Everything You Need To Know About Prostate Cancer Surgery

It can be scary hearing that your doctor is recommending surgery for your prostate cancer. But knowing what to expect can help you feel empowered and confident through your procedure and recovery.

The first thing to know is that not everyone needs surgery. Factors your doctor will consider include:

• Your PSA level and Gleason score (grade of cancer)
• Stage of your cancer and whether it's spread
• Your overall health and life expectancy
• Your feelings about potential side effects

Surgery is only recommended for men with high-risk or intermediate-risk prostate cancer who are healthy enough for the procedure. If your prostate cancer is considered very low risk, your doctor may recommend active surveillance instead, which involves monitoring your cancer with periodic blood work and imaging. Many men on active surveillance can forgo treatment.

You Need Surgery? Next Steps

Surgeons who perform a higher volume of prostate cancer surgeries every year have better patient outcomes, data shows. When choosing a surgeon, don't be afraid to ask questions like how many prostate surgeries they perform every year and what their complication rates are.

The standard surgery for prostate cancer is known as a radical prostatectomy. During this surgery, your surgeon will remove your prostate gland and seminal vesicles, which are the small glands that sit next to your prostate. Nearby lymph nodes may also be removed to determine if the cancer has spread. Afterward, your surgeon will reconnect your bladder and urethra with dissolvable stitches.

Prostate surgery can be performed robotically, laparoscopically or via open surgery. The most common method used today is robotic-assisted surgery. Your surgeon will make a few small cuts in your abdomen and use robotic arms to manipulate small instruments to perform the surgery. Because it is less invasive than open surgery techniques, robot-assisted surgery usually results in less pain, shorter hospital stay and quicker recovery.

After surgery, you will likely spend one to two nights in the hospital recovering, with a catheter for one week. You may begin walking on the day of surgery and then slowly increase your activity level. You should avoid heavy lifting for four to six weeks.

You'll have your first PSA test six to eight weeks after surgery, and you will ideally have an undetectable PSA level, which means all the cancer was removed.

Possible Side Effects

All surgeries carry risks. The most common side effects of prostate cancer surgery are urinary incontinence (leaking urine), blood clots, infection, hernia and bladder healing problems.

Most men will recover bladder control within one year after surgery, although a full recovery can take up to two years. Studies have found pelvic floor physical therapy and exercises greatly improve recovery.

You may also experience erectile dysfunction. Studies show erectile dysfunction (ED) can occur in 25% to 75% of men one year after surgery. Your age, overall health and whether your surgeon was able to spare the nerves during surgery will play a role.

Treatment options include oral medications, vacuum devices, penile injections or implants. Research shows that by improving your heart health with exercise, healthy eating and blood pressure management, you can accelerate your ED recovery.

Tips for Recovery

Taking care of yourself before and after surgery can improve your recovery. Here are some tips:

Before Surgery:

• Begin Kegel exercises no less than two weeks before surgery
• Walk every day to improve your fitness
• Quit smoking if you smoke
• Review all your medications with your doctor (they may recommend stopping certain medications like blood thinners before surgery)

After Surgery:

• Continue doing your pelvic floor exercises
• Follow your doctor's Enhanced Recovery After Surgery (ERAS) guidelines to help you recover faster
• Stay active, but don't lift anything heavy
• Attend all your follow-up appointments

Follow-Up Care

It's important to continue seeing your doctor for follow-up care and PSA testing after surgery. You should have PSA tests every six to 12 months for five years, then once a year thereafter. If your PSA begins to rise to 0.2 ng/mL or higher, this can be an indication that your cancer has returned. If this happens, your doctor will discuss other treatment options with you.

This content is not AI generated.