SURGERY

Surgery is a common treatment option for early-stage prostate cancer.

Surgery can be used as the primary treatment plan or as part of a treatment option. This surgical procedure involves removing the tumor and a portion of normal prostate tissue surrounding it, known as the surgical margin.

A positive surgical margin indicates the presence of cancer cells at the edges of the removed tissues during surgery. A negative surgical margin indicates that the edges of the removed tissue are free of cancerous cells, which suggests that all tumors in that area were eliminated.

The type of surgery received depends on the size, location of the tumor and if surrounding organs or tissues are cancerous.

 

Radical Prostatectomy

Prostatectomy is the removal of the prostate through surgery. During radical prostatectomy, the prostate, surrounding tissues, seminal vesicles, and sometimes nearby lymph nodes are removed. This procedure can be an effective way of curing prostate cancer. Radical prostatectomy is used when:

  • The tumor can be removed completely with surgery.
  • You have a life expectancy of at least 10 years.
  • The tumor is found only in the prostate.
  • There are no other significant health conditions.

There are 2 surgical approaches for radical prostatectomy:

  1. Open (Abdominal or perineal) – the prostate is removed through a single long incision.
  2. Minimally Invasive (Robotically assisted or Laparoscopic)- Small incisions are made and tiny surgical tools are inserted, sometimes with the guidance of a robot.

Minimal-invasive surgery is now more common than open surgery, resulting in shorter hospital stays, less blood loss, fewer surgical complications, and faster recovery rates for patients. The more experience a surgeon has, the better the results of the surgery as it demands great skills due to its complexity.

During the immediate postoperative period, the following are common, regardless of the approach:

  1. A catheter in place for 3–14 days to allow for healing.
  2. Limited activities for several weeks
  3. Stay in the hospital for a few days after the surgery

Major possible side effects may include

  1. Urinary incontinence
  2. Erectile dysfunction

There are times, depending on the pathologic findings at the time of surgery, when postoperative radiation therapy may be indicated once the patient recovers from his operation.