Large numbers of you may be disappointed to hear this, but the fact that a diagnosis of prostate cancer can depend on the size of your ‘host’ tissue is indisputable. Our bodies are incredibly flexible and able to deal with bone, muscle, fat and fat cells that are present on the surface of the prostate. Prostate cancer cells present a particularly challenging challenge to the ability of the urinary tract to move any of these cells away from the surface of the prostate.
In the usual course of treatment for prostate cancer, the patient usually has a biopsy, followed by a new surgery involving the insertion of an incision around the prostate to remove the gland. While these operations may save the life of your patient, they would certainly not cure prostate cancer. But are there many other ways to look for prostate cancer that, in fact, do provide a good clinical outcome? New advances in robotic surgery, which can make all the difference for patients with localized prostate cancer, are making a huge impact on quality of life.
Prostate cancer remains one of the UK’s deadliest diseases. In 2009 more than 11,500 men died from the disease in the UK, 2,500 of whom died from the most aggressive forms. More than 40,000 men are expected to be diagnosed with prostate cancer this year.
Prostate cancer is usually very slow growing. There are many different types of prostate cancer, and it is possible for it to spread or progress outside the prostate gland, but it is rarely the case. Your chances of having a death-threatening prostate cancer are very small. However, the disease can become slow growing, too, and if it becomes fast growing the risk of cancer progression goes up, as do the chances of death. And there are many men who have aggressive disease that does not recur or progress despite two or more courses of radiotherapy, surgery or hormone therapy.
It is only when this aggressive cancer is advanced that many patients will want to undergo radical surgery or radiotherapy to try to ‘block’ its growth. And when you do choose this course of treatment for aggressive prostate cancer, you may want to consider external beam radiotherapy (EBRT). EBRT takes a previously ‘normal’ prostate, transplants it to the body and irradiates it with concentrated radio waves. The radiation treatment target is the prostate and the cancer cells. This kind of therapy has many advantages over standard prostate surgery, which treats the prostate as a mass and attempts to remove all the prostate mass that is now a cancer. However, most routine prostate cancer surgery (oophorectomy) is not suitable for all patients for a number of reasons. For instance, we usually can’t remove the entire prostate gland and also don’t give the patient the best possible outcome.
Of course, any prostate cancer which is not cancerous can still be treated with surgery and radiotherapy to remove the ‘cancer’. However, the risks of these treatments might be greater than we would like to take if the cancer is found very early, or if the size and the aggressiveness of the cancer are unknown. This is why you should always insist on a complete and comprehensive evaluation and evaluation by your doctor before considering any surgical, radiotherapy or hormone treatment for your prostate cancer.
And if you are diagnosed with prostate cancer, do be sure to have a definitive discussion with your doctor about alternatives for treatment, and if you are getting a biopsy, make sure that it is a normal prostate biopsy, not an inflammatory biopsy.
With positive outcomes for many prostate cancer patients, it is becoming very difficult to treat prostate cancer with surgery and radiation without it having the unpleasant side effects. To help manage these side effects, the prostate cancer treatment guidelines recently recommended that fertility preservation was to be offered to men after successful surgery as an alternative to prophylactic hormone therapy. You should expect to have a follow-up checkup at 18 to 36 months after surgery. For those with treatment-resistant cancer and are no longer having sexual function, it is recommended that the return of the sexual function is expected in 18 to 36 months. For those men with benign tumors, the return of sexual function may be expected in 24 to 36 months.
So the bottom line is that, for most patients with localized prostate cancer, surgery or radiotherapy are probably not your best option. Despite this, you should have a discussion with your doctor to find out which of these treatments might be best for you.