Everything You Need to Know About Prostate Cancer Surgery

If your prostate becomes too large, you may experience symptoms like difficulty in urination, frequent urges to urinate, painful urination or ejaculation, presence of blood in your urine, etc. Prostate cancer has the same symptoms; visit a doctor as soon as possible for a prostate exam.

What Does a Prostate Exam Involve?

A prostate exam requires the doctor to feel your prostate using a finger. This is usually done by inserting a finger into your rectum, which helps the doctor feel the size, texture and shape of your prostate.

What Does a Prostate Cancer Exam Involve?

The doctor may insert a finger in your rectum as indicated above, but the best way is usually to carry out a PSA (prostate-specific antigen) test. This is a blood test to check for PSA levels in your blood; a small amount is okay. High levels of PSA might mean that there is a problem with your prostate. It can be that it is inflamed, infected, enlarged or you have prostate cancer.

If the doctor suspects you have prostate cancer, an ultrasound or MRI is requested for better visualisation. A biopsy can also be carried out; this involves taking a sample of your prostate tissue and testing it for cancer cells.

What Happens If You Have Prostate Cancer?

Your doctor will carry out further tests to determine the type of cancer you have, which could be any of the following three types of cancer:

  • Low-risk — this is cancer that cannot spread to other organs; it is confined to your prostate.
  • Medium-risk — this is cancer that is confined in your prostate, but there is a chance that it might spread.
  • High-risk — this is cancer that has already spread to other organs.

Tests carried out include a Gleason score test, bone scan, CT scan, MRI, ultrasound and PET scan. The Gleason score test grades the prostate cells obtained during a biopsy. A score of six means you have low-risk cancer, seven means you have medium-risk cancer and eight to ten means high-risk prostate cancer. Bone scans, CT scans, MRIs, ultrasounds and PET scans are then used to find out how far your cancer has grown.

Prostate Cancer Surgery and Other Treatments

Before recommending prostate cancer surgery, your prostate surgeon may recommend treatments like radiation therapy, chemotherapy and cryotherapy. If these treatments do not work, or the surgeon, through experience and the state of your cancer knows that they will not work, prostate cancer surgery may be recommended.

How the surgery is performed depends on the grade of prostate cancer. Three types of prostate cancer surgeries include:

  • Laparoscopic radical prostatectomy for low and medium risk prostate cancer
  • Robotic-assisted radical prostatectomy for low and medium risk cancer
  • Open radical prostatectomy for high-risk cancer 

The difference between these methods is that laparoscopic and robotic-assisted radical prostatectomy utilise modern tools that only require a small incision to be made on your skin. An open radical prostatectomy means opening you up to reach where the cancer has spread.