By Sean A. Castellucci, D.O. –
After being diagnosed with prostate cancer a wide variety of treatment options may be available depending on your specific stage and degree of cancer. These options can be confusing for even the most educated of patients. Advice comes from a lot of different sources including your doctor, friends and family, reports in the news, and of course the internet, making it difficult to know which one of these options is the best for you. Let me walk you through the most important issues in your decision-making process.
Cancer Cure and Treatment Options
Almost every patient I see tells me that their primary goal is to cure their prostate cancer. Fortunately, this is possible in over 90 percent of patients. There are many treatment options with the two most common being: surgery and radiation. There are other viable treatment options that include active surveillance and cryotherapy. Surgery has its benefits which include the complete removal of all prostate tissue and the removal of lymph nodes (if necessary). After surgery, the PSA (a blood test that is an excellent indicator of cancer progression in patients known to have cancer) should drop to zero. Subsequent rises in the PSA can trigger immediate action to stop its spread. In terms of radiation, although the prostate is not removed, the rates of long term control are very good. Following PSA after radiation can be more complicated since you do still have a prostate. The lymph nodes can also be treated with radiation therapy if it is warranted.
Despite what you may hear, any treatment for prostate cancer has its potential for side effects. Radiation and surgery both can have effects of erectile dysfunction, or difficulty obtaining an erection, and changes to your urination. Surgically, there are “nerve-sparing” techniques that can reduce the risk of erectile problems but there is still a risk of having these types of problems. Radiation can also irritate the tissues around the prostate, namely the bladder and rectum which can also have some of these same effects. Recent advancements in radiation have improved these side effects. Incontinence, or leakage of urine, can also be an issue with either treatment option.
Surgery: The Robotic Prostatectomy
The da Vinci Surgical System is designed to provide surgeons with enhanced capabilities, including high-definition 3D vision and a magnified view. Thanks to technological advances, doctors now have an effective alternative to traditional open and laparoscopic surgery that allows them to offer patient the best of both approaches. In the procedure, the surgeon controls the da Vinci System, which translates hand movements into smaller, more precise movements of tiny instruments inside your body. This technology allows the surgeon to perform complex procedures through just a few small openings of 1/2cm and with greater vision, precision and control than ever before. Until recently, the open prostatectomy required an 8-10 inch incision, and resulted in substantial blood loss, and an uncomfortable and lengthy recovery. Now, with the da Vinci Prostatectomy Incision, you will get less blood loss and transfusions, excellent cancer control, and the potential for faster recovery of urinary continence and sexual function.
Prostate cancer is a complex issue and you need to be sure to bring a list of questions to ask your Urologist, and thoroughly explore all available options. It is also important to remember that every man’s prostate cancer is different and what works for one individual may not work for another.
Dr. Sean Castellucci recently joined the staff at Urology Partners in Bradenton, which has provided urological care to Manatee County since 1971. Previously, he practiced at Urology Center of Columbus in Columbus, Georgia where he served as Medical Director. He also was the co-program chair for the American College of Osteopathic Surgeons from 2010-2011. Urology Partners has two locations; one in Bradenton and one in Lakewood Ranch.
For more information or to make an appointment, please call 941.792.0340.