Prostate Cancer: Surgery

It can be scary to learn that you have prostate cancer. But this type of cancer often can be treated with surgery.

Surgery is usually used to treat early-stage prostate cancer. The goal is to remove all the cancer. If the cancer has spread outside your prostate, it’s less likely surgery will cure it. But surgery still may be able to help relieve your symptoms, such as trouble urinating.

If you’re thinking about surgery to treat prostate cancer, be sure you understand the goal of treatment. Read on for more facts to consider.

Find the right procedure

The type of surgery you have depends on several factors, including how much the cancer has spread. Options include:

Radical prostatectomy

This surgery removes the whole prostate gland and some nearby tissue. The surgeon can do this by making a long incision (cut) in your belly. Or they may make an incision in the area between your scrotum and rectum.

Laparoscopic radical prostatectomy

This surgery also removes the whole prostate gland and some nearby tissue. But the surgeon uses a few small incisions instead of one larger incision. This approach may help you have a shorter hospital stay, less pain, and a quicker recovery.

For this surgery, the surgeon uses a thin, flexible lighted tube called a laparoscope and special small tools. There is a tiny camera at the end of the scope. Your surgeon may also do the surgery with robotic assistance. In that case, they use a control panel to move robotic arms that hold the tools.

Transurethral resection of the prostate (TURP)

This surgery removes only a part of the prostate gland. The goal is to relieve symptoms, not to cure cancer. During TURP, the surgeon puts a small tool inside your prostate through your urethra. There’s no incision.

Cryosurgery (cryotherapy)

This surgery kills cancer cells by freezing them. The surgeon places a small metal probe in the tumor through a tiny incision. Then they put liquid nitrogen into the probe to freeze the cancer cells. This treatment may be used for early-stage prostate cancer or for cancer that returns after radiation therapy.

Understand risks and possible side effects

Surgery can treat or even cure prostate cancer, but it has risks, too. For a smoother experience, make sure you understand these risks before your procedure.

In the short term, you and your healthcare team should watch for:

• Reaction to anesthesia

• Excess bleeding

• Infection

• Blood clots

• Damage to nearby organs or tissue

Also look out for side effects, such as:

• Incontinence. This is when you have trouble controlling urine. You might have slight leakage or dribbling. Or you could experience complete loss of bladder control. These problems are usually worse just after surgery. Sometimes they can be long-lasting. But normal bladder control usually returns a few weeks or months after surgery.

• Erection problems, including erectile dysfunction or impotence.  Most likely, you will not be able to get an erection for a few months after surgery. But in time, you should be able to get an erection and have sex. You won’t ejaculate semen, though. That isn’t possible because the glands that make fluid for semen are removed. If you have erection problems after surgery, ask your healthcare provider about medicines or devices that might help.

Everyone is different. Your provider can’t say for sure whether you’ll have side effects. But talking with them about potential issues will help you better prepare.

Get ready for surgery

Before your surgery, you’ll have a chance to talk with your surgeon about the details and what to expect. Then you’ll sign a consent form to give them permission to do the surgery.

You’ll also speak with an anesthesiologist. This is a healthcare provider who will give you the medicine (anesthesia) that prevents pain and allows you to sleep during surgery. The anesthesiologist will monitor your vital signs such as breathing, heart rate, and blood pressure. They will ask about your health history, medicines you take both prescription and over-the-counter, including vitamins and supplements and if you have any allergies. After talking, you’ll sign a consent form giving them permission to give the anesthesia.

Know what to expect

Having surgery can be stressful. But knowing what to expect can help.

On the day of surgery, your healthcare team will take you into the operating room. The team will include the anesthesiologist, the surgeon, and nurses.

During a typical surgery you can expect that your healthcare providers will:

• Move you onto an operating table.

• Give you compression stockings to wear to help prevent blood clots.

• Place electrocardiogram (ECG) electrodes on your chest to track your heart rate and rhythm. They’ll also place a blood pressure cuff on your arm and a small monitor on your finger to watch oxygen levels.

• Give you anesthesia through an IV (intravenous) tube in your hand or arm.

• Do the surgery.

• Put a urinary catheter into your bladder. It will stay in place for at least a few days.

After surgery, you’ll wake up in the post anesthesia care unit (PACU). Your providers will watch you closely. They’ll give you medicine to treat pain. Once you’re awake and stable, you’ll move to your hospital room. You might need to stay there for one or more nights depending on the type of surgery you had.

Have a healthy recovery

Try to take good care of yourself as you recover. Follow any instructions from your provider. Make sure to keep any follow-up appointments with your surgeon and other providers. If you have any questions or concerns, your healthcare team will be there to help. Together, you can stay on the path to healing.