Surgery for Prostate Cancer

Prostate cancer is a very common cancer in men over 65 but is not often a cause of early death. Many men live with prostate cancer for years, and may die of an unrelated cause. It tends to be a slow growing cancer, although some forms can be more aggressive.

The treatments available depend on the stage of the cancer and how aggressive it is. In the early stages, when the cancer is confined within the prostate gland and does not seem to be a threat, it is sensible not to rush into treatments straight away. Your doctor will possibly recommend watching and waiting, while your condition is carefully monitored over a period of months.

Surgical Treatment for Prostate Cancer

If it is right in your case, your medical team may advise that your prostate gland is removed completely to prevent the cancer from spreading elsewhere in the body. This type of operation is called a radical prostatectomy and it can be carried out using open abdominal surgery, or a keyhole technique. Surgery for prostate cancer can be followed up by radiotherapy, either by external beam, or from tiny radioactive ‘seeds’ that are implanted in your body near to where the prostate gland has been removed.

The operation itself does not take very long but normally requires either a general anaesthetic or spinal anaesthesia and a short stay in hospital. It needs to be done carefully to avoid damaging the delicate tissues around the prostate. If the tendons, ligaments and muscles are affected during the surgery, this can interfere with urination and also sexual function. Sometimes impotence and problems maintaining and erection can occur after removal of the prostate.

What to Expect from Prostate Surgery

It will take about 24 hours to recover from the effects of the anaesthetic but then you will be encouraged to get up and mobile as soon as possible to prevent blood clots forming in your veins. You will probably have a catheter into your bladder to drain urine away for 2 days or so, and a drip to give you fluids. Once the medical team is sure your bladder is draining normally, and you have no problems with urination and you show no signs of infection, you should be allowed home.

It is sensible not to return to work, if you still work, for three weeks and to avoid heavy lifting and strenuous activity and sports for about 6 weeks but then you should be able to do everything you normally do.

Prostate Surgery to Relieve Symptoms

Prostate surgery may also be carried out to reduce the symptoms caused by an over-sized prostate, even though there is no cancer present. This operation is called a transurethral resection of the prostate and it removes only part of the enlarged gland. This is more usually done as a keyhole operation and carries less risk of side effects. It will reduce the size of the prostate and stop it pressing on the urethra, where it can impede the flow of urine. Urination should be easier after a few days.

Success Rates in Prostate Cancer

The combination of early detection, radical surgery and radiotherapy means that over 60% of men with prostate cancer now survive for 15 years. More than 90% survive for 5 years, making prostate cancer a very treatable form of cancer.

If the cancer does spread, despite prostate surgery and follow up treatment, hormone therapy is also then available to prevent further spread and development of the cancer. Eventually, in more aggressive cases that continue to worsen, chemotherapy with docetaxel is available and new therapies are also in development.