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The normal approach for surgery in the case of localized prostate cancer is to remove the entire prostate gland and surrounding tissue in an operation known as a radical prostatectomy. The operation is usually performed as a retropubic prostatectomy, in which access is achieved through the lower abdomen, or a perineal prostatectomy, in which access is gained through the perineum which lies between the scrotum and the anus.
During a radical prostatectomy the prostate gland is removed, together with the seminal vesicles, the ampullae (the lower sections of the tubes which carry sperm from the testicles to the prostate gland) and some other adjoining tissue. In addition, that part of the urethra which passes through the prostate gland, as well as the neck of the bladder and a part of the sphincter muscle that controls urine flow is also removed.
From this you will see that a radical prostatectomy is not minor surgery, but is a demanding procedure which generally lasts anywhere from about 2 to 4 hours. It is also an operation which generally requires a stay in hospital of about 3 days followed by 10 days to 2 weeks at home during which time you will need to use a catheter to drain urine.
In the past a radical prostatectomy almost always resulted in impotence, but today improvements in surgical techniques and the introduction of what is known as 'nerve sparing' surgery means that an increasing number of men are now spared from impotence. When nerve sparing surgery is performed the two sets nerves and other vessels that run along the side of the prostate gland are carefully preserved in order to retain the erectile function. This technique is unfortunately not suitable in all cases of prostate cancer.
One of the commonest results of prostate surgery is a degree of incontinence. Almost all patients will experience some loss of control following their operation and this can vary from occasionally dribbling to a complete loss of urinary control. Fortunately, some men are suitable for further surgery to ease this problem and it is sometimes possible to surgically implant an artificial urinary sphincter or to use collagen injections to narrow the opening of the bladder.
Some men will also suffer muscle damage during surgery leading to fecal incontinence, which is essentially a problem caused by a reduction in the elasticity of the rectum. This too can be corrected surgically in some cases. Radiation therapy can also sometimes be used to stiffen the rectal muscles.
Of course surgery is just one of the treatments available for localized prostate cancer today and, while many men favor it because it involves the immediate and complete removal of cancer cells from the body, you should not automatically assume that this is the best treatment for you. Take some time to look at all of your options and discuss each with your physician before coming to any decision.
The prostate gland is a small, hormone producing organ that encircles the upper part of the urethra. It is only found in men, and is responsible for the creation of certain male hormones. It is vital to proper sexual functioning and to regular bladder control. The prostate gland is necessary in order to survive, reproduce and just live comfortably, making conditions that affect it of the utmost importance.
Your doctor may have suspected prostate cancer after talking with you about your health and completing a physical examination.
You may have had a DRE (digital rectal examination) and a blood test for a substance called PSA (prostate specific antigen) to look for signs of cancer. If your PSA result is higher than expected for your age, a more detailed analysis may help determine if it's prostate cancer, or another prostate problem.
All men over the age of 50 years should discuss with their doctor the potential benefits and risks of early detection of prostate cancer using Prostate Specific Antigen (PSA) and digital rectal examinations (DRE) so that they can make informed decisions about the use of these tests.
Men at higher risk because of family history or those of African ancestry should discuss the need for testing at an earlier age.
Digital rectal examination (DRE)
A digital rectal examination (DRE) is the most common way to screen for prostate cancer. During your annual physical check-up, your doctor places a gloved finger into the rectum to feel the prostate gland. Most prostate cancers develop in the peripheral zone, which is the part of the prostate that lies closest to the rectum. This makes it easy to feel for lumps, irregularities or changes in size or consistency.
A normal prostate feels smooth and rubbery. Abnormalities detected by DRE may suggest a need for more tests.
Prostate Specific Antigen (PSA) test for prostate cancer
The Prostate Specific Antigen (PSA) test is a blood test to help detect prostate cancer. It measures a substance called prostate specific antigen made by the prostate. It is normal to find small quantities of PSA in the blood but problems with your prostate can cause your PSA level to rise.
PSA levels vary according to age and tend to rise gradually in men as they age . Elevated levels of PSA can be caused by several prostate problems and not necessarily cancer. Sometimes men with prostate cancer still have normal PSA levels. If you have an enlarged prostate that is non-cancerous , your PSA level may also be high.
If your DRE or PSA tests suggest abnormalities in your prostate, your doctor may suggest more tests to rule out or confirm a diagnosis of cancer.
Cells or tissues are removed from the body and checked under a microscope. If the cells are cancerous, they may be studied further to see how fast they are growing.
To stop cancer from ever returning, you must completely stop cancer at its source. Cancer is foremost a psychological disease and its appearance in your body is a sign that at a deep level, your life is not working. Unless you approach and treat ALL the areas of your life, cancer is likely to re-occur.