Best Treating Options for Prostate Cancer in India : Prostate Cancer Treatment India

Knowing the various treatments for prostate cancer available and what the risks associated with each are is the first step in being informed about what will be one of the most important decisions of your life. The potential side effects of some of the treatments are too life altering to leave this decision to chance.

Have a discussion with your doctor. Ask questions about any side effects you need to be aware of. While your treatment options become less viable if your cancer has progressed beyond your prostate gland, it is important to be aware of what to expect after the treatment has been completed.

Here are some of the options open to you.

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Prostate Cancer Treatment India | Prostate Cancer Surgery at Best Cancer Hospital India - MedWorldIndia

Surgery

Surgical options available are as follows.

A complete prostatectomy where your entire prostate gland is removed     A lymph node dissection where only the nodes surrounding the urethra are removed     A transurethral resection is done in which small pieces of your prostate are removed

Each of the above procedures requires a hospital stay and you would be anesthetized and put under. They are effective in most cases although cancers have been known to return weeks or months afterward. As well, side effects can include urinary incontinence, impotence and infertility.

Radiotherapy

There are 2 common approaches to radiation therapy in treating prostate cancer, external beam radiotherapy and brachytherapy.

External beam radiotherapy is a procedure where a high energy radioactive source is used to project a beam at your prostate from a short distance outside your pelvic area. There is no anesthesia required and it is done on an out-patient basis. It is typically done on 5 consecutive days over a period of about 5 to 7 weeks.

Brachytherapy is the usage of about 100 to 150 small radioactive pellets or seeds. They are placed directly into your prostate with a syringe a few at a time; it usually takes up to 40 injections to implant them all. This procedure is painful and requires a general anesthetic.

These two procedures use radioactivity to burn away cancerous cells. Side effects include impotence, inflammation of the bladder and rectum and cancers have been known to return.

Chemotherapy

Drugs known to be toxic to cancerous cells are introduced to your body. It is used to slow cancerous growths and relieve pain. It is not a cure but it can be used to help patients where cures through other means are not possible.

High Intensity Focused Ultrasound (HIFU)

HIFU is a procedure that uses sound waves to destroy cancerous cells. A focused ultrasound beam is aimed only at the regions of the prostate that are diseased with cancer. The cells targeted are destroyed using heat. Surrounding tissue is not affected by the beam and remains undamaged.

The entire prostate can be exposed to the ultrasound beam in about three hours. The procedure is done quickly and is effective in eradicating prostate cancer in over 90% of patients treated. Side effects are minimal resulting in urinary incontinence in only 5% of patients. Only 8% suffered urethral blockage and about 40% suffered sexual impotence. Impotence drops to 20% in patients whose cancer does not affect the prostate nerve.

These reasons alone make HIFU the choice you should make when thinking about prostate cancer treatment options.

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What are the Tumors and Lesions that can be Treated by the CyberKnife System ?

What is the CyberKnife System?

The CyberKnife® Robotic Radiosurgery System is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body, including the head, spine, lung, prostate, liver and pancreas.  The treatment – which delivers beams of high dose radiation to tumors with extreme accuracy – offers new hope to patients worldwide.

Though its name may conjure images of scalpels and surgery, the CyberKnife treatment involves no cutting. In fact, the CyberKnife System is the world’s first and only robotic radiosurgery system designed to treat tumors throughout the body non-invasively.  It provides a pain-free, non-surgical option for patients who have inoperable or surgically complex tumors, or who may be looking for an alternative to surgery.

What can the CyberKnife System treat?

The CyberKnife® System is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body, including the head, spine, lung, prostate,  liver and pancreas.  The treatment – which delivers high doses of radiation to tumors with extreme accuracy – offers new hope to patients who have inoperable or surgically complex tumors, or who may be looking for a non-surgical option. To date, more than 100,000 patients have been treated and 244 systems are installed worldwide.

Below is a list of some tumors and lesions that can be treated by the CyberKnife System:

• Osteosarcoma
• Nasopharyngeal carcinoma
• Squamous cell carcinoma
• Non-small cell lung cancer
• Small-cell lung cancer
• Pancreatic cancer
• Hepatocellular carcinoma
• Prostate cancer
• Renal cell carcinoma
• Colon cancer
• Ovarian cancer
• Uterine cancer
• Arteriovenous malformation (AVM)

The CyberKnife combines a linear accelerator, robotic arm and image guidance system. The flexibility of the robotic arm allows the CyberKnife to precisely target lesions in areas of the body unreachable by other means. The CyberKnife also is unique in its ability to continually monitor and adjust in near real-time for changes in target location during treatment. Finally, unlike most other stereotactic radiosurgery systems, the CyberKnife is able to locate and treat lesions in the head or neck without the use of an invasive head frame.

There are numerous patient benefits to the CyberKnife system, including:

• Non-invasive treatment—no head frames affixed to the skull
• No anesthesia
• No recovery time
• Surgically precise targeting (sub-millimeter clinical accuracy)
• 100% frameless
• Minimal effects to surrounding critical tissues
• Robotics adjust to compensate for patient movement
• Flexible treatment planning; image acquisition scheduled around the patient’s availability
• Complements existing St. Joseph’s radiosurgery technologies
• Treatment is typically outpatient, with just one to five treatment days required
• Suitable for treatment of many tumors or lesions throughout the body, including soft tissue, spinal, head and neck and intracranial cases
• Appropriate treatment for some patients diagnosed with inoperable or untreatable tumors or other lesions

CyberKnife radiosurgery treatment vs traditional radiation therapy treatment?

Traditional radiation therapy typically delivers radiation to a wide field of tissue in the body resulting in the treatment of both the tumor and a large amount of surrounding healthy tissue. This is necessary because traditional radiation therapy systems did not account for tumor motion and were therefore much less accurate. These wide radiation fields increased the possibility of damage to normal tissue, increasing the risk of side effects following the radiation treatment. To reduce the number of side effects, clinicians were forced to rethink the way traditional radiation therapy was delivered. As a result, the overall radiation dose was reduced and the number of treatments was divided into 30 to 40 sessions, delivered over a period of weeks.

Radiosurgery devices, such as the CyberKnife Robotic Radiosurgery System, were designed to deliver radiation with extreme accuracy, targeting the tumor with minimal damage to the surrounding healthy tissue.  The accuracy of the CyberKnife System allows clinicians to deliver very high doses of radiation safely because the size of the radiation field is smaller and only includes the tumor and a small amount of surrounding tissue.  This allows for less damage to surrounding healthy tissue and for clinicians to complete treatment in 1 to 5 days vs. the weeks it takes traditional radiation therapy.

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Moset Advanced Radiation Treatments offered at Best Uterine Cancer Hospital in India

EndometrialCancer (Uterine Cancer)

The uterus (womb) is part of the female reproductive system. It is shaped like an upside-down pear and sits inside the pelvis. It is in the uterus that a fertilised egg grows into a baby.

Most of these women are over the age of 50 years. Cancer of the uterus is also known as cancer of the womb, uterine cancer, endometrial cancer and cancer of the lining of the womb.

Causes of uterine cancer

The exact cause of uterine cancer is not known. Some things seem to put women at more risk including:

• endometrial hyperplasia (an abnormal increase in the number of cells in the endometrium)
• menopause, never having children or being infertile
• being overweight
• high blood pressure and diabetes
• a family history of endometrial, breast or bowel cancer
• being on oestrogen hormone therapy without progesterone
• being on tamoxifen or anastrozole for treatment of breast cancer. if you are on either of these medications, you should discuss this risk with your doctor.

Uterine cancer is not caused by sexual activity and cannot be passed on this way. Remember, most women who have known risk factors do not get cancer of the uterus and many women who do get cancer of the uterus have none of these risk factors.

Types of Uterine Cancer :- 

Sarcoma: Sarcoma cancer grows in the supporting tissues of the uterine glands or in the myometrium. This cancer accounts for 2-4% of uterine cancers.

Adenocarcinoma: This cancer is considered as the main type of uterine cancer that grows from the cells in the uterus lining. Endometrial cancer is the other name of this cancer.

The Symptoms of Uterine Cancer include :

• Unusual Vaginal Bleeding or Discharge
• Trouble Urinating
• Pelvic Pain
• Pain during sexual intercourse
• Discomfort or pain in the lower abdomen

Diagnosis of Endometrial Cancer (Uterine Cancer)

A pelvic exam is performed by the doctors checking the vagina, uterus, ovaries, bladder, and rectum for Endometrial Cancer (Uterine Cancer). An instrument called a speculum is used to widen the vagina so the doctor can see the upper portion of the vagina and the cervix.

The Pap Smear test is often performed during a pelvic exam Endometrial Cancer (Uterine Cancer). The doctor uses a wooden scraper (spatula) or small brush to collect a sample of cells from the cervix and upper vagina. The cells are then sent to a medical laboratory to be checked for abnormal changes. Because uterine cancer begins inside the uterus, it may not show up on a Pap test, which examines cells from the cervix.

A biopsy may be needed for a definitive diagnosis where the doctor removes a sample of tissue from the uterine lining. In some cases, a woman may require a dilation and curettage (D&C), which is usually a day care procedure. During a D&C, the opening of the cervix is widened and the doctor scrapes tissue from the lining of the uterus. A pathologist examines the tissue to check for cancer cells, hyperplasia, or other conditions.

Common Endometrial Cancer (Uterine Cancer) Symptoms

•   Abnormal bleeding- heavy bleeding between periods, or heavy bleeding  during irregular periods
•    Pain during intercourse, pelvic pain or pain in the legs or back
•    Difficulty urinating or pain during urination
•    Enlarged uterus , Vaginal discharge and or unexplained weight loss

Surgical Treatment of EndometrialCancer (Uterine Cancer)

Surgery is the best option when Endometrial Cancer (Uterine Cancer) is diagnosed in its very early stages. At this time, the location and the stage of cancer make removal easy. Sometimes patients are treated with a combination of surgery and radiation therapy. Laparoscopy Assisted Vaginal Hysterectomy - involves the minimally invasive or open surgery to remove the uterus. If required teh surgeon may decide to remove both ovaries and the fallopian tubes if there is a risk of Endometrial cancer spread to the ovaries.

In most cases, uterine cancer is an Adenocarcinoma that metastasizes late, usually from the endometrium to the cervix, ovaries, fallopian tubes, and other peritoneal structures. It may spread to distant organs, such as the lungs and the brain, through the blood or the lymphatic system. In such cases advanced tratement post Hystrectomy like Chemotherapy and Radiation are advised

Chemotherapy 

Involves modern cancer drugs that are administered intravenously or orally to kill cancer cells and to reduce the chances of the tumour returning elsewhere in the body.


Radiation therapy 

India's leading Cancer hospitals now have some of the world's moset advanced radiation equipment like Linac, Novelis, Gamma Knife and Cyberknife for treating Colon rectal Cancers. High technology radiation is used to kill cancer cells without affecting the healthy tissues. Radiation may be used to reduce the tumor prior to surgery or to obviate the symptoms of colorectal cancer such as pain, bleeding, or blockage.

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What are the Different Types of Brain Tumors? : Advanced Brain Tumor Treatment

There are many different types of brain tumors. They are usually categorized by the type of cell where the tumor begins, or they are also categorized by the area of the brain where they occur.

The most common types of brain tumors include the following:

• Gliomas. The most common type of primary brain tumor is a glioma. Gliomas begin from glial cells, which are the supportive tissue of the brain. There are several types of gliomas, categorized by where they are found, and the type of cells that originated the tumor. The following are the different types of gliomas:
  
  
• Astrocytomas. Astrocytomas are glial cell tumors that are derived from connective tissue cells called astrocytes. These cells can be found anywhere in the brain or spinal cord. Astrocytomas are the most common type of childhood brain tumor, and the most common type of primary brain tumor in adults. Astrocytomas are generally subdivided into high-grade, medium-grade, or low-grade tumors. High-grade astrocytomas (glioblastomas) are the most malignant of all brain tumors. Astrocytomas are further classified for presenting signs, symptoms, treatment, and prognosis, based on the location of the tumor. The most common location of these tumors in children is in the cerebellum, where they are called cerebellar astrocytomas. These people usually have symptoms of increased intracranial pressure, headache, and vomiting. There can also be problems with walking and coordination, as well as double vision. In adults, astrocytomas are more common in the cerebral hemispheres (cerebrum), where they commonly cause increased intracranial pressure (ICP), seizures, or changes in behavior.
  
  
• Brain stem gliomas. Brain stem gliomas are tumors found in the brain stem. Most brain stem tumors cannot be surgically removed because of the remote location and delicate and complex function this area controls. Brain stem gliomas occur almost exclusively in children; the group most often affected is the school-age child. The child usually does not have increased intracranial pressure (ICP), but may have problems with double vision, movement of the face or one side of the body, or difficulty with walking and coordination.
  
  
• Ependymomas. Ependymomas are also glial cell tumors. They usually develop in the lining of the ventricles or in the spinal cord. The most common place they are found in children is near the cerebellum. The tumor often blocks the flow of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing increased intracranial pressure. This type of tumor mostly occurs in children younger than 10 years of age. Ependymomas can be slow growing, compared to other brain tumors, but may recur after treatment is completed. Recurrence of ependymomas results in a more invasive tumor with more resistance to treatment. Two percent of brain tumors are ependymomas.
  
  
• Optic nerve gliomas. Optic nerve gliomas are found in or around the nerves that send messages from the eyes to the brain. They are frequently found in children who have neurofibromatosis, a condition a child is born with that makes him or her more likely to develop tumors in the brain. People usually experience loss of vision, as well as hormone problems, since these tumors are usually located at the base of the brain where hormonal control is located. These are typically difficult to treat due to the surrounding sensitive brain structures.
  
  
• Oligodendrogliomas. This type of tumor also arises from the supporting cells of the brain. They are found commonly in the cerebral hemispheres (cerebrum). Seizures are a very common symptom of these tumors, as well as headache, weakness, or changes in behavior or sleepiness. These tumors have a better prognosis than most other gliomas, but they can become more malignant with time. About two percent of brain tumors are oligodendrogliomas.
  
  
• Metastatic tumors. In adults, metastatic brain tumors are the most common type of brain tumors. These are tumors that begin to grow in another part of the body, then spread to the brain through the bloodstream. When the tumors spread to the brain, they commonly go to the part of the brain called the cerebral hemispheres, or to the cerebellum. Often, a patient may have multiple metastatic tumors in
  
  several different areas of the brain. Lung, breast, and colon cancers frequently travel to the brain, as do certain skin cancers. Metastatic brain tumors may be quite aggressive and may return even after surgery, radiation therapy, and chemotherapy.
  
  
• Meningiomas. Meningiomas are usually benign tumors that come from the meninges, the outer coverings of the brain just under the skull. This type of tumor accounts for about one third of brain tumors in adults. They are slow growing and may exist for years before being detected. Meningiomas are most common in older patients, with the highest rate in people in their 70s and 80s. They are commonly found in the cerebral hemispheres just under the skull. They usually are separate from the brain and can sometimes be removed entirely during surgery. They can, however, recur after surgery and certain types can be malignant.
  
  
• Schwannomas. Schwannomas are usually benign tumors, similar to meningiomas. They arise from the supporting cells of the nerves leaving the brain, and are most common on the nerves that control hearing and balance. When schwannomas involve these nerves, they are called vestibular schwannomas or acoustic neuromas. Commonly, they present with loss of hearing, and occasionally loss of balance, or problems with weakness on one side of the face. Surgery can be difficult because of the area of the brain in which they occur, and the vital structures around the tumor. Occasionally, radiation (or a combination of surgery and radiation) is used to treat these tumors.
  
  
• Pituitary tumors. The pituitary gland is a gland located at the base of the brain. It produces hormones that control many other glands in the body. These glands include the thyroid gland, the adrenal glands, the ovaries and testes, as well as milk production by pregnant women, and fluid balance by the kidney. Tumors that occur in or around the area of the pituitary gland can affect the functioning of the gland, or overproduce hormones that are sent to the other glands. This can lead to problems with thyroid functioning, impotence, milk production from the breasts, irregular menstrual periods, or problems regulating the fluid balance in the body. In addition, due to the closeness of the pituitary to the nerves to the eyes, patients may have decreased vision.

Tumors in the pituitary are frequently benign, and total removal makes the tumors less likely to recur. Since the pituitary is at the base of the skull, approaches for removal of a pituitary tumor may involve entry through the nose or the upper gum. Certain types of tumors may be treated with medication, which, in some cases, can shrink the tumor or stop the growth of the tumor.

• Primitive neuroectodermal tumors (PNETs). PNETs are much more common in children than in adults. They can occur anywhere in the brain, although the most common place is in the back of the brain near the cerebellum. When they occur here, they are called medulloblastomas. The symptoms depend on their location in the brain, but typically the patient experiences increased intracranial pressure. These tumors are fast growing and often malignant, with occasional spreading throughout the brain or spinal cord.
  
  
• Primary CNS lymphoma. Lymphocytes are carried in lymph fluid in and out of the brain. A CNS tumor occurs when these cells turn malignant. A weakened immune system may increase the risk of this tumor. 
  
  
• Medulloblastomas. Medulloblastomas are one type of PNET that are found near the midline of the cerebellum. This tumor is rapidly growing and often blocks drainage of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing symptoms associated with increased ICP. Medulloblastoma cells can spread (metastasize) to other areas of the central nervous system, especially around the spinal cord. A combination of surgery, radiation, and chemotherapy is usually necessary to control these tumors.
  
  
• Craniopharyngiomas. Craniopharyngiomas are benign tumors that occur at the base of the brain near the nerves from the eyes to the brain, and the pituitary gland. These tumors are more common in children and comprise only about 1% of all brain tumors diagnosed in the U.S. Symptoms include headaches, as well as problems with vision. Hormonal imbalances are common, which may lead to poor growth in children. Symptoms of increased intracranial pressure may also be seen. Although these tumors are benign, they are hard to remove due to the sensitive brain structures that surround them.
  
  
• Pineal region tumors. Many different tumors can arise near the pineal gland, a gland that helps control sleep and wake cycles. Gliomas are common in this region, as are pineal blastomas (a type of PNET). In addition, germ cell tumors, another form of malignant tumor, can be found in this area. Benign pineal gland cysts are also seen in this location, which makes the diagnosis difficult between what is malignant and what is benign. Biopsy or removal of the tumor is frequently necessary to tell the different types of tumors apart. People with tumors in this region frequently experience headaches or symptoms of increased intracranial pressure. Treatment depends on the tumor type and size.
  
  
  Latest and Advanced Treatment options for
  
  Brain Tumor in India
  
  
  Brain Tumor is no more a scary health condition as modern technology and advanced surgical modalities now offer near perfect clinical outcomes and the patients can soon return to normal life after surgery.
  
  
  • Brain Suite - Intra-operative MR Navigation Microsurgery
    
  • Trans-Nasal Endoscopic Removal of brain Tumor through the nose
    
  • Stereotactic Radiosurgery - Gamma Knife & Novalis TX
    
  • Tumor Embolization using Neuro Interventional Radiology
    
  • CyberKnife Radiosurgery

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Treatment of Pancreatic Cancer - Pancreatic Cancer Hospitals India

Pancreatic Cancer

The pancreas is in the upper abdomen and lies behind the stomach and intestines (guts). The shape of the pancreas is like a tadpole, and so the pancreas has a 'head', a 'body' and a 'tail'. The head section is nearest to the duodenum (the part of the gut just after the stomach). The pancreas makes a fluid that contains enzymes (chemicals) that are needed to digest food. The enzymes are made in the pancreatic cells and are passed into tiny ducts (tubes). These ducts join together like branches of a tree to form the main pancreatic duct. This drains the enzyme-rich fluid into the duodenum. The enzymes are in an inactive form in the pancreas (otherwise they would digest the pancreas). They are 'activated' in the duodenum to digest food.

Symptomsof Pancreatic Cancer

In most of the cases the tumour first develops in the head of the pancreas and it tends to block the bile duct. This stops the flow of bile into the duodenum which leads to :

• Jaundice (yellow skin caused by bile seeping into the bloodstream due to the blockage).
• Dark urine - caused by the jaundiced blood being filtered by the kidneys.
• Pale faeces - as the faeces contain no bile which causes their normal brown colour.
• Pain is often not a feature at first. Therefore a 'painless jaundice' that becomes worse is often the first sign of pancreatic cancer. Nausea and vomiting are also fairly common symptoms..
• Pain in the upper abdomen. Pain can also pass through to the back.

Diagnosis Of Pancreatic Cancer

The initial tests revolve around the symptoms of Jaundice to confirm if its because of blocked gallstone or hepatitis (liver inflammation) or if the cause of jaundice is a blockage from the head of the pancreas..

• CT scan (computerised tomography) is a commonly used test to assess pancreatic cancer. It is a specialised X-ray test that can give quite clear pictures of the inside of your body.

• MRI scan is sometimes done. MRI stands for magnetic resonance imaging. An MRI scan uses a strong magnetic field and radio waves to create pictures on a computer of tissues, organs and other structures inside your body.

• Endoscopic ultrasound (EUS). An endoscope (gastroscope) is a thin, flexible, telescope. It is passed through the mouth, into the oesophagus and stomach and on into the duodenum. The endoscope contains fibre optic channels which allows light to shine down so the doctor or nurse can see inside. Some endoscopes are fitted with a tiny ultrasound scanner at their tip which can obtain pictures of structures behind the gut such as the pancreas.
• Endoscopic retrograde Cholangiopancreatography (ERCP): a test that uses a flexible scope inserted through the nose, stomach, and into the pancreas and may be used to introduce a dye for X-rays or to place a stent (a metal or plastic tube that can help keep a duct open and functioning)

• Magnetic resonance cholangiopancreatography (MRCP): a type of MRI that is used to see the pancreas, its ducts, and the bile ducts more clearly, often used before or instead of ERCP.

                                             

Treatment of Pancreatic Cancer

Surgery - One of the following types of surgery may be used to take out the tumor: Whipple procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Care is taken to preserve pancreas to produce digestive juices and insulin.

Total Pancreatectomy: This surgery removes the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen and nearby lymph nodes.

Distal Pancreatectomy: The body and the tail of the pancreas and usually the spleen are removed. If the cancer has spread and cannot be removed, the following types of palliative surgery may be done to relieve symptoms:

Surgical Biliary Bypass: If cancer is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct and sew it to the small intestine to create a new pathway around the blocked area.

Endoscopic Stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin tube) to drain bile that has built up in the area. The doctor may place the stent through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.

Gastric Bypass: If the tumor is blocking the flow of food from the stomach, the stomach may be sewn directly to the small intestine so the patient can continue to eat normally.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body

Radiation therapy

India's leading Cancer hospitals now have some of the world's moset advanced radiation equipment like Linac, Novelis, Gamma Knife and Cyberknife for treating Pancreatic Cancers. High technology radiation is used to kill cancer cells without affecting the healthy tissues

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Prostate Enlargement, Prostate Problem - Prostatectomy Surgery Options in India

Prostatectomy is surgical removal of a man's prostate gland. It is one possible treatment for prostate cancer and other prostate conditions, such as an enlarged prostate. The operation is performed by a urologist (urologic surgeon) in either open or laparoscopic surgery .

Radical prostatectomy, which includes removal of tissues near the gland, usually cures prostate cancer if the surgery removes all the malignant cells. The incision is usually made through the lower abdomen (retropubic) but also can be made in the groin (perineal). Typically, general anesthesia is used and the patient remains in the hospital for two to four days following surgery. Full recovery may require one month or more.

Partial prostatectomy is generally a treatment for enlargement of the prostate, which is common after age 50. It can also be used to reduce pain and ease urination in men with advanced prostate cancer.

Complications from prostatectomy are those associated with any surgery, including infection and bleeding. Other complications vary depending on the age and health of the man, type of surgery and experience of the surgeon. Two primary concerns men have about radical prostatectomy are the possibilities of impotence and incontinence. Patients can retain sexual function if nerves are not injured during the surgery. Urinary incontinence is usually temporary but bladder problems can continue for years. Radical prostatectomy does cause sterility, but there are procedures that may allow a man to father children, if desired.

Procedure

Before the procedure the bladder and urethra may be numbed (local anesthesia), body below the waist may be numbed (regional anesthesia), or the patient may be completely asleep (general anesthesia). The procedure itself usually takes about 45 minutes. The doctor inserts a cystoscope (a thin, tubelike telescope) through the urethral opening in the penis and into the urethra. The doctor can view the urethra and prostate, either through the cystoscope or on a video monitor. The laser is inserted through the cystoscope to the area of the prostate. The laser is then used to destroy excess prostate tissue.

Following prostatectomy will vary depending on the type of surgery performed: -

• Radical prostatectomy (retropubic or perineal) : - This surgery may require the patient to stay hospitalized for two or three days and miss work for three to five weeks. The catheter may remain for one to three weeks. When the patient urinates, the fluid flows through the plastic tube and collects in a bag for disposal.

• Laparoscopic prostatectomy : - Long-term experience with laparoscopic prostatectomy is not yet available. This surgery may require a hospital stay of only one day. Some physicians and patients report that it involves fewer complications, less pain and faster recovery than open surgery.

• Partial (simple) prostatectomy (transurethral resection of the prostate [TURP] or transurethral incision of the prostate [TUIP]) : - Generally, a patient is discharged from the hospital after a day or two and can return to work in a week or two. A catheter placed through the urethra is used for a few days to drain urine from the bladder. TUIP does not always require a hospital stay.

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