The Basics of the Radical Prostatectomy for Prostate Cancer

What Is Radical Prostatectomy?

There are two primary active treatment options for early prostate cancer in most men: surgery and radiation therapy. Radical prostatectomy is the form of surgery that the vast majority of men undergo if they are being treated with surgery for early prostate cancer.

A radical prostatectomy involves removing the entire prostate and any immediately adjacent tissue that is thought to be cancerous.

Additionally, lymph nodes in the area of the prostate can be removed if thought necessary.

How Is It Done?

A radical prostatectomy can be performed in two ways: open or laparoscopically.

Open Surgery – This surgery involves the surgeon either making a single relatively large incision in the lower abdomen (the “retropubic” approach) or in the skin between the scrotum and the anus (the “perineal” approach). Through this incision, the prostate, the seminal vesicles, and any nearby tissue that is suspicious for cancer can be removed.

The retropubic approach is the most common type of radical prostatectomy. The retropubic approach allows the surgeon to remove lymph nodes that are in the area of the prostate, while the perineal approach does not. Being able to remove the lymph nodes for testing is a distinct advantage to the retropubic approach and is one of the key reasons why it is more popular with surgeons.

Laparoscopic Surgery – Instead of one relatively large incision to gain access to the prostate, laparoscopic prostate surgery involves several small incisions. These are made in the lower abdomen, and a thin camera is inserted into one of the incision. Through the remaining incisions, a number of thin, specialized tools are inserted to access the prostate and remove it and other nearby tissues.

Who Is a Good Candidate for a Radical Prostatectomy?

Men who have early-stage prostate cancer (cancer that hasn’t spread distantly) and who don’t have other serious health concerns that would make surgery especially dangerous are good candidates for radical prostatectomy.

Men with advanced prostate cancer (that has spread well beyond the prostate), have serious other health concerns, or are quite elderly and more likely to die from something other than prostate cancer are less likely to benefit from radical prostatectomy.

Only after discussing your treatment options with your doctors, can the right decision be made for you.

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