Prostate Cancer Treatment
Prostate Cancer Treatment options depend on the patient’s age, tumour grade (aggressiveness) and stage (extent).
For patients <75 years with no serious health issues and a cancer which appears to be confined to the prostate, surgery to remove the prostate (radical prostatectomy) offers an excellent probability of cure together with the ability to interpret follow-up results with certainty, as the PSA falls to zero within 3-4 weeks after surgery. If urinary symptoms are present because of prostatic enlargement these will also be addressed by prostatectomy.
For patients with bulky and/or aggressive prostate cancer surgery is preferable because radiotherapy can easily be given after surgery, whereas the reverse situation is rare. Surgery is also the default treatment for young men (aged less than 60 years) because of the importance of being able to interpret test results with clarity, the fall-back option of radiotherapy in the future and the increased risk of radiation-induced pelvic cancers (especially rectum and bladder) 20 years after radiation treatment. Prostate cancer surgery in younger men is also associated with much better continence and potency, so although this group of men are the ones most concerned about the risks of post-operative incontinence and impotence, in the hands of an experienced surgeon they are likely to have neither.
The importance of choosing an experienced surgeon i.e. one who does at least 100 cases a year cannot be over-emphasised. The direct relationship between surgical volume (cases per year) and results for complex procedures such as radical prostatectomy is now well established.
Click the link for more information about laparoscopic radical prostatectomy.
