Prostate Cancer (cont.)
What about surgical
treatment for prostate cancer?
The surgical treatment for prostate cancer is commonly
referred to as a radical or total prostatectomy, which is the removal of the
entire prostate gland. Since 1990, the radical prostatectomy has been the most
common treatment for prostate cancer in the United States. This operation is
done in about 36% of patients with organ-confined (localized) prostate cancer.
The American Cancer Society estimates a 90% cure rate nationwide when the
disease is confined to the prostate and the entire gland is removed. The
potential complications of a radical prostatectomy include the risks of
anesthesia, local bleeding, impotence (loss of sexual function) in 30%-70% of
patients, and incontinence (loss of control of urination) in 3%-10% of
patients.
Great strides have been made in lowering the frequency of
the complications of radical prostatectomy. These advances have been
accomplished largely through improved anesthesia and surgical techniques. The
improved surgical techniques, in turn, stem from a better understanding of the
key anatomy and physiology of sexual potency and urinary continence.
Specifically, the recent introduction of nerve-sparing techniques for the
prostatectomy has helped to reduce the frequency of impotence and incontinence.
If post-treatment impotence does occur, it can be treated
by sildenafil (Viagra) tablets, injections of such medications as alprostadil
(Caverject) into the penis, various devices to pump up or stiffen the penis, or
a penile prosthesis (an artificial penis). Incontinence after treatment often
improves with time, special exercises, and medications to improve the control
of urination. Occasionally, however, incontinence requires implanting an
artificial sphincter around the urethra. The artificial sphincter is made up of
muscle or other material and is designed to control the flow of urine through
the urethra.
Next: What about radiation therapy for prostate cancer? »
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