NCCN Guidelines for Patients® | Prostate Cancer - page 29

29
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 4: Overview of cancer treatments
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
Definitions:
Lymph node:
A small
disease-fighting organ
Metastasis:
The spread of
cancer cells from the first
tumor to another site
Nomogram:
A tool that
uses clinical information
to predict an event
!
Read page 21 for
more information on
nomograms.
Robot-assisted laparoscopic prostatectomy
A laparoscopic prostatectomy can be done with the help of a “robot.” During
a robot-assisted prostatectomy, the surgeon controls the surgical tools using
two or three robotic arms. Robotic arms make more precise cuts compared
to a surgeon’s hand. However, surgeons can detect changes in the tissue by
touching your organs. These changes aren’t detected when a robot is used.
Pelvic lymph node dissection
A PLND (
p
elvic
l
ymph
n
ode
d
issection) is an operation that removes lymph
nodes from your pelvis. In Part 5, PLND is recommended if you have a T1 or
T2 tumor, you choose to have a prostatectomy, and a nomogram predicts you
have a 2% or greater risk for cancer in your lymph nodes. Using a 2% cutoff,
nearly half of men (48 out of 100) will be spared having a PLND. See Figure 9.
Also, almost all men in this group who have cancer in their lymph nodes will be
correctly staged and treated.
An extended PLND removes more lymph nodes than a limited PLND. It finds
metastases about two times as often as a limited PLND. It also stages cancer
more completely and may cure some men with very tiny metastases that haven’t
spread far. Therefore, an extended PLND is recommended if you’re to have a
PLND. It can be done with an open, laparoscopic, or robotic method.
Side effects of surgical treatment
Side effects are unhealthy or unpleasant physical or emotional responses
to treatment. You may experience side effects from the general anesthesia,
prostatectomy, or the PLND. During the operation, you may have a serious
loss of blood and require a blood transfusion. Serious risks of anesthesia and
prostatectomy include heart attack and blood clots.
After the operation, general anesthesia may cause a sore throat from a
breathing tube, nausea with vomiting, confusion, muscle aches, itching, and
1...,19,20,21,22,23,24,25,26,27,28 30,31,32,33,34,35,36,37,38,39,...92
Powered by FlippingBook