Prostate cancer surgery: Difference between revisions

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* Under ultrasound guidance, metal rods are inserted through the skin of the [[perineum]] into the prostate. Highly purified Argon gas is used to cool the rods, freezing the surrounding tissue at −186 °[[Celsius|C]] (−302 °[[Fahrenheit|F]]). As the water within the prostate cells freeze, the cells die. The [[urethra]] is protected from freezing by a [[Foley catheter|catheter]] filled with warm liquid.
* Under ultrasound guidance, metal rods are inserted through the skin of the [[perineum]] into the prostate. Highly purified Argon gas is used to cool the rods, freezing the surrounding tissue at −186 °[[Celsius|C]] (−302 °[[Fahrenheit|F]]). As the water within the prostate cells freeze, the cells die. The [[urethra]] is protected from freezing by a [[Foley catheter|catheter]] filled with warm liquid.
* [[Cryosurgery]] generally causes fewer problems with urinary control than other treatments, but [[impotence]] occurs up to ninety percent of the time.<ref>{{cite journal| last=Bahn| first=DK| coauthors=Lee F, Badalament R, Kumar A, Greski J, Chernick M| title=Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer| journal=Urology| year=2002| month=August| volume=60| issue=2 Suppl 1| pages=3–11| pmid=12206842| doi=10.1016/S0090-4295(02)01678-3}}</ref>
* [[Cryosurgery]] generally causes fewer problems with [[urinary incontinence|urinary control]] than other treatments, but [[impotence]] occurs up to ninety percent of the time.<ref>{{cite journal| last=Bahn| first=DK| coauthors=Lee F, Badalament R, Kumar A, Greski J, Chernick M| title=Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer| journal=Urology| year=2002| month=August| volume=60| issue=2 Suppl 1| pages=3–11| pmid=12206842| doi=10.1016/S0090-4295(02)01678-3}}</ref>


==References==
==References==

Revision as of 19:07, 18 September 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

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Overview

Surgery is the mainstay of treatment for prostate cancer.

Surgery

Prostatectomy

  • Surgical removal of the prostate, or prostatectomy, is a common treatment either for early stage prostate cancer, or for cancer which has failed to respond to radiation therapy.
  • Radical prostatectomy is effective for tumors which have not spread beyond the prostate.[1]
  • Common tyes of radical prostatectomy include:
  • Surgeon removes the prostate through an abdominal incision. Another type is
  • Surgeon removes the prostate through an incision in the perineum, the skin between the scrotum and anus.
  • Radical prostatectomy has traditionally been used alone when the cancer is small. In the event of positive margins or locally advanced disease found on pathology, adjuvant radiation therapy may offer improved survival.
  • Surgery may also be offered when a cancer is not responding to radiation therapy.
  • Laparoscopic radical prostatectomy (LRP), is a new way to approach the prostate surgically with intent to cure. Contrasted with the open surgical form of prostate cancer surgery, laparoscopic radical prostatectomy does not require a large incision. Relying on modern technology, such as miniaturization, fiber optics, and the like, laparoscopic radical prostatectomy is a minimally invasive prostate cancer treatment.
  • Transurethral resection of the prostate, commonly called a "TURP", is a surgical procedure performed when the tube from the bladder to the penis (urethra) is blocked by prostate enlargement. TURP is generally for benign disease and is not meant as definitive treatment for prostate cancer. During a TURP, a small instrument (cystoscope) is placed into the penis and the blocking prostate is cut away.

Side effects of prostatectomy

Orchiectomy

In metastatic disease, where cancer has spread beyond the prostate, removal of the testicles (called orchiectomy) may be done to decrease testosterone levels and control cancer growth.

Cryosurgery

  • Under ultrasound guidance, metal rods are inserted through the skin of the perineum into the prostate. Highly purified Argon gas is used to cool the rods, freezing the surrounding tissue at −186 °C (−302 °F). As the water within the prostate cells freeze, the cells die. The urethra is protected from freezing by a catheter filled with warm liquid.
  • Cryosurgery generally causes fewer problems with urinary control than other treatments, but impotence occurs up to ninety percent of the time.[4]

References

  1. Bill-Axelson A, Holmberg L, Ruutu M; et al. (2005). "Radical prostatectomy versus watchful waiting in early prostate cancer". N. Engl. J. Med. 352 (19): 1977–84. doi:10.1056/NEJMoa043739. PMID 15888698.
  2. Gerber, GS (1996). "Results of radical prostatectomy in men with clinically localized prostate cancer". JAMA. 276 (8): 615–9. doi:10.1001/jama.276.8.615. PMID 8773633. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)
  3. PreventProstateCancer.info: A Brief Overview of Prostate Cancer [1]
  4. Bahn, DK (2002). "Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer". Urology. 60 (2 Suppl 1): 3–11. doi:10.1016/S0090-4295(02)01678-3. PMID 12206842. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)

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