If your prostate cancer hasn't spread, surgery could cure your cancer. Even if it has gone into other parts of your body, having surgery -- along with radiation or systemic therapy -- can help control the disease.
Some options your doctor might discuss with you include:
Radical Prostatectomy for Prostate Cancer
Radical prostatectomy is the most common form of surgery for prostate cancer. It involves surgically removing the entire prostate gland and some surrounding tissue. This treatment is recommended to treat early stages of the disease.
There are two types of radical prostatectomy: in a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. Both can be performed laparoscopically, where the surgeon can remove the prostate with fewer incisions and with the aid of a small camera.
Transurethral Resection of the Prostate (TURP)
People with prostate cancer have TURP done to ease symptoms like trouble peeing. Doctors don't use this surgery to try to cure the cancer.
A surgeon removes the inner portion of your prostate gland that surrounds something called the urethra. That's the tube where the urine leaves your bladder. Then they'll pass a tool called a resectoscope past the tip of your penis into the urethra. From there, they'll either send electricity through a wire to heat the area up or use a laser to vaporize or cut tissue.
High-Intensity Focused Ultrasound (HIFU)
This uses highly focused ultrasound to heat and kill prostate cancer cells. The procedure's noninvasive, so you won't have to be cut. HIFU also leaves your healthy tissue unharmed.
You might get this if you have early-stage prostate cancer. It's also an option if you still have some small tumors after you've had radiation or another surgery.
You'll be asleep during this procedure. A small probe goes inside your rectum. Then it goes to the level of your prostate. The probe creates a 3D map of your prostate and the areas where you need treatment. Once your urologist determines how to treat you, focused ultrasound waves destroy the harmful tissue.
The whole thing usually takes about 2 hours. It's an outpatient procedure, and in most cases, you can return to normal activities the next day.
Although some call this cryosurgery, it's not actually surgery. It's freezing prostate cancer cells.
Your doctor might recommend this if your cancer has come back after you've had radiation therapy. It's also an option for people who can't have surgery or radiation.
You'll have anesthesia that'll either numb the lower half of your body or put you to sleep. Then your doctor will use something called transrectal ultrasound to guide needles through the skin between your scrotum and anus.
After that, very cold gases go through those needles to freeze the prostate and destroy it. While that's happening, warm saltwater goes through a catheter in your urethra to keep it from freezing. You'll keep that catheter for a couple of weeks so that your bladder can empty while you recover.
You'll probably have blood in your urine for a couple of days afterward. You could also have:
- Soreness where the needles were
- Swelling in your penis or scrotum
- Burning sensations
- Erectile dysfunction
- Urinary incontinence
Preparing for Your Surgery
You'll work with your health care team to get ready. They'll give you specific instructions that'll depend on the procedure you'll have. Write down any questions you have so that you can ask them before you have your surgery.
Make sure to let your doctor know:
- Any medications and supplements you take
- If you take blood thinners
- If you have a heart device, like a pacemaker or AICD
- Any allergies you have
- If you drink, smoke, or take recreational drugs
- If you have sleep apnea
- If you've had problems with anesthesia