Prostatectomy

Prostate cancer is most commonly diagnosed in older men.  Even as the second-most common cancer in men in the United States, it is often slow growing and the majority of patients diagnosed with prostate cancer do not die from the disease.

There are several options for treating prostate cancer.  First factors such as age, general health, predicted life expectancy, as well as the stage of the disease when diagnosed, must be taken into consideration to determine the type of treatment.  Treatment may consist of a single therapy, or a combination of therapies may be used – including radiation, hormone therapy, surgery, cryosurgery (freezing malignant cells) and on the rare occasion, chemotherapy.

When surgery is required, a standard operation called a radical prostatectomy is performed.  This procedure includes removal of the prostate and sometimes the nearby lymph nodes.  It is most often used for stages I and II cancers that have not spread outside of the prostate.  Often the surgeon can remove the gland without severing nerves that control other bodily functions such as penile erection or bladder control, resulting in less likelihood of incontinence or impotence. Techniques used to perform a radical prostatectomy include open surgery, or a less invasive procedure such as laparoscopic surgery, and robotic-assisted laparoscopic surgery.

During open surgery, an incision is made either in the lower abdomen (retropubic approach) or in the perineum between the anus and the scrotum (perineal approach) in order to reach the prostate gland.  Generally the recovery time for the perineal approach is shorter than with the retropubic approach.

Laparoscopic surgery entails making several small incisions in the abdomen.  Using a lighted viewing instrument called a laparoscope, the surgeon removes the prostate.  Specially trained doctors have a more precise option – robotic-assisted laparoscopic surgery – which is also done through small incisions in the belly.  However the robotic arms translate the surgeon’s hand motions into finer movements, allowing them to carefully cut around the surrounding nerves and tissues.

Robotic-assisted laparoscopic surgery has shown measureable advantages over both open surgery as well as laparoscopic surgery.  Long-term survival rates are higher; major and minor complications, including blood loss are lower.  The length of hospitalization was also lower when robotic-assisted surgery was utilized.  Patients also had a higher probability of retaining or regaining urinary and sexual function with robotic-assisted surgeries.

Fortunately with early detection, the mortality rates due to prostate cancer are declining.  Medical technologies continue to advance, allowing most patients to return to productive, active lives after their treatments. For more information please click here.