How is cancer of the prostate treated?It depends on the patient's medical history, age, and stage of disease. Stage A disease usually requires either no treatment, removal of the prostate (prostatectomy), or radiotherapy, depending upon the number of sites in which the cancer cells are found. Stage B tumors are treated with either radiation therapy or surgery; both seem to have the same results. Stage C disease is treated with surgery, radiation therapy, or a combination ofthe two. Stage D disease may be treated with some form of hormone therapy, usually used when symptoms such as bone pain or bladder obstruction occur.
What is a prostatectomy?A prostatectomy is the surgical removal of all or part of the prostate. A total prostactectomy is the removal of the entire prostate.
What is a retropubic prostatectomy?Retropubic prostatectomy is the removal of all or part of the prostate when the incision is made from the navel to the pubic bone to remove the gland and permit sampling of the pelvic lymph nodes. The surgeon performs the operation without opening the bladder.
What is a perineal prostatectomy?It is similar to the retropubic procedure, with the incision a half circle around the inner side of the anus.
What is a transurethral resection or TUR?This operation permits removal of a tumor without an incision. It is usually used only for very small tumors or to treat benign disease. This approach is accomplished by inserting a special instrument through the penis to remove the tumor. Because it requires tremendous skill and expertise, this procedure should be done only by a urologist who is skillful in its use.
Adverse Effects of Hormone Therapy in Prostate Cancer
What are the after effects of total prostatectomy?Although the cancer may be controlled, there are three consequences you should be aware of:
• Since the prostate gland produces most of the fluid released at the time of sexual intercourse and climax, most patients are sterile following this operation, just as they would be following a vasectomy.
• Many of the nerves that are involved with sexual function may be damaged, so that following surgery, many patients will no longer be able to have an erection. New investigational surgery avoiding the pelvic plexus is being done by selected doctors to avoid this problem.
• Some patients find that the operation causes them to lose their ability to control urine. Strengthening of muscles through simple exercise during recovery can sometimes help to return control. Urinary sphincter implants are possible to help control incontinence.