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What Is Surgery For Prostate Cancer

There Are Three Ways That Cancer Spreads In The Body

Radical Prostatectomy (Prostate Cancer Surgery)

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Signs Of Prostate Cancer Include A Weak Flow Of Urine Or Frequent Urination

These and other signs and symptoms may be caused by prostate cancer or by other conditions. Check with your doctor if you have any of the following:

  • Weak or interrupted flow of urine.
  • Sudden urge to urinate.
  • Frequent urination .
  • Trouble starting the flow of urine.
  • Trouble emptying the bladder completely.
  • Pain or burning while urinating.
  • Blood in the urine or semen.
  • A pain in the back, hips, orpelvis that doesn’t go away.
  • Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia.

Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia, and although it is not cancer, surgery may be needed. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer.

Caring For The Incision

You will be able to take a shower the second day after your surgery. You may continue to have some discharge at the drain site for three to five days. Once you leave the hospital, the key words on caring for the drain site and incisions are clean and dry. Showering once a day and gently patting the area with a clean towel should be sufficient.

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Open Radical Prostatectomy Vs Minimally Invasive Radical Prostatectomy

In 2003, only 9.2% of radical prostatectomies were done using a minimally invasive procedure. By 2007, that number had jumped to 43.2%. In 2009, researchers in Boston reported on a study that compared outcomes, benefits, and complications of open surgery vs. minimally invasive surgery:

  • No difference was found in deaths or in the need for additional cancer therapy between the two approaches.
  • The median hospital stay was two days for minimally invasive surgery and three days for open surgery.
  • 2.7% of men having laparoscopic surgery required a blood transfusion compared with 20.8% of men having open surgery.
  • There was more anastomotic stricture narrowing of the suture where internal body parts are rejoined for open surgery than for minimally invasive surgery .
  • There were fewer respiratory complications with minimally invasive surgery than with open surgery .
  • There were lower rates of incontinence and erectile dysfunction with open surgery. The overall rate was 4.7% for laparoscopic surgery and 2.1% for open surgery.

Advantages And Disadvantages Of Prostate Surgery

Radiation therapy comparable to surgery for prostate cancer

Advantages

  • 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.

Disadvantages

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.
  • You will not be able to father children after the surgery, as the prostate, which normally makes some of the fluid needed for semen to be made, has been removed.
  • Recovery takes around 6 weeks.

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What Does It Mean

A Gleason score of 6 is low grade, 7 is intermediate grade, and a score of 8 to 10 is high grade cancer.

Get More Information

Its also important to know whether any cells rated at Gleason grade 5 are present, even in just a small amount, and most pathologists will report this. Having any Gleason grade 5 in your biopsy or prostate puts you at a higher risk of recurrence.

But because many prostate cancer cases are extremely slow-growing, the Gleason system didnt necessarily do a good job of communicating the risks for these cases. Patients with scores of 6 and 7 didnt have a clear picture of the nature of their particular cancer.

Are There Differences Between Orp Lrp And Ralrp

According to a 2010 of different surgery types for prostate cancer, the outcomes for open radical prostatectomy , laparoscopic , and robotic-assisted prostatectomy are not significantly different.

But people who choose LRP and RALRP may experience:

  • less blood loss
  • shorter hospital stay
  • faster recovery time

Also, people who choose RALRP report faster recovery in continence and decreased hospital stay, in comparison to LRP. But the overall outcomes still depend on the surgeons experience and skill.

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Treatment For Prostate Cancer: Surgery

The operation to remove the prostate, called a radical prostatectomy, is one of the most difficult surgical procedures there is. There are several reasons for this: One is simply the prostates hard-to-get-to location deep in the pelvis. Two, there are a lot of blood vessels and important nerves around there, particularly the nerve bundles that are responsible for erection, which sit on either side of the prostate. It takes an expert surgeon to know how to navigate this treacherous terrain, which also includes the rectum, bladder, and a muscle called the urinary sphincter, which you use for urinary control.

And three, there is the urethra. The urethra runs down from the bladder all the way through to the tip of the penis its the tube through which you urinate. Strategically placed between the bladder and the penis is the prostate. Basically, the prostate is like a walnut-sized donut, and the urethra is like a straw stuck right in the middle of it. You cant take out the prostate without cutting through the urethra. And you cant leave the urethra cut, because the urine would just spill out of the bladder into your body, so it must be reattached to the bladder. None of this is easy, and all of it needs to be done skillfully.

Were talking about the difficulty here to make a few key points:

If you have a very large prostate, greater than 100 grams, open surgery is most likely better for you, because it gives the surgeon more room to work.

Do You Think You Have Any Of The Above Prostate Cancer Symptoms

Which is Better – Surgery vs. Radiation for Prostate Cancer?

How is Prostate Cancer Diagnosed?

There are often no symptoms during the early stages of prostate cancer, but screening can detect changes that can indicate cancer. Therefore, men over 45 should undergo an annual medical examination which includes a rectal examination. However, the diagnoses will include the following:

What are the Prostate Cancer Stages?

The stage of prostate cancer can help a person to understand what to expect, the stages would be as below:

  • Stage 0: Precancerous cells are present, but they only affect a small area and are slow-growing.
  • Localized : Cancer is only present in the prostate gland. Effective treatment is possible at this stage.
  • Regional : Cancer has spread to nearby tissues.
  • Distant : Cancer has spread to other parts of the body, such as the lungs or bones.

Want more clarification about medical expense & treatment plan?

Plan Your prostate cancer treatment In India

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Treatments For Prostate Cancer

If you have prostate cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for prostate cancer, your healthcare team will consider:

  • the type and stage of the cancer
  • the grade or Gleason score
  • prostate-specific antigen levels
  • the risk group
  • possible side effects of treatments
  • your personal preferences
  • your overall health and any existing medical conditions
  • your age and life expectancy
  • whether you have symptoms

Prostate cancer treatments can seriously affect your quality of life and cause side effects such as erectile dysfunction and incontinence . Many prostate cancers grow slowly and cause no symptoms or problems.

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.

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What Are The Procedures For Surgery Of Enlarged Prostate

The most commonly performed surgery for enlarged prostate is transurethral resection of the prostate .

This surgical procedure involves the insertion of a scope or an instrument through the penis to scrap the innermost portion of the prostate piece by piece. This is believed to be the most effective surgical procedure since it can relief your symptoms immediately as well.

Another procedure of enlarged prostate surgery is transurethral incision of the prostate .

This operation resembles TURP, but it is indicated when the size of prostate enlargement is relatively small. It is a non-invasive surgical procedure which means that you will not need to be hospitalized after it.

Similar to TURP, a scope is introduced through the penis till reaching the prostate afterward a small cut is done to widen the hole of urethra as well as bladder opening, rather than completely getting rid of prostate in TURP.

In Simple prostatectomy a small incision is performed in the abdominal area to remove the inner most part of the enlarged prostate, while the superficial part is left.

Simple prostatectomy is definitely performed under general anesthesia. This enlarged prostate surgery involves prolonged procedures and you will need to be hospitalized from five to ten days after having it.

Nowadays there are myriad less invasive techniques to treat prostate enlargement which can be done in your doctors clinic under local anesthesia or other sedations, you will not need to be hospitalized.

Surgically Removing The Prostate Gland

If Radical Prostatectomy Has Little Advantage Over Observation, Why ...

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, such as urinary incontinence and erectile dysfunction.

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.

Studies have shown that radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery.

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.

You may want to ask your doctors about storing a sperm sample before the operation so it can be used later for in vitro fertilisation .

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A Biopsy Is Done To Diagnose Prostate Cancer And Find Out The Grade Of The Cancer

A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure may be done using transrectal ultrasound or transrectal MRI to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells.

Sometimes a biopsy is done using a sample of tissue that was removed during a transurethral resection of the prostate to treat benign prostatic hyperplasia.

If cancer is found, the pathologist will give the cancer a grade. The grade of the cancer describes how abnormal the cancer cells look under a microscope and how quickly the cancer is likely to grow and spread. The grade of the cancer is called the Gleason score.

To give the cancer a grade, the pathologist checks the prostate tissue samples to see how much the tumor tissue is like the normal prostate tissue and to find the two main cell patterns. The primary pattern describes the most common tissue pattern, and the secondary pattern describes the next most common pattern. Each pattern is given a grade from 3 to 5, with grade 3 looking the most like normal prostate tissue and grade 5 looking the most abnormal. The two grades are then added to get a Gleason score.

One Week After Surgery

After one week to ten days, your catheter will generally be removed by a urology nurse in the hospital. You will also meet Dr Arianayagam to go through the pathology results and discuss any extra treatments if needed. Pelvic floor physio therapy is restarted at this point and we also commence PDE5 inhibitors and penile vacuum devices as well to aid in recovery of erectile function. You should be active but still focus on your recovery as your body will still need to heal.

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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.

Things You Should Expect After Prostate Surgery

Robotic surgery for prostate cancer

Prostate removal is a major type of surgery and requires time for the body to recover. Even though robotic prostatectomy using the Da Vinci robot has less severe effects on the body and the patient can leave the hospital the same day, men should expect some changes in order to know how to deal with them. The surgery is performed through small incisions that are barely sensitive at the incision sites and the scar tissue is almost unnoticeable. Typically, the recovery is fast, most men are able to go home the next day and resume driving and working in two to three weeks after the surgery.

In the immediate hours after surgery:

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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.

Eight Types Of Standard Treatment Are Used:

Watchful waiting or active surveillance

Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test.

Watchful waiting is closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life.

Active surveillance is closely following a patient’s condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer.

Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management.

Surgery

Patients in good health whose tumor is in the prostategland only may be treated with surgery to remove the tumor. The following types of surgery are used:

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What Types Of Surgery Are There

Radical prostatectomy involves removing the prostate, part of the urethra and the seminal vesicles. After the prostate is removed, the urethra will be rejoined to the bladder and the vas deferens will be sealed.

Some people are able to have nerve-sparing surgery, which aims to avoid damaging the nerves that control erections. Your doctor will discuss whether this is an option for you. Nerve-sparing radical prostatectomy is more suitable for lower-grade cancers and is only possible if the cancer is not in or close to these nerves. It works best for those who had strong erections before diagnosis. Problems with erections are common even if nerve-sparing surgery is performed.

Cancer cells can spread from the prostate to nearby lymph nodes. For intermediate-risk or high-risk prostate cancer, nearby lymph nodes may also be removed .

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