NCCN Guidelines for Patients® | Prostate Cancer - page 27

NCCN Guidelines for Patients
: Prostate Cancer
Version 1.2014
Part 4: Overview of cancer treatments
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Loss of
feeling with or without loss
of wakefulness caused by
A flexible tube
inserted in the body
Injection of liquid
into the rectum to clear
the gut
A drug that is
used to clear out the gut
Seminal vesicles:
A pair
of male glands that makes
fluid used by sperm for
A tube that expels
urine and semen from the
Urinary incontinence:
Inability to control the
release of urine from
the bladder
4.1 Surgical treatment
Surgical treatment may be an option if you are healthy enough to have an
operation. The goal of an operation is to remove all the cancer from your body.
To do so, the tumor will be removed along with some normal-looking tissue
around its rim. The normal looking tissue is called the surgical margin. Other
tissue may be removed along with your prostate as described next.
Radical prostatectomy
A radical prostatectomy is an operation that removes the entire prostate gland,
seminal vesicles, and sometimes other tissue. It is often used when the cancer
appears not to have grown outside the prostate—T1 and T2 tumors. Less often,
it is used when the cancer has grown outside the prostate but not into other
There are four main types of radical prostatectomy. Results of a prostatectomy
may be related to the experience of the surgeon. Surgeons who are
experienced have better results. When choosing your surgeon, ask how many
of these surgeries he or she has done. Going to a surgeon who has and
continues to perform many radical prostatectomies may be associated with a
better outcome. Talk to other patients about their experiences.
There are a few steps to prepare for an operation. You may need to stop taking
some medications to reduce the risk of severe bleeding. Eating less, changing
to a liquid diet, or using enemas or laxatives will empty your colon. Right before
the operation, you will be given anesthesia. Anesthesia may be general, spinal,
or epidural.
After a radical prostatectomy, a catheter will be inserted into your urethra
to allow your urethra to heal. It will stay in place for 1 to 2 weeks. You will
be shown how to use it while you’re at home. If removed too early, you may
develop urinary incontinence or be unable to urinate due to scar tissue.
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