The prostate is a male gland found below the bladder, near the rectum and around the urethra. It is shaped and sized like a walnut, part of the reproductive system and responsible for secreting a fluid that nourishes and protects sperm. However, as men get older, prostate disease becomes more likely. Prostate cancer is a malignant disease characterized by the uncontrolled growth of the prostate cells.
Watchful waiting or active surveillance, surgery, radiation therapy, cryotherapy, hormone therapy, chemotherapy, vaccine treatment, and bone-directed treatment are the most common treatment options for patients with prostate case. Each case is different, and both physicians and patients discuss the possibilities and potential side effects. Surgery tends to be an aggressive but effective approach, and there are three different types of surgery for prostate cancer patients.
Prostatectomy Surgery to Treat Prostate Cancer
A radical prostatectomy is the main type of surgery for patients with prostate cancer. During the procedure, the prostate and some of the tissue around it, including the seminal vesicles, are removed. When performed as an open surgery, the surgeon makes a single long skin incision to remove the prostate and nearby tissues. In a radical retropubic prostatectomy, the incision is made in the abdomen, from the belly button down to the pubic bone, while in a radical perineal prostatectomy, the incision is made between the anus and scrotum (the perineum).
There is also the possibility of a laparoscopic approach to radical prostatectomy, which means that the surgeon makes several smaller incisions and uses special surgical tools to remove the prostate. The surgeon uses a small camera called laparoscope to increase visibility. When the surgeon manipulates the surgical instruments, procedure is known as laparoscopic radical prostatectomy. But it can also be made using a robotic interface called the da Vinci system, which is called a robotic-assisted laparoscopic radical prostatectomy. “Laparoscopic prostatectomy has some advantages over open radical prostatectomy, including less blood loss and pain, shorter hospital stays (usually no more than a day), and faster recovery times (although the catheter will need to remain in the bladder for about the same amount of time). In experienced hands, LRP appears to be as good as open radical prostatectomy, although we do not yet have long-term results from procedures done in the United States,” the American Cancer Society said.
Orchiectomy Surgery for Prostate Cancer Patients
Orchiectomy is a type of surgery included in the category of hormone therapy. It consists of the removal of the testicles to reduce the production of testosterone by the body. When both testicles are removed with an incision in the front of the scrotum, it is known as simple orchiectomy, while a subcapsular orchiectomy is the removal of the tissue from the lining of the testicles where testosterone is produced. The surgery is expected to result in a decrease of the production of the male sex hormones known as androgens, which include testosterone and dihydrotestosterone (DHT). These androgens are produced by the testicles, adrenal gland and prostate cancer tumor itself, and they promote the growth of both healthy and cancerous prostate cells.
In 90% of the men who undergo an orchiectomy, the tumor stops growing and starts to shrink. An orchiectomy is a simple surgery that takes about 30 minutes and both the penis and scrotum are left untouched. However, it is a permanent procedure and some men may have difficulties accepting the removal of their testicles. Artificial testicles (saline implants) may be implanted during the simple orchiectomy surgery, which is not necessary in a subcapsular orchiectomy procedure. Sterility, lower libido (loss of sexual interest), erectile dysfunction, hot flashes, larger breasts (gynecomastia), weight gain, loss of muscle mass, and thin or brittle bones (osteoporosis) are some of the potential side effects associated with an orchiectomy surgery.
TURP Surgery for Patients with Prostate Cancer
Transurethral resection of the prostate (TURP) is usually used to treat benign prostatic hyperplasia (BPH), but it may be used in prostate cancer patients to relieve urinary symptoms of the disease. It consists of the removal of the inside of the prostate gland using electricity to decrease the pressure. While the patient is asleep under anesthesia, the surgeon inserts a scope with a tiny camera and an eyepiece through the urethra. A cutting tool is then placed through the scope and used to remove the inside of the prostate gland. TURP does not cure cancer, but the decrease in the blockage is expected to relieve symptoms associated with diseases of the prostate.
The procedure takes about an hour and it may be recommended for patients who have difficulties in passing urine, fully emptying their bladder or other urinary problems. There are, however, risks associated with TURP, including blood clots in the legs that may travel to the lungs, breathing problems, infection in the surgical wound, lungs (pneumonia), or bladder or kidney, blood loss, heart attack or stroke during surgery, and allergic reactions to medication. Additional problems that may occur after the surgery are problems controlling urine, loss of sperm fertility, erectile dysfunction, passing semen into the bladder instead of out through the urethra (retrograde ejaculation), tightening of the urinary outlet from scar tissue (urethral stricture), transurethral resection (TUR) syndrome (water buildup during surgery), or damage to internal organs and structures.
Note: Prostate Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.