Patients & Visitors

Urology

D11

Treatment

Treatment for prostate cancer will depend on whether the cancer is contained within the prostate gland (localised) has spread just outside of the prostate (locally advanced) or has spread to other parts of the body (advanced)

In patients who have localised prostate cancer there are a number of treatment options and it may be difficult to decide on the best option:

Active surveillance

Active surveillance is a way of closely monitoring prostate cancer that aims to avoid or delay treatment in men with less aggressive cancer.

Many prostate cancers are detected at an early stage. Prostate cancer can be slow growing and, for many men, the disease may never progress or cause any symptoms.

Treatments for prostate cancer can cause side effects which can effect quality of life and by monitoring the cancer these can be avoided or delayed.

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Laparoscopic Radical Prostatectomy

The Urology Department at the RUH specialises in laparoscopic (keyhole) surgery and offers this approach to treat prostate cancer. Prior to 2006 we treated prostate cancer with an open operation.

In 2006 we embarked on a mentored program to learn the laparoscopic operation with the surgeons at the Clinique Saint Augustin in Bordeaux, one of the worlds leading laparoscopic centres. We now perform about 100 of these operations a year.

The operation involves removing the prostate gland and the seminal vesicles then joining the bladder to the urethra (water pipe). A catheter (tube draining the bladder) stays in place for 10 days to protect this join. Most patients go home the day after the operation.

There is a small chance that a laparoscopic operation is converted into an open operation, usually if there is too much bleeding or there are difficulties gaining access to the prostate. This occurs in about 2% of operations.

About 50% of men will not get erections following surgery. This is a big improvement on the outcomes we achieved following an open operation for prostate cancer.

Most men will experience some leaking of urine after the catheter comes out but the majority will quickly regain continence over 3-6 months and after 12 months only about 3% of patients will have troublesome urine leakage.

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External Beam Radiotherapy (EBRT)

External beam radiotherapy uses high energy X-ray beams to treat prostate cancer. The X-ray beams are directed at the prostate gland from outside the body. They damage the cancer cells and stop them growing. It is given by our oncology colleagues and requires daily visits to hospital (5 days a week) for 6 weeks.

Like surgery it aims to cure the cancer. Hormone treatment (3 monthly injections by your GP) is normally given alongside, and for a variable time after, EBRT as trials have shown an improved outcome when they are used.

Side effects of EBRT include bladder and bowel inflammation causing urgency and frequency of urination and diarrhoea.

Radiotherapy can also be used after surgery if your PSA level starts to rise or if not all the cancer was removed with surgery.

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