• Surgical Procedures for Prostate Cancer

    Surgical options for the treatment of prostate cancer include:

    Prostatectomy

    Surgical removal of the prostate gland is called prostatectomy . It is a common treatment for prostate cancer. Removal of the prostate gland can cause impotence and urinary incontinence . Two commonly used methods of removing the prostate are:
    Radical Retropubic Prostatectomy
    The surgeon makes an incision through the skin of the lower part of the abdomen and removes the prostate gland and surrounding lymph nodes. Newer techniques (nerve-sparing prostatectomy) may allow surgeons to avoid cutting into the nearby nerves that control erections.
    Radical Perineal Prostatectomy
    This form of prostatectomy is not as common as radical retropubic prostatectomy. For this procedure, the surgeon makes an incision on the perineum, which is the skin between your rectum and scrotum, and removes the prostate but not the lymph nodes.

    Orchiectomy

    Orchiectomy is the removal of the testicles. The surgeon removes the testicles through an incision in the skin of the scrotum. This procedure is done to remove the major source of male hormones in the body and is considered a type of hormonal therapy. It is generally used only to manage hormone-responsive metastatic prostate cancer.
    Prescription hormonal therapies are available as alternatives to orchiectomy. Your surgeon may recommend an orchiectomy or injectable (or oral) hormones when the prostate cancer is suitably large, involves the lymph nodes, or has spread beyond the pelvis. This treatment should not be offered for early stage cancer.
    Orchiectomy may cause impotence and reduced sexual desire, as well as hot flashes, breast tenderness, and osteoporosis .

    Cryosurgery

    Cryosurgery is the freezing of abnormal areas of the prostate gland. The surgeon inserts a tool through the skin between the anus and the scrotum until it reaches the prostate. The tool allows a chemical to freeze the abnormal areas of the prostate. A catheter is placed through the lower abdomen into the bladder to drain urine for one to two weeks after the surgery.
    Although cryosurgery is performed at many centers in this country, its current use is limited as other minimally invasive procedures (brachytherapy) have become more popular.
    Cryosurgery may cause impotence as well as bleeding, bruising, and temporary swelling of the penis and scrotum.

    References

    Causes, natural history and diagnosis of prostate cancer. American Foundation for Urologic Disease website. Available at: http://www.urologyhealth.org/ . Accessed October 9, 2008.

    Detailed guide: prostate cancer. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed October 9, 2008.

    Prostate cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/prostate . Accessed October 9, 2008.

    University of Pittsburgh Cancer Institute website. Available at: http://www.upci.upmc.edu .

    Way LW. Current Surgical Diagnosis and Treatment . 10th ed. New York, NY: Appleton and Lange; 1994.

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