Prostate Cancer Surgery
Prostate cancer develops in the prostate, a small male reproductive gland located deep within the groin at the base of the penis and rectum. The prostate produces seminal fluid (semen), which mixes with sperm from the testes to help the sperm travel and survive.
According to the American Cancer Society, approximately one in eight men will be diagnosed with prostate cancer during their lifetime, usually after age 65. Although the condition is common, the tumors tend to grow slowly, especially in older men.
Early-stage prostate tumors are often asymptomatic, but as the cancer progresses, it may begin to cause noticeable symptoms, such as blood in the urine or semen, interrupted urine flow and urinary urgency, frequency or difficulty. Through routine screening tests, such as the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE), many cases are detected early, leading to effective treatment and potential cure.
Treatment options for prostate cancer may include active surveillance, radiation therapy, hormone therapy, immunotherapy, chemotherapy or surgery. For many patients, surgical removal of the prostate (prostatectomy) is a key part of treatment, particularly if the cancer is localized.
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Schedule an AppointmentWho is a candidate for prostate cancer surgery?
Prostate cancer surgery may be considered for a man who has a localized tumor that has not spread beyond the prostate. The patient should be in good overall health and able to tolerate the procedure and recovery process. Surgical treatment may be a particularly good option for a young patient with a long life expectancy. It may also be suitable for a patient whose cancer cannot be effectively managed with other treatments, such as radiation therapy and hormone therapy.
The types of prostate cancer surgery include:
Radiofrequency ablation (RFA) for prostate cancer
A minimally invasive treatment option for prostate cancer, RFA uses heat to destroy cancerous tissues. Guided by advanced imaging, such as magnetic resonance imaging (MRI) or ultrasound, a physician will insert a thin, needle-like probe directly into the prostate tumor. Using the probe, the physician will then precisely deliver high-frequency electrical currents to the cancer cells while sparing the surrounding healthy tissues.
Usually performed on an outpatient basis, radiofrequency ablation has lower risks and a shorter recovery than more invasive treatments. It may be suitable for a patient who has localized or recurrent prostate cancer and is not a candidate for surgery or radiation therapy.
How to prepare for radiofrequency ablation for prostate cancer
To prepare for RFA, the patient will typically undergo imaging tests, such as MRI or ultrasound, to help the physician pinpoint the prostate tumor and assess its size and position. The patient may be advised to stop taking certain medications, such as blood thinners, to reduce the risk of bleeding. They should also avoid eating and drinking for a specified period, usually starting the night before surgery. Through a detailed discussion with the healthcare team, the patient can gain a full understanding of the process, risks and anticipated recovery.
What to expect after radiofrequency ablation for prostate cancer
Because RFA is a minimally invasive technique, most patients can return home on the same day as the procedure. Mild discomfort, swelling and bruising at the treatment site are common and usually resolve within a few days. Some patients experience temporary changes in urinary function, such as increased frequency or mild irritation, which typically improves over time. Follow-up appointments may include imaging and PSA testing to monitor the effectiveness of treatment and ensure the prostate tumor was successfully targeted.
What are the risks and potential complications of radiofrequency ablation for prostate cancer?
RFA is generally safe but carries some risks, including infection at the probe insertion site, mild bleeding, bruising and temporary urinary issues, such as frequency or discomfort. There is also a slight chance of damage to nearby structures, such as the bladder and urethra, due to the heat used during the procedure. Additionally, incomplete removal of cancerous tissue may occur, necessitating further treatment. The patient should discuss these risks with their physician and take any recommended steps to minimize them.
The emotional toll of prostate cancer is often difficult for many men, and Robert was no exception.
Request an AppointmentCryoablation for prostate cancer
Cryoablation is a minimally invasive treatment that uses extreme cold to eliminate cancerous tissues. After inserting a thin probe into the prostate under imaging guidance, a physician will deliver a freezing gas to create ice crystals that destroy the cancer cells. The physician will precisely control the process to target the tumor while sparing the surrounding healthy tissues.
Often performed on an outpatient basis, cryoablation can be effective in addressing localized or recurrent prostate cancer. The procedure may also be suitable for a patient who is not a candidate for surgery or radiation therapy.
How to prepare for cryoablation for prostate cancer
To prepare for cryoablation, the patient may undergo imaging tests, such as MRI or ultrasound, to help the physician assess the size and location of the prostate tumor. To reduce the risk of bleeding, the patient may be instructed to temporarily stop taking certain medications, such as blood thinners. They may also be advised to fast for several hours beforehand. During the procedure, a catheter may be inserted into the bladder to help drain urine. The physician will provide individualized preoperative instructions based on the patient’s unique health needs and treatment plan.
What to expect after cryoablation for prostate cancer
Because cryoablation is an outpatient procedure, the patient can expect to go home the same day. Mild pain, swelling and bruising in the pelvic area are common and can usually be managed with pain medication. Any urinary symptoms, such as urgency, frequency or mild incontinence, should improve over time. A catheter may be placed temporarily to help with urination. Follow-up appointments will be necessary to monitor the effectiveness of the treatment, typically through imaging or PSA tests. Recovery is generally quick.
What are the risks and potential complications of cryoablation for prostate cancer?
Cryoablation is generally safe, but potential risks include infection at the probe insertion site, mild bleeding and urinary issues, such as frequency or incontinence. Some men also experience temporary erectile dysfunction, and there is a slight risk of damage to nearby tissues, such as the rectum and bladder. In rare cases, the cancer may not be fully destroyed, necessitating further treatment. The patient should discuss these risks with their physician to determine if cryoablation is the right prostate cancer treatment for them.
Prostatectomy surgery for prostate cancer
Prostatectomy is a surgical procedure that involves removing all or part of a cancerous prostate. The most common type is radical prostatectomy, which involves removing the entire prostate gland along with some nearby surrounding tissues. The removed tissues will be sent to a laboratory for microscopic examination by a pathologist. If the pathologist does not find cancerous cells in the margin, further treatment may be unnecessary.
The types of radical prostatectomy include:
- Open radical prostatectomy – This traditional surgical approach involves making a single large incision in the lower abdomen, providing the surgeon with direct access to the prostate and surrounding tissues.
- Radical retropubic prostatectomy – A type of open surgery, this procedure involves making an incision above the pubic bone, allowing the surgeon to access the prostate without cutting through muscle.
- Laparoscopic radical prostatectomy – To perform this minimally invasive procedure, the surgeon will make several small incisions in the abdomen and then insert a miniature camera and specialized surgical instruments to remove the prostate.
- Robotic-assisted radical prostatectomy – Similar to laparoscopic radical prostatectomy, this surgical technique is performed through small incisions. While operating, the surgeon will use advanced robotic technology for enhanced surgical precision.
- Cystoprostatectomy – This combined surgical procedure involves removing the bladder (cystectomy), the prostate (prostatectomy) and possibly the semen-producing glands (seminal vesicles).
How to prepare for prostatectomy surgery for prostate cancer
Before prostatectomy surgery, the patient will typically undergo a series of tests, including blood work, imaging scans and possibly a biopsy, to check for cancer spread and assess their overall health. In the days leading up to the procedure, the patient may be instructed to stop taking certain medications, such as blood thinners, to reduce the risk of excessive bleeding. Additionally, the patient may be advised to fast and follow specific bowel preparation instructions to clear the intestines before surgery. The healthcare team will provide detailed guidance based on the patient’s individual health needs and surgical plan.
What to expect after prostatectomy surgery for prostate cancer
After prostatectomy surgery, the patient can expect to remain in the hospital for a few days for monitoring during the initial phase of recovery. If a bladder catheter is in place to help with urinary function, it will likely be removed during that time. In addition to some pain, swelling, bruising and fatigue, the patient may experience urinary incontinence or erectile dysfunction, which should improve over time with treatment and rehabilitation. To promote healing, the healthcare team may suggest pelvic floor exercises and other therapies. A follow-up appointment will be scheduled to monitor the patient’s recovery, assess for signs of complications and discuss the next steps. Full recovery can take up to several weeks, and most patients gradually resume their normal activities as they heal.
What are the risks and potential complications of prostatectomy surgery for prostate cancer?
Prostatectomy surgery carries several risks and potential complications, including urinary incontinence, erectile dysfunction, infection, bleeding and damage to nearby organs, such as the bladder and rectum. There is also a slight possibility of fluid buildup in the pelvic area (lymphocele) and blood clots. The patient should fully discuss the risks and benefits of the procedure with their surgeon before proceeding.
Transurethral resection of the prostate (TURP) surgery for prostate cancer
TURP is a minimally invasive procedure typically used to treat benign prostate enlargement (BPH), but it may also be considered in certain cases of advanced prostate cancer, particularly to relieve symptoms caused by an obstruction in the urinary tract. To perform a transurethral resection of the prostate, the surgeon will insert a thin, tube-like instrument with a camera and surgical tools attached (resectoscope) through the urethra. The surgeon will then remove excess prostate tissue, relieving pressure on the urethra and improving urine flow. This procedure does not remove the prostate entirely or cure prostate cancer. Instead, the goal is to manage symptoms and improve the patient’s quality of life.
How to prepare for transurethral resection of the prostate
To prepare for TURP surgery, the patient will typically undergo a thorough evaluation, including blood testing, a physical examination and possibly imaging to help the physician assess the prostate and urinary tract. The physician may advise the patient to stop taking certain medications, particularly blood thinners, a week or more before surgery to reduce the risk of bleeding. The patient may also be instructed to avoid eating and drinking after midnight on the night before the procedure. It will be important for the patient to arrange for someone to drive them home from the hospital because they may be sedated during the procedure.
What to expect after transurethral resection of the prostate
After TURP surgery, the patient can expect a short hospital stay, typically one to two days, for initial post-surgical monitoring. During that time, a bladder catheter will remain in place to help with urination. The patient will likely have some mild to moderate discomfort, such as burning sensations or urinary frequency, and blood may be visible in the urine. Some patients also experience mild incontinence or difficulty controlling urination, but these symptoms generally improve over time. Full recovery can take a few weeks, during which time the patient should avoid heavy lifting and other strenuous activities. Follow-up appointments will be scheduled to monitor recovery and check for complications.
What are the risks and potential complications of transurethral resection of the prostate?
TURP surgery carries some risks and potential complications, although it is generally considered a safe procedure. Risks include bleeding during or after surgery, urinary tract infections (UTIs) and temporary difficulty urinating after the catheter is removed. Other risks include urinary incontinence and retrograde ejaculation, which occurs when semen flows into the bladder instead of out of the penis. This can affect fertility but not sexual performance.
Possible complications of TURP surgery include injury to nearby structures, scarring of the urethra or bladder neck and electrolyte imbalances from fluid absorption during surgery. Though highly uncommon, some patients develop TURP syndrome, a condition caused by excessive fluid absorption, which can lead to confusion, nausea and high blood pressure. The patient should fully discuss these risks with their physician before proceeding with surgery.
Benefit from world-class care at Moffitt Cancer Center
Moffitt’s high-volume Urologic Oncology Program is accredited by the Society of Urologic Oncology (SUO), as is our fellowship program, which trains new oncology fellows. Our multispecialty team provides comprehensive diagnostic and treatment services for prostate cancer, including the latest surgical techniques and promising clinical trials. We emphasize individualized cancer care to help each patient achieve the best possible outcome and quality of life.
If you would like to learn more about prostate cancer surgery, you can request an appointment with a specialist in the Urologic Oncology Program at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.
Helpful Links:
- Radical retropubic prostatectomy
- Robotic radical prostatectomy
- Laparoscopic radical prostatectomy
- Cryoablation
- Saturation biopsy
- TRUS biopsy
- TURP
- Cystoprostatectomy
- Radiofrequency ablation