Making the Decision to Have a... Health Article

Radical prostatectomy is a common surgery to treat prostate cancer. This surgery may be a good choice for you if the following statements are true.

• You are healthy enough to withstand general anesthesia and the surgery itself.

• Your cancer is confined to the prostate gland. Your doctor may have to remove lymph glands before the surgery to know for sure if the cancer hasn’t spread.

• You expect to live for at least another 10 years so that you will benefit from the surgery.

Prostate surgery is more likely to cure your cancer if it hasn’t spread. However, it can be hard to figure out if your prostate cancer has spread without actually doing the surgery. Doctors find a higher stage of cancer than expected in 20% to 60% of men during or after the surgery when the prostate tissue is looked at under a microscope.

Your doctor has some choices for how to remove your prostate, surrounding tissue, and nearby lymph nodes. The choice depends on the doctor’s experience, your health, and the stage of the tumor. The surgeries differ based on where the cut, called the incision, is made.

• Radical retropubic prostatectomy. This may also be called radical suprapubic. One larger cut is in the lower abdomen. The doctor may or may not be able to keep some of the nerves involved in erections. If so, it’s called nerve sparing surgery.

• Radical perineal prostatectomy.  The cut is between the testicles and the anus.

• Laparoscopic radical prostatectomy.  There are several small cuts in the abdomen.

Just because you’re able to have prostate cancer surgery doesn’t mean that you have to choose this treatment. You must think carefully at your lifestyle, the risks of having surgery, and your quality of life before making a decision. For example, if you can’t stand the possibility of incontinence, scarring, or erectile dysfunction, then maybe surgery is not the best treatment for you. But if the idea of leaving your cancerous prostate in place will constantly worry you, then surgery may be a good choice for you. If you choose surgery, ask your doctor when you can expect to return to your normal activities and what the scars will look like.