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Tag: Surgery

Surgical removal of the prostate provides useful information about the size and grade of the cancer enabling physicians to estimate the risk of future relapse more accurately. Such information may be useful in selecting treatment if larger amounts of high-grade cancer are discovered. Recent studies of implementing immediate Testosterone Inactivating Pharmaceuticals (TIP) right after surgery in men found to have advanced disease at the time of surgery suggest that cure rates can be augmented. Also the possibility of administering adjuvant Zytiga or Xtandi can be discussed. The removal of the prostate also creates a “clean slate” by removing all non-cancerous PSA producing tissue. This simplifies the monitoring process as PSA elevations greater than 0.07 allow doctors to be confident about the presence or absence of relapsing cancer.

The disadvantage of a radical prostatectomy is that it entails a major surgical procedure with its attendant discomfort and risks. A urinary catheter remains in place for about a week or two after the operation. Urinary incontinence usually takes several months to be restored. However, in about 10% of men urinary control is never reestablished. Impotence is universal for the first months after surgery. Patients who eventually recover function do so slowly over a 2 to 24 month period. Even after recovery occurs only 5% of men describe their erections as being identical to the erections they had before surgery. Patients with slow recovery are at risk for penile atrophy. To reduce this risk “penis exercises” with prophylactic injection therapy with prostaglandins should be started right after the operation.

It cannot be over emphasized that urologists vary greatly in surgical ability. One of the best measures of surgical skill is determining how often the surgeon leaves cancer behind while trying to remove the gland. The best surgeons get the cancer out 90% of the time. Studies have documented that many urologists – even those operating out of large universities – can leave cancer behind up to 50% of the time. Leaving cancer behind is called a positive margin.

High hopes for robotic surgery have not panned out. Men do recover from robotic surgery more quickly because the operation is performed through a smaller incision. Unfortunately the risk of impotence and incontinence is the same as standard surgery.

Newly Diagnosed / Prostate Cancer

I Want My Prostate Out!

BY MARK SCHOLZ, MD & LIZ GRAVES For many men, surgery seems like the best option: “A quick operation and the problem will be gone.” While this thinking may apply …

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Advanced / High Risk / Intermediate Risk / Low Risk / Newly Diagnosed / Prostate Cancer / Stages

PROSTATE PROS Episode 1: Assemble Your Optimal Treatment Team

Listen to the episode: https://soundcloud.com/prostate-oncology/assemble-your-optimal-treatment-team “Patients need to be bold…Your quality of life and your longevity are at stake and making optimal treatment decisions is totally essential.”- Dr. Scholz Surgeons …

Advanced / High Risk / Intermediate Risk / Low Risk / Newly Diagnosed / Prostate Cancer / Stages

Treatment Options for Prostate Cancer

BY MARK SCHOLZ, MD Selecting treatment for prostate cancer is complex. Start by taking the Staging Quiz (keytopc.com). This is the first-step to understanding proper management.  Once you know your …

Advanced / Azure / Elevated / High Risk / Indigo / Intermediate Risk / Low Risk / Newly Diagnosed / Prostate Cancer / Relapsed / Royal / Sky / Stages / Teal

Making an Informed Decision about Prostate Cancer

BY MARK SCHOLZ, MD What Is the Best Therapy for Me? This is one of the greatest questions for men with prostate cancer. How do you arrive at a reliable …

Prostate Cancer / Relapsed

Scan for the Site of Prostate Cancer Relapse with Axumin

BY MARK SCHOLZ, MD PSA testing is an essential part of prostate cancer treatment, and it is done at various stages in a patient’s journey.  Initial PSA screening of healthy …

Azure / Elevated / Indigo / Newly Diagnosed / Prostate Cancer / Royal / Sky / Stages / Teal

Frequently Asked Questions About Prostate Cancer After Diagnosis

(These FAQs are for men who have received an elevated PSA or have a definitive diagnosis of prostate cancer. As medical oncologists who specialize in the treatment of prostate cancer …

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Azure / Indigo / Prostate Cancer / Royal / Sky / Stages / Teal

Fundamentals Required for Prostate Cancer Staging

BY MARK SCHOLZ, MD For prostate cancer patients, an optimal treatment plan is the most important factor for long-term survival, and finding that ideal treatment begins with accurate staging. The …

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Prostate Cancer

The 15 Stages of Prostate Cancer

BY MARK SCHOLZ, MD There are many barriers to achieving optimal care for prostate cancer. First of all, as we will see by the end of this article, prostate cancer is …

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Elevated / Newly Diagnosed / Prostate Cancer

Prostate Vanguard E005: Active Surveillance

Active Surveillance is a revolutionary concept: The thought you can monitor prostate cancer rather than treat prostate cancer. This is a surprising development because anything called cancer, one would assume …

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Prostate Cancer / Relapsed

Relapsed Prostate Cancer After Surgery

BY MARK SCHOLZ, MD What is the most frightening thing about cancer? For many, it’s the chance the cancer might return after surgery. With most common cancers—colon, breast, brain, melanoma, …

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