Prostate Cancer Surgery

Prostate Cancer Surgery aims to remove cancerous tissue while preserving important surrounding structures whenever possible.

The main surgical option is radical prostatectomy, during which the prostate gland and seminal vesicles are removed. Nearby lymph nodes may also be removed when indicated to assess or treat possible cancer spread.

Radical prostatectomy can be performed through open surgery or minimally invasive techniques, including laparoscopic or robotic-assisted prostatectomy. The most appropriate approach depends on the stage and location of the cancer, the patient's overall health, and the surgeon's assessment.

Conditions That May Require Prostate Cancer Surgery

Prostate Cancer Surgery may be considered for selected patients with:

• Localized prostate cancer

• Prostate cancer that has not spread beyond the prostate in patients suitable for surgery

• Selected cases of locally advanced prostate cancer

• Cancer with a significant risk of progression where surgical treatment is considered appropriate

• Recurrent prostate cancer in selected cases, depending on previous treatment and overall assessment

Not every patient diagnosed with prostate cancer requires surgery. Depending on the cancer's characteristics, other options may include active surveillance, radiation therapy, hormone therapy, or other systemic treatments.

Early prostate cancer may not cause noticeable symptoms. When symptoms occur, they may include:

• Difficulty starting urination

• Weak or interrupted urine flow

• Frequent urination, particularly at night

• Difficulty completely emptying the bladder

• Blood in the urine or semen

• Erectile dysfunction

• Pain in the back, hips, or pelvis in more advanced cases

The exact cause of prostate cancer is not always known. Risk may increase with age, family history of prostate cancer, certain inherited genetic changes, and other factors.

Before Prostate Cancer Surgery, the patient undergoes a comprehensive evaluation to determine the type, grade, and stage of the cancer and whether surgery is appropriate.

Assessment may include:

• Prostate-specific antigen (PSA) blood testing

• Digital rectal examination when appropriate

• Prostate MRI

• Prostate biopsy

• Pathological examination of biopsy samples

• Imaging tests to assess possible cancer spread when indicated

• Evaluation of overall health and suitability for surgery

During radical prostatectomy, the surgeon removes the prostate gland and seminal vesicles. Depending on the cancer's characteristics, nearby lymph nodes may also be removed.

In selected patients, robotic-assisted prostatectomy or laparoscopic surgery may be used. The choice of surgical technique depends on the patient's condition, cancer stage, anatomy, and surgical expertise.

Benefits of Prostate Cancer Surgery

For appropriately selected patients, Prostate Cancer Surgery may:

• Remove localized prostate cancer

• Provide a potential long-term cancer-control option

• Allow detailed pathological examination of the removed tissue

• Provide information about the extent and characteristics of the cancer

• Allow additional treatment decisions to be based on the surgical and pathology results

The expected outcome depends on the cancer stage and grade, surgical findings, pathological results, overall health, and whether cancer is present outside the prostate.

Recovery After Prostate Cancer Surgery

Recovery after radical prostatectomy varies depending on the surgical technique, overall health, and individual recovery.

Patients may initially have a urinary catheter, which is usually removed according to the surgeon's instructions after the urinary connection has healed.

Temporary urinary leakage and changes in sexual function can occur after surgery. Recovery of urinary control and erectile function varies considerably between patients and may take months or longer.

Regular follow-up usually includes PSA testing and clinical assessment to monitor the patient's recovery and detect any evidence of recurrent disease.

Is Prostate Cancer Surgery Suitable for Everyone?

Prostate Cancer Surgery is not appropriate for every patient with prostate cancer. The decision depends on the cancer stage and grade, tumor characteristics, patient's age and overall health, urinary and sexual function, personal preferences, and the expected benefits and risks of surgery.

A specialized urologic oncology team should evaluate the patient and discuss surgery alongside other appropriate treatment options before a treatment decision is made.