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Your Prostate Cancer Treatment Options

Surgery for Prostate Cancer continued...

Robot-assisted radical prostatectomy is performed through five or six tiny “keyhole” cuts in the lower abdomen. Manipulating robot-like fingers that pass through these cuts, surgeons can remove the diseased prostate with minimal disturbance to healthy surrounding tissue. The technique also allows surgeons to remove cancerous lymph nodes. The principle advantage of this robot-assisted prostatectomy is a shorter hospital stay and faster recovery time from surgery. 

Laparoscopic prostatectomy involves your surgeon making four or five very small cuts -- about a half inch each -- in the abdomen. The surgeon inserts tiny cameras and surgical tools through the cuts to remove the cancerous tissue.

Nerve-sparing surgery is performed by cutting prostate tissue carefully away from the nerve bundles without damaging them. This surgical technique was developed to potentially prevent erection difficulties that may occur after prostate surgery.

High-intensity focused ultrasound involves delivering high energy to the affected area using ultrasound waves. Cancer cells heat up and are destroyed.

Cryosurgery for Prostate Cancer

Cryotherapy kills prostate cancer by freezing prostate tissue. But so far, the technique has not been widely adopted because of a high risk of damage to the rectum or urethra from freezing. Loss of sexual function is also much more likely after cryosurgery than after other treatments. 

In cryotherapy, surgeons pass liquid nitrogen or argon gas through narrow rods inserted into the prostate. Cryosurgery can be performed in two to three hours, and patients are often able to leave the hospital the same day.

Hormone Therapy for Prostate Cancer

Male sex hormones, mostly testosterone, provide the fuel that drives prostate cancer growth.  The goal of hormone therapy is to deprive prostate cancer cells of that fuel. Hormone therapy is used to treat advanced prostate cancer, but it can also be used to shrink larger tumors, making other treatments easier. Hormone therapy does not kill cancer cells but can significantly shrink tumors and slow any further growth. Side effects include loss of sex drive, impotence, nausea, diarrhea, and fatigue. Hormone therapy takes three forms:

ADT or androgen deprivation therapy. These medications are injected into the buttocks either once a month, once every three to four months, or once a year, depending on the specific drug. If these treatments are used instead of surgery, these drugs must be administered regularly for life.

Anti-androgens prevent prostate cancer cells from using testosterone. They are given in pill form.  This type of therapy is not given by itself. It is used in combination with surgery or other hormonal therapies.

Orchiectomy involves the removal of the testicles, which reduces testosterone production by about 90%. (About 10% of testosterone is produced by the adrenal glands.) This approach is sometimes chosen by older men who do not want the inconvenience or expense of taking medications.  Silicone implants are placed within the testicular sac to preserve a natural look.

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