Radical Prostatectomy, surgery for prostate cancer, is done when there is a possibility of completely curing the disease. It is used for younger healthy patients in whom the cancer is in the first stage. Surgery has better results in patients in whom the ‘Gleason grade’ (a score to measure the malignancy of prostate cancer) is high.  Surgery should not conducted on patients above the age 70 as it does not counterbalance the increased risk. The operation is done through a lower abdominal incision or between the scrotum and rectum or through laparoscopy or a surgical robot.

Surgery Procedure:

The operation involves removing the entire prostate and seminal vesicles and reconnecting the Urinary bladder to the urethra so that the patient may void normally. The open operation takes 3 to 4 hours and requires at least 3 to 5 days of hospitalization. When the procedure in done through laparoscope, the procedure takes a longer time but the hospital stay is reduced to a day.

The advantage of surgery is that the cancer is removed from the body. Post operation problems may include inability to control urine after surgery and infertility. However the best long term treatment for prostate is surgical treatment.

Operative Method to retain sexual potency after removal of cancer cells:

This type of operation is known as ‘Nerve sparing operation’ in which the surgeon makes the incision very close to the prostate or at times replaces the native nerve with a graft nerve from the foot to preserve potency. The younger the patient quicker is the recovery. He is able to lead a life like all other males with normal potency. However as his age advances he starts losing his potency. Fortunately post operative erection can be restored by the use of drugs like Viagra or PGE-1. Some patients may need a penile implant.

Post operative care

Most patients are out of bed on the first day or a day after operation. They can lead a normal life, except that they should restrict themselves from lifting or carrying heavy weight at least for four weeks and no heavy exercises for six weeks after operation. The inconsistency in urination can be brought under control through light exercises and rehabilitative services. Diet is progressed as the patient can tolerate it. Pain can be controlled through proper medication which is usually not severe.

Prostate cancer can also be treated through radiation. The treatment is called as ‘Radiation Therapy’.

Radiation Therapy, also called X-ray therapy, uses high levels of radiation to kill prostate cancer cells or keep them from growing and dividing, while minimizing damage to healthy cells.

Radiation can be produced from a machine outside the body (external radiation) and directed right at the prostate or by putting radioactive elements known as radioisotopes through thin plastic tubes into the cancer infected area(internal radiation or brachytherapy).

Internal radiation therapy places radioactive implants directly into the tumor. These radioactive sources can be temporary (removed after the proper dose is reached) or permanent.

What happens while the treatment?

External radiation therapy requires regular sessions (generally five days a week) during a period of eight to nine weeks. During each treatment the therapist puts the patient in proper position on the treatment table and leaves the room and starts the treatment.

The patient is under constant observation during the treatment; cameras and intercom are in the treatment room so that the therapist can constantly watch and also hear the patient. The patient has to remain still and relaxed throughout the treatment and has to inform the therapist in case of any problem or discomfort.

The therapist has to keep coming into the room time to time to reposition the machine and the patient. The machine actually does not touch the patient and the patient feels nothing during the treatment. On completion of the treatment the therapist help’s the patient out of the treatment table.

The therapist has to take an X-ray or port film every week to verify that the patient is positioned accurately during the treatment as well as helps him to make sure that the radiation is delivered in the precise area.

After effect of treatment:

After the treatment small marks resembling freckles is marked by the therapist on the skin along the treatment area. The marks provide an outline of the treatment which has to be left untouched by the patient.

Will diet affect treatment?

Good nutrition is important for recovering from the side effects of radiation therapy. Eating well helps the body to heal fast and fight infections and it also gives a sense of well being. The best way is to consult a dietician who can help in framing a diet chart.

Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system.

What causes prostate cancer?

Male hormone called androgen causes the growth of the prostate gland. There are several types of cells in the prostate gland and nearly all types of prostate cancer begin in the gland. As a result the gland starts growing in size and infection may spread to other parts of the body too. Invariable the gland increases in size because of large amount of hormone (androgen) secretion.

There are a number of ways to treat and prevent prostate cancer of which ‘Hormone therapy treatment’ is one. Hormone therapy also known as ‘androgen deprivation therapy’ is one of the primary treatment options for prostate cancer.

How does it work?

Androgen is produced at a much higher level in men. It is primarily produced in the testicles, but the adrenal gland situated at the top of the kidney also produces small amount of it. The basic principal behind this treatment is to block the production or effect of androgen in the body and thus slow the growth of the prostate cancer cells. Thus there are two groups of drugs that are administered to block the production of androgen in the testicles.

Luteinizing Hormone-Releasing Hormone (LHRH) Agonists and Antagonists

These two group of drugs work by blocking the hormones that cause the production of androgen. It also lowers the level of testosterone (the most well known androgen) in the body.

They are administered via implant under the skin or as injections. Common drugs in this category include ‘leuprolide, goserelin, triptorelin and abarelix’.

However these drugs are expensive and require frequent visit to the physician.

How can androgen be blocked from working in the body?

Anti- androgen medication also exists that do not block the production of the hormone but stops their function in the body. They are used while LHRH agonists and antagonists are being used. They are rarely used alone.

Anti-androgen blocks the function of androgens throughout the body regardless whether they are produced in the testicles or adrenal gland. They are usually given as pills that are to be taken every day.

Common medication in this category include ‘flutamide (Eulexin) and bicalutamide (Casodex)’

Due to the invention of hormone treatment most patients avoid surgery (Orchiectomy).