A diagnosis of prostate cancer often comes as a shock for most men.
The mere thought of a tumor growing inside you, wherever it is, is sickening.
And almost immediately, our first impulse would be to “cut out” cancer.
But you should know that choosing how to treat prostate cancer should not be a hasty decision. Especially if what you’re considering is prostate surgery.
What treatment options are available for Prostate Cancer?
Surgery for Prostate Cancer
- Transurethral resection (TURP)– is a surgery usually used to treat urinary problems due to an enlarged prostate (benign prostatic hyperplasia). However, it may be used in prostate cancer patients to relieve urinary symptoms of the disease.
- Radical prostatectomy is an operation to remove the prostate gland and tissues surrounding it. This usually includes the seminal vesicles and some nearby lymph nodes.
- Laparoscopic radical prostatectomy – during laparoscopic radical prostatectomy (LRP), the surgeon inserts special long instruments through several small incisions to remove the prostate. One of the apparatus has a video camera, allowing the surgeon to see inside the body. However, the success of laparoscopic surgery will often depend on the skill of the surgeon.
- Robotic-assisted laparoscopic radical prostatectomy -as the name suggests, this prostatectomy is done using a robotic system. The surgeon sits at a control panel in the operating room and moves robotic arms to operate through several small incisions in the patient’s abdomen.
Radiation for Prostate Cancer
- External beam radiation therapy (EBRT) – Beams of radiation are focused on the prostate gland. This type of radiation can be used to try to cure earlier stage cancers. Alternatively, it can be used to help relieve symptoms such as bone pain experienced in metastatic prostate cancer.
- Proton beam radiation therapy– This type of radiation therapy is not widely available. Proton beam therapy focuses beams of protons instead of x-rays on cancer. This is believed to cause less damage.
Cryotherapy for Prostate Cancer
Cryotherapy is sometimes used to treat early-stage prostate cancer. Most doctors do not use cryotherapy as the first treatment for prostate cancer, but it is sometimes an option if cancer has come back after radiation therapy.
Hormone Therapy for Prostate Cancer
Hormone therapy is also known as androgen deprivation. The goal of this type of treatment is to reduce levels of male hormones (androgens), in the body, or to stop them from affecting prostate cancer cells.
There is mounting evidence of why surgery is not always the best treatment, so here are 5 factors to consider before undergoing prostate surgery…
1) It might not be necessary
Prostate surgery is a radical procedure with many side effects. If you’re an older man with a slowly growing prostate cancer, surgery might not be needed.
A 2009 study reveals that in a group of 12,677 men who had radical prostate surgeries between 1987 and 2005, only 12 percent of deaths were directly linked to prostate cancer. This is although many of the patients’ cancers were aggressive.
The study shows a remarkably low risk of dying from prostate cancer, and that men with slow-growing cancers may not need immediate treatment. This also means an older man is more likely to die from old age or other causes than from prostate cancer.
2) Doesn’t lead to a longer life
A recent long-term study suggests that prostate surgery does not lower deaths related to prostate cancer. The study, known as the Prostate Cancer Intervention Versus Observation Trial (PIVOT), evaluated around 731 men with an average age of 67 years and all who have localized prostate cancer.
Out of those who had prostate cancer surgery, about 61% died of other causes after 20 years of follow-up. Only about 7% died of prostate cancer. For men who did not have prostate surgery, only 11% died of prostate cancer.
3) Urinary incontinence
Incontinence often results from bladder weakness brought about by prostate surgery. Although this is a common problem with surgical prostate treatment, it is a big challenge that many have to cope with.
These long-term side effects occur when the bladder neck sphincter and pelvic floor muscles are damaged following prostate surgery. As surgery can be a traumatic procedure, it can affect the tone and strength of these muscles. Hence, its ability to control the flow of urine is impaired.
4) Erectile dysfunction
Even with the best surgeons and advances in nerve-sparing techniques, men can still experience problems with erectile function after prostate surgery.
Most men suffer to some degree because of the trauma brought about by surgery to the soft erectile tissue and the surrounding nerves.
While erection problems are temporary in most cases, it can be a permanent, long-term effect. Its severity depends on the type of surgery, the surgeon’s skill, and the stage of cancer.
5) Reduced quality of life
One study reveals that one in five men who undergo prostate surgery to treat cancer later regret the decision.
While each person’s reason for regretting the decision may vary, the study finds that it has something to do with many quality-of-life issues, like erection problems and other bodily changes.
After all, the prostate gland is a vital part of the male reproductive system. Therefore, it is vital for doctors to talk to their patients carefully about the risks and benefits of prostate surgery, so their patients have more realistic expectations and can make an informed decision.
Is there an alternative to prostate surgery?
Active surveillance is a means of monitoring prostate cancer when it hasn’t yet spread outside of the prostate.
It is suitable for men with low-risk prostate cancer, which has a low risk of spreading (localized prostate cancer). Active surveillance includes grade group 1 or Gleason 6, a PSA level <10, cancer that is confined to the prostate.
A benefit of monitoring low-risk cancer is that you might avoid having unnecessary surgery. In fact, one study of men undergoing active surveillance found that, 15 years later, less than 1% of men developed metastatic disease.
If you have been diagnosed with prostate cancer and surgery is necessary, research minimally invasive surgeries.
The majority of procedures damage the prostate and therefore, cause short or long-term side effects. The only difference between them is that they use different technologies, but it doesn’t matter how you damage the prostate, it is damage.
Exceptions to this are Uro lift since it just relieves pressure on the urethra, but even that is still invasive.
It seems to me that of all the procedures that cause damage to the prostate, Rezum causes the least amount of damage. The only truly minimally invasive procedure which does not damage the prostate is prostate artery embolization.
Before diving into the deep end, consult with your doctor, your family, and most importantly yourself, to weigh up all your options before having surgery.