diet the first day after surgery. But while waiting for normal bowel function to return, you should avoid large meals in favor of several small meals a day. To prevent constipation, we recommend drinking at least eight to 10 glasses of fluids each day and eating lots of fruits and vegetables. Avoid carbonated beverages and cruciferous vegetables such as broccoli, cauliflower, brussels sprouts and cabbage for approximately two weeks, as they frequently cause gassy discomfort and distention.
Take your stool softener and laxative as prescribed. Normal trajectory for return of bowel function is one to two days to pass gas, three to five days for the first bowel movement.
If you haven’t had a bowel movement by day three after your surgery, take oral Miralax , an over-the-counter laxative. You can combine Miralax with the prescribed stool softener and laxative. Follow the instructions on the box. Do not use any enemas or take stronger laxatives, such as magnesium citrate. Contact the clinic if you still haven’t had a bowel movement by day five.
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Side Effects From Hormone Therapy
Hormone therapy for prostate cancer, known as androgen deprivation therapy , suppresses production of testosterone. ADT can cause several side effects. These include fatigue, hot flashes, decreased bone density, ED, depressed mood, decreased sex drive, weight gain, heart risks, breast growth and cognitive decline.
The severity and length of side effects depend on how long treatment lasts. âIf a man has only six months of treatment, their level of testosterone rises again, and theyâll go back to feeling like themselves,â Calvaresi said.
Often, mood changes in men on ADT are caused by other side effects such as weight gain and hot flashes. âIf we can manage those other side effects, then often that improves mood,â she said. Following a healthy diet and exercising regularly often helps to decrease fatigue, prevent weight gain and improve overall mood. Before beginning hormone therapy, you should discuss the effects of ADT with your doctor, and talk about how you can change your exercise and eating habits to help head off side effects before they occur.
Radical Prostatectomy Retropubic Or Suprapubic Approach
You’ll be positioned on the operating table, lying on your back.
An incision will be made from below the navel to the pubic region.
The doctor will usually perform a lymph node dissection first. The nerve bundles will be released carefully from the prostate gland and the urethra will be identified. The seminal vesicles may also be removed if necessary.
The prostate gland will be removed.
A drain will be inserted, usually in the right lower area of the incision.
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How Soon After Prostate Cancer Treatment Can I Be Sexually Active Again
This will depend on what type of treatment you have had and how you feel. It could be several weeks, for others it may be a lot longer for erections to return. Some men will never be able to keep an erection without the help of artificial methods like medicines or medical devices . If you were having problems having erections before treatment, this will not get better after treatment.
When You Might Have A Radical Prostatectomy
Your doctor might recommend a radical prostatectomy if:
- your cancer hasn’t spread outside the prostate gland. This is localised prostate cancer
- your cancer has broken through the covering of the prostate and spread to the area just outside the prostate gland. This is locally advanced prostate cancer
- you are well enough to have this operation
The aim of a radical prostatectomy operation is to cure prostate cancer.
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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
Risks Of The Procedure
As with any surgical procedure, certain complications can occur. Somepossible complications of both the retropubic and perineal approaches to RPmay include:
Some risks associated with surgery and anesthesia in general include:
-
Reactions to medications, such as anesthesia
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Difficulty with breathing
One risk associated with the retropubic approach is the potential forrectal injury, causing fecal incontinence or urgency.
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.
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Enlarged Prostate Surgery: The Real Risks And Side Effects
Enlarged prostate surgery unfortunately has real risks and side effects that are often downplayed or minimized by urologists making you the guinea pig with very possible impotence and incontinence as a result.
Furthermore, you will often have to repeat the operation later on as your prostate continues to grow because the real causes of this prostate disease have not been addressed by radical surgeries.
Also known as a TURP surgery or BPH surgery, this is the gold standard of prostate surgeries for enlarged prostate symptoms.
The bloody pieces are removed allowing more space for the urethra tube to pass urine from your bladder.
The operation is done under anesthesia and you will usually spend a couple of days recovering. You will have to wear a catheter for some time while you heal, and then it can be removed.
It would be great if that was all there was to it. Yet, its not so simple
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What Are The Risks Or Complications Of Radical Prostatectomy
- Urinary incontinence: Some people experience urinary incontinence, although most people recover continence. Your provider can help you manage loss of bladder control and urine leakage.
- Erectile dysfunction: Many people have problems maintaining erections after this surgery. The likelihood of recovery of erectile function depends on your erections before surgery and your surgeons ability to spare the nerves that control erection at the time of surgery. You may need to use erectile dysfunction medications or other treatments. The older you are, the more likely problems may occur.
There is also a small risk that you may experience:
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Surgery To Remove Your Prostate Gland
You might have surgery to remove your prostate gland if:
- your cancer hasnt spread outside the prostate gland
- you are younger and have a fast growing tumour
- as part of treatment for locally advanced or high risk localised prostate cancer
The aim of a radical prostatectomy operation is to cure prostate cancer. It is major surgery with some possible side effects. If youre an older man with a slow growing prostate cancer, this type of surgery may not be necessary for you. This is because your cancer might grow so slowly that youre more likely to die of old age or other causes than from prostate cancer.
In The United Kingdom Where Health Care Is Generally Free And Takeda Sells The Drug Under A Different Name All Physicians Can Purchase A Three
5:00 AM on Dec 15, 2022 CST
Dr. Josie Tenore and Paul Hinds were introduced by a mutual friend in 2017 and hadnt been going out long when she laid down the law: He had to get a physical.
I dont date people who dont take care of their health, said Tenore, who practices cosmetic dermatology and functional medicine in suburban Chicago.
One of Hinds blood tests that summer came back with an alarming result: His prostate-specific antigen, or PSA, level was very high. A biopsy confirmed he had advanced prostate cancer.
There arent a lot of comfortable alternatives for treating prostate cancer, which generally progresses as long as testosterone levels remain high. to lower testosterone levels, so after his diagnosis, Paul dosed a liquid form of cannabis for several weeks. That cut his PSA in half, but Hinds, a cybersecurity expert who likes yoga and bicycling, was stoned out of his mind and couldnt function, Tenore recalled.
And then the bills came.
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Open Rp Versus Robotic
The ability to perform robotic-assisted laparoscopic RP was first described in 2000. Over the past decade, RALRP has gained widespread acceptance and now is the dominant approach to RP in the United States. Many attribute the adoption of the RALRP to marketing as opposed to any objective outcomes data showing superiority over the open approach.
All of the intermediate- and long-term HRQOL outcomes reported in the literature are limited to open RP. The question is, are these findings relevant to RALRP?
Unfortunately, there are no randomized studies comparing HRQOL outcomes following open versus robotic RP. The majority of studies comparing HRQOL outcomes between the two techniques are flawed in design. First, the level of experience of surgeons performing the two techniques and their patient volume are often not comparable. In addition, validated instruments for capturing outcomes are usually not employed. Surgeons are sometimes involved in the data acquisition, entry, and interpretation, which can introduce bias. There are several studies that have examined large administrative databases, which often mitigate bias, but the quality of outcome measures is subject to criticism. A few studies stand out as objective and worthy of comment.
Barocas and colleagues compared men undergoing open and RALRP and failed to show any advantages of either approach for preventing biochemical recurrence.
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Impotence After Prostate Surgery
In the past, up to 70 per cent of men who had their whole prostate removed because of cancer had some difficulty achieving an erection afterwards. This is because the prostate lies next to the nerves and blood vessels that are important for erections, and these nerves and vessels can be damaged during the operation. Newer surgical techniques that aim to spare the nerves associated with erectile function have reduced the risk of impotence.
While there is a still a significant risk of erectile dysfunction after prostate surgery, there is often a gradual improvement in erectile function over time. Some men only have short-lived erectile dysfunction and others continue to improve for up to 3 years.
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Robotic Or Laparoscopic Prostatectomy
Robotic prostate surgery removes the entire prostate gland and is done by laparoscopic or robotic techniques. This type of surgery is less invasive than radical prostatectomy, in which a camera and instruments are inserted through key-hole incisions into the pelvic region. This allows a better view of the pelvic area without a large abdominal incision. The surgeon then controls the robotic instrument for the operation of prostate removal.
Robotic prostatectomy causes less bleeding and less pain and may shorten recovery time. The sexual and urinary side effects are similar to those of radical prostatectomy.
Why is da Vinci® prostatectomy a good option for prostate removal?
Robotic prostate surgery is accomplished using the da Vinci® Surgical System, which allows surgeons to operate with improved vision, dexterity, and control.
How Do Doctors Perform Prostate Removal
During prostate removal the prostate gland and some tissue around the gland, including the seminal vesicles, are removed. A prostatectomy takes about two hours and is performed under general anesthesia.
There are two approaches used for a prostatectomy:
- Robotic surgery
- Minimally invasive procedure with faster recovery time
- Uses smaller incisions and robotic technology
The surgical process is as follows:
- The doctor will make a small incision to gain access to the prostate
- The prostate is removed
- The bladder is reconnected to the urethra
- A catheter is connected to the bladder to allow urine to drain while the area heals
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Help Managing Cancer Treatment Side Effects
The team at Compass Oncology is experienced in helping patients treat prostate cancer and manage the side effects of treatment. If you live in the Portland-Vancouver area, have more questions about the side effects of prostate cancer treatment, or need help managing your side effects, request an appointment at one of our locations that’s convenient for you. We’re here with you every step of the way.
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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Removal Of The Prostate Gland
Surgeons perform prostatectomy in several ways, which depends upon:
- The condition of the patient
- Appropriate treatment option
The main indication of this procedure is localized prostate cancer.
Surgeons use different techniques which are as follows:
- Robot-assisted radical prostatectomy:
In this surgery, the surgeon makes several small incisions in the lower abdomen to reach the prostate gland. After approaching, the doctor removes the prostate gland with the help of a computer-assisted device, which makes the movement of the physicians hands precise.
- Laparoscopic radical prostatectomy:
Similar to the other techniques, the surgeon makes small incisions in the lower abdomen. In this technique, doctors use specialized tools and inserts to remove the gland.
- Open radical prostatectomy:
Surgery involves the removal of the prostate gland through an incision in the lower abdomen. It is also known as retropubic surgery.
- Simple prostatectomy:
Surgeons recommend this surgery for the patients who are suffering from severe urinary symptoms. Surgeons can either perform this surgery openly or through robot machines. The enlargement of the prostate gland is a condition known as BPH or benign prostatic hyperplasia. Simple prostatectomy does not remove the entire gland form the body. This technique only removes the portion of the prostate, which is blocking the flow of urine.
Indications of prostatectomy:
Prostatectomy removes:
- Lymph nodes and their surrounding tissues.
Procedure:
Surgery To Remove Prostate Cancer
Surgery is one of the main treatments for prostate cancer. You usually have surgery to remove your prostate gland. This is a radical prostatectomy.
A radical prostatectomy is a major operation with some possible side effects. You may not need this type of surgery if you’re an older man with a slow growing prostate cancer. This is because your cancer might grow so slowly that you’re more likely to die of old age or other causes than from prostate cancer.
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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
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