Advantages of Robotic Prostate Surgery over the Conventional Prostate Cancer Surgery

A boon for Prostate Cancer patients - Advanced Robotic Prostate Surgery is now preferred choice for Prostate Cancer patients due to following Unmatched advantages

• Minimal Bleeding
• Much quicker recovery
• Reduced hospital stay
• Lesser pain killer requirements
• Lower blood transfusion rates
• Improved preservation of physical appearance
• Three (3) D vision enables surgeon to perform Prostate excision with Cancer
• Control without risk of Post Surgery Continence (control over urinary and
• fecal discharge) and causing Impotency

What is Da Vinci master slave Robotic System?

Da Vinci master slave robotic system is used to completely eradicate cancer with minimal side effects for treating Prostate Cancer. Through this system a minimally invasive robot assisted radical prostatectomy technique has been developed in which doctors evolved a unique sequence of surgical steps.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation. The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field.

 How it is  performed ?

Robotic Prostatectomy, also known as Robotic surgery for prostate cancer or da Vinci Prostatectomy is a minimally invasive surgery that is now the preferred approach for removal of the prostate in those diagnosed with organ-confined prostate cancer. The da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

The operation is performed using the daVinci Surgical system and 3-D endoscopic and wristed instruments inserted through 5-6 small incisions across the mid-abdomen

Unbeatable Advantages of Robotic Prostate Surgery over the Conventional Prostate Cancer Surgery
1) Usually in conventional approach, surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave cancer behind. In the Advanced Robotic Technique (ART) surgeons uses a sophisticated mastr slave robot that incorporates 3-D high definition vision, scaling of movement and wristed instrumentation that gives him the ability to perform Prostate excision with minimal risk of leaving the cancer behind and also minimal bleeding and post operative risk of incontinence and impotence.

2) Neither clinical nor imaging tests are sensitive enough to capture a tumour at T3 stage where it has become locally advanced and a risk for spreading to other body parts. Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence Da vinci robot system minimizes side effects thereby greater control for the patient over urinary discharge i.e. continence and return to normal sexual function after the surgery.

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Prostate Cancer - Alternative Cancer Treatments in India

The prostate is a walnut-sized gland in the male reproductive system that helps in formation and storage of seminal fluid. The prostate gland in a male body is located in pelvis under the urinary bladder  and in front of the rectum. In simple words we can define and understand Prostate cancer as one which is mainly associated with urinary dysfunction

Prostate cancer tends to develop in men over the age of fifty and very uncommon in men younger than 45 but becomes often common with the men of advancing age. As of 2011, prostate cancer is the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males worldwide.

 Signs and Symptoms:-

 Early prostate cancer usually causes no symptoms because most of the prostate cancers are slow growing however, there are cases of aggressive prostate cancers with following symptoms:-

·         Frequent urination,

·         Nocturia (increased urination at night)

·         Hematuria (blood in the urine)

·         Dysuria (painful urination)

·         Difficulty in starting and maintaining a steady stream of urine

·         Loss of weight and appetite, fatigue, nausea, or vomiting

·         Weakness or paralysis in the lower limbs

   

Diagnosis:-

• Prostate-Specific Antigen (PSA) Test : A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream but if the value increases, the cause must be located.
• Ultrasound : If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. This gives a clear picture of the prostate gland.
• Bone Scans and X-rays : It may reveal whether the cancer has invaded the bones. To perform a bone scan, doctors inject low doses of a radioactive substance into the patient's vein, which accumulates in bones that have been damaged by cancer.
• Digital Rectal Exam (DRE): During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. It helps to detect any structural anomalies in the prostate.
• Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) Scans : They can further pinpoint the location of cancer that has spread beyond the prostate.
• Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the biopsy sample to see if there are cancer cells and find out the Gleason score.

    Treatment for Prostate Cancer :-

·         Active surveillance:- It refers to the process of observation and regular monitoring and it               can be used effectively when prostate cancer is suspected in its early stage. It includes PSA blood tests and prostate biopsies.   

·         Surgery:- prostatectomy i.e Surgical removal of the prostate. It is most common mode of treatment either for early stage prostate cancer or for aggressive prostate cancer cases. It involves the two major kinds of radical prostatectomy those are radical perineal prostatectomy, and radical retropubic prostatectomy.       

·         Cryosurgery:- It is yet another method of the  treatment of prostate  cancer in which the prostate gland is exposed to freezing temperatures.

·         Radiation therapy:- It is also known as radiotherapy which is used  in the treatment of all  stages of  prostate cancer patients. There are two different kinds of radiation therapy used: external beam radiation therapy and brachytherapy . Brachytherapy involves the surgical placement of radioactive seeds or implants directly into the cancerous portions of the prostate where the radiation kills the available cancerous cells.

·   Advanced Robotic Prostate Surgery  is now preferred choice for Prostate Cancer patients due to following unmatched advantages:-

•  Minimal Bleeding
• Much quicker recovery
• Reduced hospital stay
• Lesser pain killer requirements
• Improved preservation of physical appearance
• Three (3) D vision enables surgeon to perform Prostate excision with Cancer
• Control without risk of Post Surgery Continence (control over urinary and fecal discharge) and causing Impotency

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EARLY PROSTATE CANCER DETECTION & SCREENING : SHOULD YOU GET A PSA TEST?

When to Start—and Stop—Screening

When to start screening is generally based on individual risk, with age 40 being a reasonable time to start screening for those at highest risk (genetic predispositions or strong family histories of prostate cancer at a young age).

Guidelines differ for men at average risk. Some recommend an initial PSA and DRE at age 40, and others recommend starting at age 50. In general, all men should create a proactive prostate health plan that is right for them based on their lifestyle and family history.

When to stop screening is also controversial. Some groups propose 75 as a reasonable cut-off age. Other groups suggest this is an individual decision based on life expectancy and overall current health.

A prostate cancer screening may reveal results that prompt a doctor to recommend a biopsy. There are many other supplementary tests and considerations that can help a man who is undergoing screening decide if a biopsy is necessary, including:

·         Lower vs. higher free PSA test

·         PSA velocity (rate of rise over time)

·         PSA density (PSA per volume of prostate)

·         Family history

·         Ethnicity

·         Prior biopsy findings

·         Digital rectal exam results

·         Different forms of PSA

In general, a lower free PSA (percentage) indicates a higher risk of finding cancer at biopsy, as does a higher PSA velocity and PSA density.

What is PSA?

Prostate-specific antigen (PSA) is a protein produced by both cancerous (malignant) and noncancerous (benign) prostate tissue. PSA helps liquefy the semen. A small amount of PSA normally enters the bloodstream. Prostate cancer cells usually make more PSA than do benign cells, causing PSA levels in your blood to rise. But PSA levels can also be elevated in men with enlarged or inflamed prostate glands. Therefore, determining what a high PSA score means can be complicated.

Besides the PSA number itself, your doctor will consider a number of other factors to evaluate your PSA scores:

·         Your age

·         The size of your prostate gland

·         How quickly your PSA levels are changing

·         Whether you're taking medications that affect PSA measurements, such as finasteride (Propecia, Proscar), dutasteride (Avodart) and even some herbal supplements

When elevated PSA isn't cancer

While high PSA levels can be a sign of prostate cancer, a number of conditions other than prostate cancer can cause PSA levels to rise. These other conditions could cause what's known as a "false-positive" — meaning a result that falsely indicates you might have prostate cancer when you don't. Conditions that could lead to an elevated PSA level in men who don't have prostate cancer include:

·         Benign prostate enlargement (benign prostatic hyperplasia)

·         A prostate infection (prostatitis)

·         Other less common conditions

False-positives are common. Only about 1 in 4 men with a positive PSA test turns out to have prostate cancer.

When prostate cancer doesn't increase PSA

Some prostate cancers, particularly those that grow quickly, may not produce much PSA. In this case, you might have what's known as a "false-negative" — a test result that incorrectly indicates you don't have prostate cancer when you do. Because of the complexity of these relating factors, it's important to have a doctor who is experienced in interpreting PSA levels evaluate your situation.

What's the advantage of a PSA test?

Detecting certain types of prostate cancer early can be critical. Elevated PSA results may reveal prostate cancer that's likely to spread to other parts of your body (metastasize), or they may reveal a quick-growing cancer that's likely to cause other problems.

Early treatment can help catch the cancer before it becomes life-threatening or causes serious symptoms. In some cases, identifying cancer early means you will need less aggressive treatment — thus reducing your risk of certain side effects, such as erectile dysfunction and incontinence.

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Prostate Cancer Patient from Zambia - Most Advanced Robotic Surgery in India

Medworld India offers comprehensive care for patients with Prostate Cancer, including advanced diagnosis, best treatment options . A team of Surgical Oncologists, Radiation Oncologists, Medical Oncologists, Urologists, Rehabilitation team and other medical specialties work together to treat each Prostate Cancer patient We consider each patient's type and extent of Prostate Cancer to recommend the most appropriate treatment plan. They also carefully consider and select the treatment option that will allow the patient to maintain quality of life with good survival rate.

Why should you choose to get Indian hospitals offer the Best Cancer Treatment in India at affordable prices. MedWorld india associated Best Cancer Treatment Hospitals in India have the latest technology and infrastructure to offer the Most Advanced Cancer Treatment at low cost

Prostate Cancer Patient from Zambia Treated with Robotic Surgery

Minimally Invasive Laser Prostate Surgery for Prostate Cancer Green Light Laser PVP :

Green Light Laser Therapy is a minimally invasive treatment option that combines the effectiveness of the traditional surgical procedure known as transurethral resection of the prostate (TURP). The GreenLight laser system delivers the ultimate BPH solution 

• GreenLight is suitable for most patients with an enlarged prostate, the GreenLight procedure is creating a new standard of care — a standard that offers freedom from enlarged prostate / Prostate cancer symptoms .Most patients return home a few short hours after the GreenLight procedure and can return to normal, non-strenuous activities within days.
  
  
   The advantages of this approach over the traditional TURP (transurethral resection of the prostate) are many: Rapid urine flow improvement,Quick return to normal activities ,Virtually bloodless procedure , Outpatient procedure in otherwise healthy patients.
  
  
  • Surgical Treatment for Enlarged Prostate Cancer :
    
    
    • Radical Prostatectomy Surgery : Radical prostatectomy surgery aims to remove the whole prostate gland and the nearby lymph nodes. After the prostate gland is taken out through an incision, a catheter (a narrow rubber tube) is put in the bladder to carry urine out of the body until the area heals.
    
    
    • Laparoscopic Radical Prostatectomy : The surgeon deploys a Laproscope a thin tube with a tiny camera . Its a minimally invasive procedure where small cuts are made near the tumor site, and thin tools are used to remove the tumor and surrounding tissue. Usually patient are given general anaesthesia or an epidural or spinal anaesthesia that blocks nerve routes from the spine and numbs the area. If the cancer spreads outside the esophagus, it often goes to the lymph nodes first. (Lymph nodes are small, bean-shaped structures that are part of the body's immune system.) Esophageal cancer can also spread to almost any other part of the body, including the liver, lungs, brain, and bones.
  
  
  • Radiotherapy :Radiotherapy uses high energy waves to treat cancer. If your cancer has not spread beyond the prostate gland you can have radiotherapy to try to cure it. This is called radical radiotherapy. This type of treatment involves giving a high dose of radiation to the prostate gland.
  
  
  • Chemotherapy :Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy may be used if your cancer has spread beyond the prostate and is no longer controlled by hormone therapy. In some cases, chemotherapy will improve your quality of life with better control of your symptoms.
    
    
    
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Surgery for Prostate Cancer - Prostatectomy at World Best Hospital in Inda

A surgical approach to treating prostate cancer will remove all or part of the prostate. Typically, men with early-stage disease or cancer that’s confined to the prostate will undergo radical prostatectomy—removal of the entire prostate gland, plus some surrounding tissue. Other surgical procedures may be performed on men with advanced or recurrent disease.

In the most common type of prostatectomy—radical retropubic prostatectomy—an incision is made in the abdomen and the prostate is removed from behind the pubic bone. The surgeon then stitches the urethra directly to the bladder so urine is able to flow.

Because it typically takes a few days for the body to get used to this new setup, the surgeon will insert a catheter, or tube, into the bladder. Urine will flow automatically out of the bladder, down the urethra, and into a collection bag without the need for conscious control of the sphincter. The catheter is usually kept in place for about a week to 10 days.

Another type of surgery, known as radical perineal prostatectomy, is performed less frequently these days. In this procedure, the surgeon makes the incision in the perineum (the space between the scrotum and the anus) and the prostate is removed from behind.

Who Should Undergo Radical Prostatectomy?

Men younger than age 75 with limited prostate cancer who are expected to live at least 10 more years tend to get the most benefit from radical prostatectomy.

Before performing radical prostatectomy, doctors first try to establish that the prostate cancer has not spread beyond the prostate. The statistical risk of spread can be determined from tables comparing the results of a biopsy and PSA levels. Further testing for spread, if needed, can include CT scans, bone scans, MRI scans, and ultrasound.

If it appears that the prostate cancer has not spread, a surgeon (urologist) may first offer other options besides surgery. These can include radiation therapy, hormone therapy, or simply observing the prostate cancer over time, since many prostate cancers grow slowly.

Surgical Techniques

Nerve-Sparing

In a nerve-sparing prostatectomy, the surgeon cuts to the very edges of the prostate, taking care to spare the erectile nerves that run alongside the prostate. If the nerves cannot be spared because the cancer extends beyond the prostate, it might be possible to surgically attach, or graft, nerves from other parts of the body to the ends of the cut erectile nerves.

Surgeons won’t know until the time of the procedure if nerve-sparing is possible; it depends on whether the cancer is invading the nerves. However, the nerve-sparing procedure offers the best chance to preserve long-term erectile function.

Laparoscopic

In laparoscopic surgery, very small incisions are made in the abdomen. The surgeon then inserts narrow instruments fitted with cameras and/or surgical tools, allowing him or her to visualize and operate on the internal structures without cutting open the entire abdomen.

With a robotic interface, the surgeon maneuvers a robot’s arms, which in turn control the cameras and instruments. Robotic surgery has become very popular over the past 10 years due to the smaller incision and shorter post-operative recovery period.

To date, open and laparoscopic procedures have never been compared head-to-head in terms of cancer control and side effects. In general, in the hands of a skilled surgeon, these outcomes are optimized with either approach.

What to Expect After Radical Prostatectomy

Most men stay in the hospital for one to three days after radical prostatectomy. A urinary catheter is inserted during the surgery, and some men may need to wear the catheter home for a few days to a few weeks. Another catheter inserted through the skin also may need to stay in place for a few days after returning home.

Pain after radical prostatectomy can generally be controlled with prescription pain medicines. It can take weeks or months for urinary and sexual function to return to their maximum levels.

After radical prostatectomy, regular follow-up is essential to make sure prostate cancer does not return.

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Importance of a PET scan - To diagnose and Identify Cancer

PET (Positron Emission Tomography) scan

Positron Emission Tomography (PET) is a powerful imaging technique in Radiation Oncology that holds great promise in the diagnosis and treatment of many diseases, particularly cancer. A non-invasive test, PET scans accurately image the cellular function of the human body. In a single PET scan your physician can examine your entire body. PET scanning provides a more complete picture, making it easier for your doctor to diagnose problems, determine the extent of disease, prescribe treatment, and track progress.

PET (Positron Emission Tomography) and CT (Computed Tomography) scans are advanced imaging techniques that physicians use to locate and pinpoint disease states in the body. A PET scan shows the biological function of the body before anatomical changes take place, while the CT scan provides information about the body’s anatomy such as size, shape and location. By combining these two scanning technologies, a PET/CT scan enables physicians to more accurately diagnose and identify cancer, heart disease and brain disorders. 

A PET scan helps in detecting the abnormalities of those areas of the body where chemical activity is happening. This scan is most effectively used for those people who have brain disorders, cancer or heart disease.

• Brain disorders : The different areas of the brain having majority of activities while performing various tasks can be revealed by a PET scan. Specific brain abnormalities can also be evaluated by this scan that includes:
  • Seizures
  • Memory disorders
  • Tumors
• Cancer : Bright spot of cancer cells can be seen in a PET scan due to their high metabolism rate as compared to normal cells. The scan helps in determining:
  • Whether the cancer has recurred
  • The response of the cancer to the treatment
  • The spread and extent of some cancers
• A proper interpretation of the PET scans is required as some non-cancerous conditions may look like cancer. It is also possible that certain cancer types may also not appear on PET scans. Following are the different cancer types that will appear on PET scans such as:
• Thyroid
• Brain
• Pancreatic
• Lymphoma
• Breast
• Melanoma
• Lung
• Cervical
• Esophageal
• Colon

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Prostate Cancer What all Men Must Know - Symptons , Diagnosis , Stages and Treatment in India

Prostate Cancer

The prostate is part of a man's reproductive system and is a walnut-sized gland located between the bladder and the penis. The prostate is just in front of the rectum. The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body. The prostate is a gland.

The  prostate cancer is the most common type of cancer in men. Prostate cancer is the second leading cause of cancer death in men, exceeded only by lung cancer. Adenocarcinoma of the prostate is the clinical term for a cancerous tumor of the prostate gland. As prostate cancer grows, it may spread to the interior of the gland, to tissues near the prostate, to sac-like structures attached to the prostate (seminal vesicles), and to distant parts of the body . Prostate cancer confined to the gland often is treated successfully.

Symptoms of Prostate Cancer

A man with prostate cancer may not have any symptoms. Symptoms of prostate cancer are often similar to those of benign prostatic hyperplasia (BPH). Men observing the following signs and/or symptoms should see their physician for a thorough examination:

·         Urinary problems -  Not being able to pass urine  Having a hard time starting or stopping the urine flow

·         Needing to urinate often, especially at night

·         Weak flow of urine

·         Urine flow that starts and stops

·         Pain or burning during urination

·         Blood in the urine or semen

·         Frequent pain in the lower back, hips, or upper thighs If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated.

Blood test for prostate-specific antigen (PSA): A lab checks the level of PSA in your blood sample.

The prostate makes PSA. A high PSA level is commonly caused by BPH or prostatitis (inflammation of the prostate). Prostate cancer may also cause a high PSA level. The digital rectal exam and PSA test can detect a problem in the prostate. However, they can't show whether the problem is cancer or a less serious condition. If you have abnormal test results, your doctor may suggest other tests to make a diagnosis.

Transrectal ultrasound: The doctor inserts a probe into the rectum to check your prostate for abnormal areas. It also measures the size of the prostate, which can help to determine if the PSA level is elevated for the size of the prostate. The probe sends out sound waves that people cannot hear (ultrasound). The waves bounce off the prostate. A computer uses the echoes to create a picture called a sonogram.

Transrectal biopsy: A biopsy is the removal of tissue to look for cancer cells. It's the only sure way to diagnose prostate cancer. The doctor inserts needles through the rectum into the prostate. The doctor removes small tissue samples (called cores) from many areas of the prostate. Transrectal ultrasound is usually used to guide the insertion of the needles. A pathologist checks the tissue samples for cancer cells.

Diagnosis of Prostate Cancer

If cancer cells are found, the pathologist studies tissue samples from the prostate under a microscope to report the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue. It suggests how fast the tumor is likely to grow. Tumors with higher grades tend to grow faster than those with lower grades. They are also more likely to spread. Doctors use tumor grade along with your age and other factors to suggest treatment options. The most commonly used system for grading is the Gleason score. Gleason scores range from 2 to 10. To come up with the Gleason score, the pathologist uses a microscope to look at the patterns of cells in the prostate tissue

Staging of Prostate Cancer

If the biopsy shows that you have cancer, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. Staging is a careful attempt to find out whether the tumor has invaded nearby tissues, whether the cancer has spread and, if so, to what parts of the body. Some men may need tests that make pictures of the body:

 Bone scan: The doctor injects a small amount of a radioactive substance into a blood vessel. It travels through the bloodstream and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of the bones on a computer screen or on film. The pictures may show cancer that has spread to the bones. Many times a plain x-ray is taken to help evaluate an abnormality seen on a bone scan.

 CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pelvis or other parts of the body. Doctors use CT scans to look for prostate cancer that has spread to lymph nodes and other areas. You may receive contrast material by injection into a blood vessel in your arm or hand, or by enema. The contrast material makes abnormal areas easier to see.

 MRI: A strong magnet linked to a computer is used to make detailed pictures of areas inside your body. The doctor can view these pictures on a monitor and can print them on film. An MRI can show whether cancer has spread to lymph nodes or other areas.

When prostate cancer spreads, it's often found in nearby lymph nodes. If cancer has reached these nodes, it also may have spread to other lymph nodes, the bones, or other organs. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to bones, the cancer cells in the bones are actually prostate cancer cells.

 Stage I  The cancer can't be felt during a digital rectal exam, and it can't be seen on an imaging study, such as ultrasound. It's found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate and is very low grade (low Gleason score)

 Stage II: o The tumor is more advanced or a higher grade than Stage I, but the tumor doesn't extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram. It is detected either after a needle biopsy or surgery done for other reasons, i.e. resection of the prostate for benign enlargement.

 Stage III: o The tumor extends beyond the capsule (outer covering) of the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven't spread to the lymph nodes, bones or other organs.

 Stage IV: o The tumor may have invaded the bladder, rectum, or nearby structures (beyond the seminal vesicles). It may have spread to the lymph nodes, bones, or to other parts of the body.

Treatment of Prostate Cancer in India

Men with prostate cancer have many treatment options. The treatment that's best for one man may not be best for another. Your doctor will make recommendations that are best for each individual. The options include active surveillance (also called watchful waiting), surgery, radiation therapy, cryotherapy, hormone therapy, and chemotherapy. You may have a combination of treatments. The treatment that's right for you depends mainly on your age, the grade of the tumor (the Gleason score), the number of biopsy tissue samples that contain cancer cells, the stage of the cancer, your symptoms, and your general health. Your doctor can describe your treatment choices, the expected results of each, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

Surgery

Surgery is an option for men with early (Stage I or II) prostate cancer. It's sometimes an option for men with Stage III or IV prostate cancer. Before the surgeon removes the prostate, the lymph nodes in the pelvis may be removed. If prostate cancer cells are found in the lymph nodes, the disease may have spread to other parts of the body. If cancer has spread to the lymph nodes, the surgeon does not always remove the prostate and may suggest other types of treatment. After removing the prostate, the bladder is reconnected to the urethra (tube that men urinate through). Once healed, this will allow men to urinate normally. There are several types of surgery for prostate cancer. Each type has benefits and risks. You and your doctor can talk about the types of surgery and which may be right for you:

 Robotic laparoscopic surgery: The surgeon removes the entire prostate through small cuts  A laparoscope and a robot are used to help remove the prostate. Instruments are passed through the small cuts and are used to remove the prostate. The surgeon uses handles below a computer display to control the robot's arms.

 Open surgery: The surgeon makes a large incision (cut) into your body to remove the tumor. There are two approaches:

Through the abdomen: The surgeon removes the entire prostate through a cut in the abdomen. The incision typically is from the umbilicus (belly button) down to the pelvic bone. This is called a radical retropubic prostatectomy.

Between the scrotum and anus: The surgeon removes the entire prostate through a cut between the scrotum and the anus. This is called a radical perineal prostatectomy.

 Laparoscopic prostatectomy: The surgeon removes the entire prostate through small cuts , rather than a single long cut in the abdomen. A thin, lighted tube (a laparoscope) helps the surgeon see. Other instruments are passed through the small cuts. These instruments are used to remove the prostate.

 TURP: A man with advanced prostate cancer may choose TURP (transurethral resection of the prostate) to relieve symptoms. The surgeon inserts a long, thin scope through the urethra. A cutting tool at the end of the scope removes tissue from the inside of the prostate. TURP may not remove all of the cancer, but it can remove tissue that blocks the flow of urine.

After surgery, a catheter (flexible tube) is often left through the penis into the bladder. This allows the area to heal where the bladder and urethra are reconnected. Oftentimes patients only have to stay in the hospital overnight and can go home the following day. With newer surgical techniques, the complications from surgery are significantly reduced.

Radiation Therapy

Radiation therapy is an option for men with any stage of prostate cancer. Men with early stage prostate cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. It also may be used if the cancer recurs after surgery. In later stages of prostate cancer, radiation treatment may be used to help relieve pain. Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cells only in the treated area. Doctors use two types of radiation therapy to treat prostate cancer. Some men receive both types:

•  External radiation
•  Internal radiation (implant radiation or brachytherapy)

Hormone Therapy

A man with prostate cancer may have hormone therapy before, during, or after radiation therapy. Hormone therapy is also used alone for prostate cancer that has returned after treatment. Male hormones (androgens) can cause prostate cancer to grow. Hormone therapy keeps prostate cancer cells from getting the male hormones they need to grow. The testicles are the body's main source of the male hormone testosterone. 

Chemotherapy

Chemotherapy may be used for prostate cancer that has spread and no longer responds to hormone therapy. Chemotherapy uses drugs to kill cancer cells. The drugs for prostate cancer are usually given through a vein (intravenous). You may receive chemotherapy in a clinic, at the doctor's office, or at home. Some men need to stay in the hospital during treatment. The side effects depend mainly on which drugs are given and how much.  Most go away when treatment ends.

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