Prostate cancer is a common health concern that affects millions of men worldwide. Choosing the right treatment plan is crucial to ensure a successful recovery and a better quality of life. 

Here are the various prostate cancer surgery options available, along with their advantages and potential side effects. By understanding these options, you can make an informed decision together with your healthcare team.

Understanding prostate cancer surgery

Prostate cancer surgery is often the first line of treatment for men diagnosed with localized prostate cancer. The main goal of the surgery is to remove the cancerous tissue from the prostate gland, as well as any nearby lymph nodes if necessary. This process can be achieved through several surgical methods, which we will explore in detail below.

Types of prostate cancer surgery

Radical prostatectomy

The most common surgery for prostate cancer is radical prostatectomy. This procedure involves the removal of the entire prostate gland, along with the seminal vesicles and nearby lymph nodes if necessary. There are two main approaches to radical prostatectomy:

• Open radical prostatectomy. A surgeon makes an incision in the lower abdomen to access the prostate gland. This method provides a direct view of the surgical area, allowing for the precise removal of the gland.
• Laparoscopic radical prostatectomy. This minimally invasive approach uses small incisions and a laparoscope, a thin tube with a camera on the end, to visualise and remove the prostate gland. This method can result in a faster recovery time and reduced blood loss compared to open surgery.

Robot-assisted laparoscopic prostatectomy

A more advanced form of laparoscopic surgery, robot-assisted laparoscopic prostatectomy (RALP), uses a robotic system to assist the surgeon in performing the procedure. The robotic arms provide enhanced precision and control, potentially leading to improved surgical outcomes and faster recovery times.

Nerve-sparing prostatectomy

To minimise the risk of erectile dysfunction and urinary incontinence after surgery, a nerve-sparing prostatectomy can be performed. This technique aims to preserve the delicate nerves surrounding the prostate gland, responsible for erections and bladder control. Nerve-sparing can be done during open, laparoscopic, or robot-assisted procedures.

Advantages and disadvantages of different surgery options

Each type of prostate cancer surgery comes with its unique set of advantages and drawbacks. Here are some factors to consider when choosing the right option for you:

Open radical prostatectomy

Advantages:

• Direct visualization of the surgical area
• More experience among surgeons with this technique

Disadvantages:

• Larger incision, leading to a longer recovery period
• Increased risk of blood loss

Laparoscopic radical prostatectomy

Advantages:

• Smaller incisions and faster recovery time
• Reduced blood loss

Disadvantages:

• Steeper learning curve for surgeons
• Limited tactile feedback during the procedure

Robot-assisted laparoscopic prostatectomy

Advantages:

• Enhanced precision and control for the surgeon
• Smaller incisions and faster recovery time

Disadvantages:

• Expensive equipment and higher overall cost
• Limited availability in some regions

Nerve-sparing prostatectomy

Advantages:

• Reduced risk of erectile dysfunction and urinary incontinence

Disadvantages:

• May not be suitable for all patients
• Requires a skilled surgeon to perform

Recovery and potential side effects

Recovery time after prostate cancer surgery varies depending on the type of procedure and individual factors. Generally, patients can expect to spend one to three days in the hospital, followed by several weeks of limited activity at home. Some common side effects of prostate cancer surgery include:

• Pain and discomfort. Mild to moderate pain is expected after surgery, which can usually be managed with prescribed pain medications.
• Urinary incontinence. Temporary or long-term urinary incontinence is a possible side effect of prostate surgery. Most men regain bladder control over time, but some may continue to experience leakage or the need for protective pads.
• Erectile dysfunction. The risk of erectile dysfunction varies depending on the type of surgery, the patient’s age, and whether nerve-sparing techniques were used. Some men may regain erectile function over time, while others may require additional treatments such as medications, vacuum devices, or penile implants.
• Lymphedema. Swelling in the legs can occur if lymph nodes are removed during surgery. This condition is typically managed through compression garments, exercise, and other therapeutic interventions.

Making the Right Choice for You

Selecting the most suitable prostate cancer surgery option is a crucial decision that should be made in consultation with your healthcare team. Factors to consider include:

• Stage and grade of prostate cancer. The extent of your cancer will help determine which surgical options are most appropriate.
• Age and overall health. Your age, general health, and the presence of other medical conditions can influence which surgery option is best for you.
• Surgeon’s experience. The skill and experience of your surgeon are vital in achieving a successful outcome. It is essential to choose a surgeon who is experienced in the specific procedure you are considering.
• Personal preferences and values. Your personal preferences and values should be taken into account when deciding on a treatment plan.

Takeaway

Understanding the various prostate cancer surgery options, their advantages, and potential side effects is crucial in making an informed decision about your treatment plan. By collaborating with your healthcare team, you can choose the best approach to manage your prostate cancer and optimise your recovery and quality of life.

Adam Mulligan, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.