A New Treatment for Prostate Cancer?

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The most common prostate cancer treatment is complete surgical removal of the entire prostate gland, a procedure which can leave many men with annoying side effects. However, a new version of this surgery has grown exponentially in recent years. Called “minimally invasive radical prostatectomy,” this treatment is nothing all that radical, and does have it’s uses in addition to potential drawbacks.

Minimally invasive surgery is just that: instead of cutting a large slice across the abdomen and opening a wide hole, small half-centimeter or so cuts are incised and an small video camera called a laparoscope is pushed into the hole to remove the prostate. Sometimes this is even done robotically, with the surgeon remote controlling the laparoscope and surgical instruments.

The practical upshot of this type of prostate cancer treatment is that recovery time is shorter, and hospital stays are greatly diminished, from an average of 4 days down to 1 day. Not bad.

There are a few problems with it, however.

Some doctors are concerned about the direct-to-consumer marketing companies have been doing to promote minimally invasive surgery, resulting in very fast growth in the use of the treatment before larger and more comprehensive studies have been performed. Even though it is approved for use, the appeal of the surgery for patients far outweighs evidence that backs up that appeal.

For instance, most prostate cancer patients are attracted to this treatment based on perceived ease of recovery and shorter hospital stays, which is certainly true, but some evidence points to a higher risk of urinary incontinence after the surgery, up to three times more likely than with “regular” radical prostatectomy. In addition, there is a higher need for follow-up treatment such as hormonal therapy and radiation.

On the good side, minimally invasive surgery has a much higher success rate when performed by a surgeon that has done a lot of surgeries. Studies have shown that the more surgeries the doctor has performed, the less the chance of incontinence and “salvage” treatment.

While not as perfect as some hopeful patients see it, minimally invasive radical prostatectomy is an excellent treatment option for prostate cancer patients. Of course each patient is different and depending on the prostate cancer advancement as well as the health and age of the patient, the doctor will put together the best treatment regimen, which will usually consist of a combination of available treatments including surgery, radiation, and hormonal treatment.

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