The prostate is a small walnut shaped gland in the pelvis of men. It is located next to the bladder and can be examined by getting a digital rectal exam. Prostate cancer is a form of cancer that develops in the prostate gland. It is the second-leading cause of cancer deaths for men in the U.S.
Are rarely a threat to life
Don't invade the tissues around them
Don't spread to other parts of the body
Can be removed and can grow back very slowly (but usually don't grow back)
May sometimes be a threat to life
Can spread to nearby organs and tissues (such as the bladder or rectum)
Can spread (metastasize) to other parts of the body (like lymph nodes or bone)
Often can be removed but sometimes grow back
Prostate biopsy is usually done using an ultrasound probe to look at the prostate and guide the biopsy. You may be given an enema and antibiotics to prevent infection. For the test, you will lie on your side as the probe goes into the rectum. First, your provider takes a picture of the prostate using ultrasound. Your healthcare provider will note the prostate gland's size, shape and any abnormalities. He/she will also look for shadows, which might signal cancer. Not all prostate cancers can be seen, and not all shadows are cancer. The prostate gland is then numbed (anesthetized) with a needle passed through the probe. Then, the provider removes very small pieces of your prostate using a biopsy device. The amount of tissue removed depends on the size of the gland, PSA results and past biopsies.
Some cancers grow so slowly that treatment may not be needed at all. Others grow fast and are life-threatening so treatment is usually necessary. Deciding what treatment you should get can be complex. Talk with your healthcare team about your options. Your treatment plan will depend on:
The stage and grade of the cancer (Gleason score and TNM stage)
Your risk category (whether the cancer is low, intermediate or high risk)
Your age and health
Your preferences with respect to side effects, long-term effects and treatment goals
Results from other diagnostic tests will help your provider understand if the cancer can spread or recur (return) after treatment.
There are three types of radical prostatectomy surgery:
Robotic Assisted Laparoscopic Radical Prostatectomy (RALP)
Robotic Assisted Laparoscopic Radical Prostatectomy (RALP) is the most common type of prostate cancer surgery done today. The surgeon is assisted with a robotic system that holds and guides the laparoscopic surgical tools and camera. It also allows the prostate to be removed through tiny ports placed in your belly. In experienced hands, RALP and retropubic prostatectomy (see below) have similar outcomes. There is also less blood loss with robotic surgery than other methods.
For this procedure, your surgeon will make a cut (incision) in your lower belly and remove the prostate through this opening. The entire prostate gland is removed. Your surgeon can assess the prostate gland and surrounding tissue at the same time, while reducing injury to nearby organs. There can be enough blood loss to need a transfusion.
This surgery uses small cuts in the abdomen to remove the prostate with small tools and a camera. This surgery has mostly been replaced with robotic assisted laparoscopic surgery.
Each year, more men are surviving prostate cancer and winning back their lives. Prostate cancer can be a manageable disease if caught early and treated appropriately.
Once you have finished treatment, it is time to manage your side effects. It is time to create a long-term schedule with your doctor for future tests. It's also time to go on with your life.
Talk to your healthcare provider about the side effects or problems you have after treatment. You and your healthcare provider can decide your best next steps.
If you haven't yet started treatment, consider the expertise of your doctor before you begin. With more experienced surgeons, the risk of permanent side effects, like incontinence, is lower.
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