Prostate Cancer Treatment Options

Prostate cancer can be treated with medication, radiation therapy or surgery. The latest surgical treatment options are cryosurgery and laparoscopic prostatectomy.

Open Retropublic Radical Prostatectomy

Radical prostatectomy is a major surgical procedure to remove the prostate, along with both seminal vesicles, both ampullae and other surrounding tissues, including a section of the urethra and part of the sphincter muscle.

Radical prostatectomy is a recommended treatment option for patients whose cancer is localized, or confined to the prostate, and those patients who are younger and have a high-grade tumor.

Radical prostatectomy is a complicated procedure that takes two to four hours to perform and requires at least a three-day hospital stay. Patients must wear a catheter for 10 days to three weeks following the surgery.

Certain risks and complications are involved with prostatectomy, including bleeding, infection or cardiopulmonary problems. More serious problems can include urinary incontinence, stool incontinence and impotence. In fact, most patients experience some level of incontinence following the procedure and many may lose all urinary control. At one time, impotence was inevitable following prostatectomy, but today that risk may be reduced with nerve-sparing surgery.

Brachytherapy

Brachytherapy, or internal radiation, is a treatment option in which radioactive material in the form of "seeds" is placed into or near a tumor in the prostate gland. With this procedure, high doses of radiation can be delivered to the immediate area of the tumor, minimizing damage to nearby tissues.

The procedure takes less than an hour and generally does not require an overnight hospital stay. The seeds are placed using thin needles inserted through the perineum, guided by ultrasound. They emit radiation for several weeks and continue to stay in place, causing no harm.

Brachytherapy is not recommended for large or advanced tumors, but is extremely advantageous for men with smaller tumors. The procedure is less invasive, takes less time, is less costly and has fewer side effects than external radiation or surgery.

More than 90 percent of patients continue to be disease-free five years after the procedure.

Cryosurgery

Cryosurgery is less invasive than traditional surgery, involving only a small incision or insertion through the skin, and uses liquid argon gas to destroy abnormal tissue. For years, cryosurgery has been used to treat skin cancers. Now, physicians are starting to use the procedure in cancer treatments for the liver, prostate, pancreas and kidney. Researchers have determined that cryosurgery is a good alternative to surgery or radiation therapy, both of which often have severe side effects.

Because physicians can focus on a limited treatment area, destruction of nearby tissue is avoided. This minimizes pain, bleeding and other complications of surgery. Cryosurgery also requires shorter recovery time and is typically an outpatient procedure. Cryosurgery is especially good for men who cannot have surgery due to their age or other medical problems. The procedure is also a good alternative for those patients who have had unsuccessful radiation therapy.

The cryosurgery process works by using argon gas to freeze and destroy abnormal cells. Argon gas is circulated through a hollow instrument called a cryoprobel, which is placed inside the tumor. A ball of ice crystals forms around the probe, freezing nearby cells. Ultrasound is used to guide the cryoprobe and monitor the freezing of the cells, thus limiting damage to nearby healthy tissue. After cryosurgery, the frozen tissue thaws and is naturally absorbed by the body.

Laparoscopic Prostatectomy

Laparoscopic prostatectomy uses small laparoscopic instruments that are inserted through small incisions in the abdomen to dissect and remove the cancerous prostate gland.

This procedure is less painful and requires a shorter period of recovery than open prostatectomy but achieves the same cancer control. The typical hospital stay is 36 hours with a recovery period of two to three weeks, compared with a 72-hour hospital stay and six- to eight-week recovery period with open prostatectomy.

Laparoscopic prostatectomy is a minimally invasive procedure that requires four or five small incisions at or below the navel. Because of the amazing clarity the laparoscope provides, the surgeon can identify the muscles that control continence and the nerves involved with sexual function.