What You Need To Know About Prostate Cancer

Prostate can­cer affects the prostate gland and may spread to sur­round­ing struc­tures. While most men with prostate can­cer have no symp­toms, physi­cian can find prostate can­cer dur­ing a reg­u­lar check­up, using a com­bi­na­tion of a blood test called a PSA and a dig­i­tal rec­tal exam (DRE).

Near­ly one in sev­en Amer­i­can men will be diag­nosed with prostate can­cer dur­ing his life­time. With greater aware­ness, prostate can­cer detec­tion is on the rise and mor­tal­i­ty is declin­ing. More­over, bet­ter treat­ments are allow­ing more men to return to active and pro­duc­tive lives after treatment.

Treat­ment Options

If the you have an ear­ly diag­no­sis of prostate can­cer, there is usu­al­ly a range of treat­ment options. These may include con­ser­v­a­tive man­age­ment, radi­a­tion ther­a­py with either exter­nal bream or brachyther­a­py ther­a­py, cryosurgery and prosta­te­c­to­my – sur­gi­cal removal of the prostate. Your treat­ment options will depend on a num­ber of fac­tors, includ­ing the stage of the dis­ease, your age and health or per­son­al preference.

Prosta­te­c­to­my

The gold stan­dard treat­ment option for men under 70 with ear­ly-stage, organ-con­fined can­cer is sur­gi­cal removal of the prostate using nerve-spar­ing rad­i­cal prosta­te­c­to­my. Prosta­te­c­to­my is also the most wide­ly used treat­ment for prostate can­cer today in the US.

The pri­ma­ry goal of prosta­te­c­to­my is removal of the can­cer. A sec­ondary goal is to pre­serve uri­nary func­tion and — when applic­a­ble — erec­tile func­tion. Preser­va­tion of the nerves nec­es­sary for erec­tions can be an extreme­ly impor­tant goal for patients. These nerves run along­side the prostate and are often dam­aged when remov­ing the prostate. A nerve-spar­ing prosta­te­c­to­my attempts to pre­serve these nerves so that the patient may be able to return to his pri­or erec­tile function.

Types of Prostatectomy

Approach­es to this pro­ce­dure include tra­di­tion­al open surgery, con­ven­tion­al laparo­scop­ic surgery or da Vin­ci ® Prosta­te­c­to­my, which is a robot-assist­ed laparo­scop­ic surgery.

With a tra­di­tion­al open pro­ce­dure, your sur­geon uses an 8 – 10 inch inci­sion to access the prostate. This approach often results in sub­stan­tial blood loss, a lengthy, uncom­fort­able recov­ery and a risk of impo­tence and incontinence.

Con­ven­tion­al laparoscopy uses a spe­cial­ized sur­gi­cal cam­era and rigid instru­ments to access and remove the prostate using a series of small inci­sions. This approach pro­vides your sur­geon with bet­ter visu­al­iza­tion than an open approach. In addi­tion, it pro­vides patients the ben­e­fits of a min­i­mal­ly inva­sive procedure.

Despite these advan­tages, con­ven­tion­al laparoscopy relies on rigid instru­ments and stan­dard 2D video, tech­ni­cal lim­i­ta­tions that can be chal­leng­ing for the sur­geon. Because of these draw­backs, con­ven­tion­al laparoscopy doesn’t lend itself well to com­plex pro­ce­dures like prosta­te­c­to­my. There­fore, very few urol­o­gists use this approach for prosta­te­c­to­my. More­over, nei­ther laparoscopy nor open surgery can pro­vide ade­quate visu­al­iza­tion for a very pre­cise, nerve-spar­ing prostatectomy.