Radical Prostatectomy for Basic Teal Prostate Cancer | Prostate Cancer Staging Guide

PCRI’s Executive Director, Mark Scholz, MD, talks about radical prostatectomy as a treatment for men with Teal stage (intermediate-risk) prostate cancer. He compares it with other treatments, gives an overview of its side effects, and describes cases where it should be considered.

0:38 Surgery has been known as the gold standard in the past, and is well established. But nowadays it compares poorly with the other options that are available. Radiation technology has advanced immensely, whereas surgery technology has not. Men who choose other options can have higher cure rates and less long term side effects.

1:20 Disadvantages of surgery. Its an operation, so it has all the risks of a surgical operation that involves anesthesia. The risk of erectile dysfunction and incontinence are considerably higher with surgery than with the other options. Men rarely recover their erectile function to the same quality as before the treatment. 5-10% of men describe their erections as being like before the procedure. Urinary incontinence is rare with radiation options but is common with surgery. Men are completely incontinent after surgery and must wear catheters and pads for a few months after the operation. Most men recover but up to 15% of men will not.

2:45 Other urinary complications. Stress incontinence is another issue that comes with surgery. When men laugh, jump, cough, sneeze, they can squirt urine. Finally, men can ejaculate urine during orgasm, a problem known as climacturia, which occurs in up to 20% of men after surgery.

3:29 Advantages of surgery. Men with very large prostates with a lot of urinary blockage symptoms can experience relief from those symptoms while being cured of the disease. Giving radiation to large prostates can increase the side effects. Another small advantage of surgery is more accurate staging. When the prostate is removed, the pathologist can examine the entire prostate and determine the aggressiveness of the disease more thoroughly. Modern multiparametric MRI, though, is an accurate way to stage the disease. So this is less of an advantage than it used to be.

5:07 When considering surgery for intermediate-risk prostate cancer (Teal stage). Men with Basic Teal are the only candidates. Men with low Teal (low intermediate-risk) are candidates for active surveillance, and men with high Teal (high intermediate-risk) should consider combination therapy (IMRT, brachytherapy (radioactive seeds), and short course hormone therapy).

5:30 Addressing a common myth about prostate surgery. This myth used to be correct when 10-15 years ago radiation therapy had low cure rates and high side effects. The "sequence argument" goes like this: If you get surgery first you have a backup chance at a cure with radiation therapy if the surgery doesn’t work, but you can’t have surgery if radiation fails. This was a problem when prostate cancer would come back often after radiation. But cure rates of modern radiation therapy are higher than surgery, so the cancer isn’t likely to come back after radiation, especially for Basic Teal, perhaps about 5% likelihood. Additionally, there are options for men who relapse after radiation therapy such as HIFU, cryotherapy, and electroporation.

7:08 Summary, surgery has higher side effect profiles for similar cure rates and necessitates a major operation. If a patient does choose surgery as a treatment for their prostate cancer, it is important to find a skilled surgeon since the procedure takes both practice and talent to achieve optimal results.

Who we are:

The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.

#ProstateCancer #Prostate #MarkScholzMD

Видео Radical Prostatectomy for Basic Teal Prostate Cancer | Prostate Cancer Staging Guide канала Prostate Cancer Research Institute