Prostate cancer – Treatment
Careful monitoring is not a cure but strategy.
Depending on the value of PSA, the result of the biopsy, the age and overall health status of the patient, we decide to monitor and only when the disease becomes symptomatic or evolved, do we proceed to treatment.
The logic behind this approach is that sometimes we may find cancer cells in prostate biopsy that may not ever grow, so move on to possible treatment that might be unnecessary.
On the other hand, it is unfortunate that there is no scientific evidence to lead us to a conclusion before treatment about which tumors can evolve and what not.
In this case we should take into account the enormous psychological burden on the patient as they often must be subjected to tests, that stress overwhelms him of the outcome.
Surgical removal of prostate is the treatment of choice for the treatment of localized prostate cancer.
This type of surgery is called radical prostatectomy since the entire prostate is removed along with the seminal vesicles, prostatic urethra and lymph nodes.
After removal of the following anastomosis of the bladder with the remaining portion of the urethra and wherein catheter remains place from 8 to 20 days depending on the type of surgery.
Radical prostatectomy may be open (radical retropubic prostatectomy), limited to the perineum (perineal radical prostatectomy), laparoscopic (laparoscopic radical prostatectomy) or via using the robotic system Da Vinci (robotic radical prostatectomy).
After surgery and catheter removal, the patient has some degree of urinary incontinence, which disappears after a time period which varies with the surgery.
With new techniques achieved safeguarding of vesicles’ bundles, which are “responsible” for the erection and in this way the patient after surgery may have erectile function.