List of Surgery for Prostate Cancer

The radical prostatectomy, basically a process for removal of the entire prostate gland, the seminal vesicles, and the vas deferens, is performed for malignant cancer. There are various ways through which radical prostatectomy surgery can be performed. Surgery for prostate cancer treatment involves removing the prostate gland, surrounding tissue, and a few lymph nodes. The entire prostate gland must be removed in order to make sure cancer cells aren’t left behind. This procedure is known as radical prostatectomy or “RP.”

Robotic-Assisted Laparoscopic Radical Prostatectomy: 

With the help of a robotic system (a mechanical device) that basically holds the surgical tools as well as camera. The prostate gland is removed through several 1- or 2-inch incisions into your belly. The success rate of this surgery generally depends upon how experienced your surgeon is. The more surgeries your doctor has done, the better he/she will be at performing this surgery.

Laparoscopic Radical Prostatectomy: 

Your surgeon will make six 1-inch cuts in your belly. Surgical tools and a small video camera fit through the incisions in order to remove your prostate.

Radical Retropubic Prostatectomy (Open): 

Your healthcare provider will make a cut in your lower belly for removing your prostate. This kind of surgery allows your healthcare provider in order to access the prostate gland and surrounding tissue at the same time, while reducing injury to other nearby organs.

Transurethral resection of the prostate: 

This is the standard surgical treatment for benign enlargement of the prostate.
This surgical procedure is used in order to relieve symptoms of urinary retention caused by the large prostate tumor, but it is not used in order to treat the cancer itself. Transurethral resection is done under spinal anesthesia, a kind of resectoscope is inserted inside the penis and the extra prostatic tissue is cut for clearing the way in order to pass the urine.

What can I expect after surgery:

As a patient you can expect to stay in the hospital for a few days after the surgery. You will return home with a catheter. Your doctor removes it at your first office visit, usually from 1 to 2 weeks after the surgery. In the case of confined prostate cancer, your doctor will go through with a screening test in order to check your PSA (prostate-specific antigen) level every 6 to 12 months. If your cancer has spread, your healthcare provider can recommend additional therapies, such as hormone therapy or radiation therapy.

When is surgery the best treatment:

Discuss with your healthcare provider as well as your family in order to find out appropriate treatment. But before making a decision you must consider the following:

• Your cancer stage and grade: Surgery is effective for prostate cancer stages T1 or T2 (cancer confined to the prostate) and sometimes stage T3 (cancer has spread outside the prostate). 
• Your overall health and age: Surgery is more suitable to those men who are healthy enough in order to handle the major operation and likely to live ten years or more. 
• Your intent: Some men with prostate cancer out there positively want their cancer completely removed. Others usually concerns about the several side effects from their treatment may affect their quality of life.

What are the side effects of surgery: 

Your side effects may be based on your health and age, and the type of the surgery you choose. But you may deal with:

• Erectile dysfunction: In some cases, erections can be recovered in about 24 months or sometimes longer. In case of not any effect, medicines, devices or surgery may help. Your healthcare provider can also prescribe drugs and devices during recovery in order to help bring back the erection function.
• Bladder problems (incontinence): Trouble controlling your urine is often temporary, but can last 6 to 12 months. You could also develop bladder irritation or infection, urine leakage, and blockage of the urine flow.                                                                                                  Physical therapy can improve bladder control.
• Changes in the shape of penis: There are chances of having a curve or a slight shortening of the length of the penis.
• Bleeding: A patient can be instructed in order to donate their own blood prior to the surgery or take a hormone in order to boost the blood count.
• Blood clots in the leg or pelvic veins: This occurs in a very small group of patients.
• Infertility: After surgery, a patient may no longer be a father through sexual intercourse. If this situation, discuss with your healthcare provider about alternate options, like artificial insemination.

Note: Apart from surgery, there are various FDA approved prostate cancer medications that are popular amongst the doctors in order to treat prostate cancer. These medications are as follows:

• Abiraterone Acetate: This medication (abiraterone 250 mg) is combined with other corticosteroids for the treatment of metastatic high-risk Castration sensitive prostate cancer and metastatic castration-resistant prostate cancer.  Abiraterone belongs to an antineoplastic class of drugs and is available in tablet form.

• Apalutamide: It is a non-steroidal anti-androgen medication used in the treatment of non-metastatic castration-resistant prostate cancer. It is consumed orally in the form of a tablet.

• Bicalutamide: This drug is an anti-androgen medication which is combined with gonadotropin-releasing hormone (GnRH) analog for the treatment of prostate cancer. It comes in a form of tablets.

• Cabazitaxel: It belongs to the microtubule inhibitor class drug used in the treatment of Castration resistant metastatic prostate cancer. This drug blocks the growth of cancerous cells by inhibiting its division.

• Casodex (Bicalutamide): It is an anti-androgen drug that is used for the treatment of prostate cancer it works by inhibiting the production of the male hormones and slowing down the growth of the cancerous cells. It is inhibited to be used in women or children.

• Darolutamide: It is a synthetic nonsteroidal androgen receptor (AR) commonly used in the treatment of non-metastatic castration-resistant prostate cancer. The highly recommended dosage of darolutamide is 300 mg available in tablet form.

• Degarelix: It is a hormonal therapy used in the treatment of advanced prostate cancer. It belongs to a group of the class called gonadotropin-releasing hormone (GnRH) receptor antagonists.

• Docetaxel: This drug is used in the treatment of prostate cancer, breast cancer, advanced stomach cancer, non-small cell lung cancer, pancreatic cancer, ovarian cancer, melanoma, soft tissue sarcoma, and head cancer. It is injected intravenously and the dose depends upon various factors such as age, weight, height, stage of cancer, and type of cancer.

• Eligard (Leuprolide Acetate): It is a palliative treatment of advanced prostate cancer. It is a prescribed drug that is injected intravenously.

• Enzalutamide: Enzalutamide 40 mg is a type of hormonal therapy used in the treatment of metastatic prostate cancer that has spread to other parts of the body.

• Erleada (Apalutamide): It belongs to a class of drugs known as anti-androgen which works by inhibiting the production of the male hormone. This drug is generally used in the case of Advanced prostate cancer.

• Firmagon (Degarelix):  it belongs to a hormonal therapy class drug that is used for the treatment of hormone-sensitive prostate cancer. It is a GnRH antagonist drug that has the ability to reduce serum testosterone.

• Flutamide: It is a nonsteroidal antiandrogen (NSAA) used in the treatment of androgen-dependent problems such as high androgen levels, excessive hair growth, and acne. It is consumed orally 3 times a day.

• Goserelin Acetate: This medication used to suppress the production of sex hormones (testosterone and estrogen), specifically for treating breast and prostate cancer.              Goserelin acetate should be administered by subcutaneous injection as an implant every 28 days for the duration of treatment. 

• Cabazitaxel: Cabazitaxel (Jevtana) is a semi-synthetic derivative of a natural taxoid. Jevtana together with the prednisone is recommended for treating hormone-refractory prostate cancer after treatment with docetaxel.

• Leuprolide Acetate: Leuprorelin (leuprolide acetate), is a manufactured version of a hormone used in order to treat prostate cancer. This drug should be given by injection into a muscle or under the skin. 

• Mitoxantrone Hydrochloride: Mitoxantrone (Novantrone) is basically an anthracenedione antineoplastic agent. Mitoxantrone together with the prednisone is approved as a second-line treatment for metastatic hormone-refractory prostate cancer.

• Nilutamide: Nilutamide, a NSAA drug (nonsteroidal antiandrogen drug) recommended for treating male patients with prostate cancer.                                                                      Nilutamide acts as the selective antagonist of the androgen receptor, in order to prevent the effects of androgens like testosterone and DHT (dihydrotestosterone) in the body. Because maximum prostate cancer cells rely on these hormones for growth and survival, nilutamide has the potential to slow down the progression of prostate cancer and extend the life in men with this disease. 

• Darolutamide: Darolutamide, an antiandrogen drug recommended for the treatment of male patients with the nmCRPC (non-metastatic castration-resistant prostate cancer). It is primarily approved in order to treat the non-metastatic castration-resistant prostate cancer (nmCRPC) in conjunction with the surgical or medical castration.

Note:- All the information given above is only for information purposes. Before taking any medication please consult with your Doctor.

Read:- Detailed on Prostate cancer medication