Surgery: Surgical procedure for prostate cancer includes several types of prostatectomies. For men in the early stages of the disease the cure may be as simple as having a prostatectomy. There's types of prostatectomies.
A radical prostatectomy involves removal of the prostate,
prostatic capsule, seminal vesicles, and a portion of the bladder neck. Many
men experience varying degrees of urinary incontinence and erectile dysfunctionA
retropubic prostatectomy is most often performed because it allows adequate
control of bleeding, visualization of the prostate bed and bladder neck, and
access to pelvic lymph nodes.
A perineal prostatectomy is often the preferred choice for
older men or men who might be poor surgical risks.
This approach takes less time and there is less bleeding.A
suprapubic prostatectomy is used if problems with the bladder are expected, but
otherwise is seldom used. It is more difficult to control any bleeding because
the surgical approach is through the bladder.
Radiation:If the cancer is stage three, or locally advanced beyond the prostatic capsule, treatment by surgical procedure becomes controversial because of the likelihood of hidden lymph node metastasis & relapse.
A prostatectomy, if performed, is used to help relieve urinary obstruction, but not to treat the cancer.Radiation therapy may be used as a primary treatment for prostate cancer. Long term issues of impotence & urinary incontinence may be avoided & survival rates are comparable to that of surgical treatment.
Radiation may be delivered either by an outside beam or interstitial implants of radioactive seeds of iodine, gold, palladium, or iridium. Interstitial radiation has a lower risk of impotence & rectal damage than outside beam radiation.
Radiation has a palliative role for men with metastatic
prostate cancer, reducing the size of bone metastasis, controlling pain, and
restoring function, such as continence.
Hormonal Therapy: Androgen depravation therapy is used to
treat advanced prostate cancer. Many cells in the growing tumor are androgen
dependent and either stop growing or die if deprived of androgens.
Other cancer cells, unfortunately, thrive without androgen
and are unaffected by therapy to reduce circulating androgens. The effects of
hormone therapy can vary from complete but temporary regression of the tumor to
no response at all.
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