Surgery is the main form of treatment to eliminate prostate cancer because, in most cases, it is possible to remove the entire malignant tumor and cure the cancer permanently, especially when the disease has not yet evolved and has not reached other organs.
This surgery, called radical prostatectomy, is preferably performed in men under 75 years of age, without chronic diseases, such as diabetes and hypertension, diagnosed with prostate cancer that is not yet metastasized. Although this treatment is critical, chemotherapy and radiation therapy after surgery may also be necessary to remove all malignant cells in addition to treatment.
- The prostate tumor has slow growth and therefore no surgery is necessary immediately after the discovery of carcinoma.
- And can wait a few days without increasing the risk of complications.
Recovery is relatively fast and only recommended to rest, avoiding effort, for about 10 to 15 days. After this time, you can resume your daily activities, such as driving or working, however, the permit to make a great effort does not occur until after 90 days from the date of the surgery. Intimate contact can be resumed after 40 days.
In the postoperative prostatectomy, it is necessary to place a bladder tube, a tube that will drive urine from the bladder to a pouch, as the urinary tract becomes very inflamed, preventing the passage of urine. This tube should be used between 1 and 3 weeks and should only be removed after a doctor’s recommendation. Learn how to care for the bladder catheter during this time.
In addition to surgery, chemotherapy and radiation therapy may be needed to kill malignant cells that have not been removed during surgery or that have spread to other organs, preventing them from continuing to multiply. Find out how all prostate cancer treatment options work.
In addition to general risks, such as scarring site infection or bleeding, prostate cancer surgery may have other important sequelae such as:
After surgery, a man may have difficulty controlling urinary flow, resulting in urinary incontinence. This incontinence can be mild or total and usually lasts a few weeks or months after surgery.
This problem is most common in the elderly, but it can occur at any age and depends on the degree of development of the cancer and the type of surgery. Treatment usually begins with physiotherapy sessions, with pelvic exercises and small instruments, such as biofeedback and kinesitherapy. In the most extreme cases, surgery may be done to correct this dysfunction. See more details on how to treat urinary incontinence.
Sexual impotence is one of the most common and worrying complications in men, as they cannot initiate or maintain an erection. This happens because next to the prostate, there are important nerves that control the erection. Thus, impotence is more common in highly developed cancer cases where many affected areas need to be removed and nerves may need to be removed.
In other cases, the erection may be affected only by inflammation of the tissues around the prostate, which put pressure on the nerves. These cases usually improve over months or years as tissues recover.
To help in the first few months, the urologist may recommend certain remedies, such as vardenafil or sildenafil, that help you have a satisfactory erection. Learn more about treating sexual impotence.
Prostate cancer surgery cuts the link between the testicles, where sperm occur, and the urethra. As a result, man will no longer be able to have children by natural means. The testicles will continue to produce sperm, but they will not be ejaculated.
Since most men with prostate cancer are elderly, infertility is not a major concern, but if you are young or want to have children, it is recommended to speak with the urologist and evaluate the possibility of storing sperm in specialized clinics. .
Surgery is performed, in most cases, under general anesthesia, but can also be performed under spinal anesthesia, which is applied to the back, depending on the surgical technique to be performed. Surgery takes an average of 40 minutes to 2 hours and is usually necessary to stay in the hospital for 3 to 5 days.
Prostatectomy involves removal of the prostate, including prostate urethra, seminal vesicles, and blisters of the various ducts, whether or not associated with bilateral lymphadenectomy.
To remove the prostate, surgery may be performed by laparoscopy, that is, through small holes in the stomach through which the instruments pass through to remove the prostate, or by laparotomy where a larger incision is made in the skin. Thus, some techniques may be:
In most cases, the most appropriate technique is laparoscopy because it causes less pain, results in less blood loss and faster recovery time.
After completing prostate cancer treatment, you should perform the PSA test every 6 months for 5 years. Bone densitometry and other imaging tests can also be done annually to make sure everything is okay or to diagnose any changes as soon as possible.
The emotional system and sexuality can be greatly affected, so it may be appropriate for a psychologist to follow you during treatment and during the first few months thereafter. Support from close family and friends is also an important help in advancing in peace.
Yes, men diagnosed with prostate cancer have an increased risk of developing other cancers, such as rectum, leukemia, bowel or bladder. Therefore, it is advisable to maintain healthy habits and not smoking, in addition to performing diagnostic tests periodically, whenever the doctor requests it, because the sooner it is diagnosed, the greater your chances of recovery.