When Considering Prostate Surgery Experience Is Important
With the majority of things in life it is fair to say that the more experienced and practiced you are the better your performance and this is most certainly true with prostate cancer surgery.
A significant problem with cancer is that, despite the best efforts of your surgeon, it has a nasty habit of returning in a number of cases. when it comes to prostate cancer following the total removal of the prostate by radical prostatectomy recent studies show that, while the likelihood of a recurrence are about 18 percent when surgery is performed by a relatively inexperienced surgeon, this figure falls to under 11 percent in more experience hands. So exactly what do we mean by 'experienced hands'?
A recent study looked at 7,800 prostate cancer patients who underwent radical prostatectomy in the United States between 1987 and 2003 involving no fewer than 72 surgeons from 4 major academic cancer centers around the country.
The study found that there is an extremely steep learning curve when it comes to performing prostate surgery and that it takes a significant amount of practice to master this particular surgical technique. Indeed, the study showed that it was not until surgeons had performed at least 250 operations that a marked improvement in recurrence rates was seen.
So exactly what can we learn from this study if we are facing the possibility of having to undergo prostate surgery?
First it is extremely important that patients select a surgeon who regularly performs this form of surgery. Indeed, it might well be advisable to select a surgeon who specializes solely in prostate surgery, or whose work involves a significant proportion of such surgery. In most general hospital settings surgeons will perform such surgery very infrequently, perhaps as rarely as just one or twice a year, and this is not sufficient to give them the expertise needed to provide you with the best possible change of a low recurrence rate.
In the light of this therefore your first choice should undoubtedly be a specialist cancer treatment center and of a surgeon whose work involves exclusively, or very largely, prostate surgery.
The study also demonstrated however that there is a marked improvement in recurrence rates not merely for specialist cancer centers, but also for teaching establishments. This is undoubtedly because, within an academic setting, a great deal of emphasis is placed on supporting mechanisms designed to assess the outcome of procedures as well as to provide feedback in an effort to create an environment of continuous improvement. This tends not always to be the case in non-academic environments. In addition, academic centers have a tendency to attract people who are especially interested not simply in the outcome of their work but in both correcting their errors and improving their technique.
So, should you find yourself in the unfortunate position of requiring prostate surgery then you would be well advised to elect to undergo surgery with an experienced surgeon who works in a specialist cancer center within a major teaching facility.
ProstateProblemCenter.com provides information on prostate cancer symptoms and all aspects of prostate cancer including the therapeutic use of prostate massage.
Prostate Surgery
From the point of view of the anatomy of the man, the prostate is a gland situated in the male reproductive system, and its found bellow the bladder, in front of the rectum. It surrounds the part of the urethra just bellow the bladder, the tube that empties the bladder, and produces a fluid which forms a part of the content of the semen. Prostate cancer is that type of cancer that forms in the tissues of the prostate, and usually the older man presents prostate cancer. Three main prostate diseases can occur in the prostate gland: inflammation or infection, called prostitutes; enlargement, called benign prostatic hyperplasia or BPH; and cancer.
Prostate surgery can be made in many ways. The most common procedures in the surgery of removing the prostate to treat non-cancerous enlargement are transurethral resection of the prostate or TURP, transurethral incision of the prostate or TUIP, and open prostatectomy. Transurethral resection of the prostate is used for glands bigger than 30 grams and less than 80 grams but this number depends on the experience of the surgeon, but in case when the prostate is bigger than 80 grams, open prostatectomy is recommended.
Transurethral incision of the prostate is when the decision regarding the type of prostatectomy to perform depends on the size of prostate gland, usually, is recommended for prostates less than 30 grams.
To perform an open prostatectomy an incision is made in the lower abdomen between the umbilicus and the penis through which the prostate gland is removed. This is a much more involved procedure and usually requires a longer hospitalization and recovery period and it?s less preferred both by the doctor and the patient. At the open prostatectomy is performed by the doctor general or spinal anesthesia. You will return from surgery with a Foley catheter in place and the drain of your bladder will be drained with a catheter. Also it?s used laparoscopic prostate surgery, even if in traditional surgery it?s a long incision down to the center of the abdomen and it?s a big recovery period this is the most used surgery. Laparoscopic surgery eliminates the need for the big incision. For result, you may experience less pain and scarring after surgery, more rapid recovery, in a day or two and less risk of infection after the operation. The surgeon is being guided by the laparoscope, which transmits a picture of the prostate on a video monitor.
Who is eligible for laparoscopy? If the cancer that has not spread outside the prostate and is not very aggressive, as well as a blood test less than 10 the patient is eligible, if he had previous open or laparoscopic pelvic surgery, even for completely another reason, or a history of hormone treatment which reduces the size of the prostate tumor.
While researchers still do not know exactly what causes prostate cancer, they have identified some risk factors.
Age. The risk of developing prostate cancer increases as you age. More than 70% of all prostate cancers are diagnosed in men over age 65.
Family History. Men whose father and/or brother had prostate cancer are up to 11 times more likely to develop prostate cancer.
Ethnicity. The death rate for prostate cancer is nearly 2.4 times higher in African-American men than in Caucasian men. (Because of this additional risk, earlier screening for prostate cancer is recommended for African-American men).
Diet. Research suggests that prostate health may be affected by diet.
Obesity. Studies have shown that the death rate from prostate cancer increases in obese men.
Men Who Pop Too Many Vitamins Are Increasing Their Risk From Prostate Cancer
Many of us take vitamins on a regular basic and this is particularly true as we start to get a bit older. However, in the case of men, and particularly men with a family history of prostate cancer, they could be doing themselves more harm than good.
In a five year study carried out by the National Cancer Institute and involving nearly 300,000 men it was found that men who were regularly taking more than the recommended daily dose of one multi-vitamin tablet a day increased their risk from advanced prostate cancer by about thirty percent. In addition, the risk of death from advanced prostate cancer was doubled. The study also noted that there was an increased risk in a sub-group of men who also had a family history of prostate cancer or who also took selenium, beta-carotene and zinc supplements.
One important finding of this study was that there was no apparent increase in the overall rate of prostate cancer within the study group and so there is no suggestion that the excessive use of vitamins actually causes prostate cancer.
However, in the case of those members of the study group who were taking multi-vitamins in excessive quantities the risk of developing advanced prostate cancer was increased by nearly one-third and their risk of dying from advanced prostate cancer was doubled.
Vitamin and mineral supplements have been shown over many hundreds of years to have considerable health benefits and today a multi-million dollar industry has been established to meet our growing demand from an ever widening range of supplements. Indeed several, such as green tea extract (EGCG), have been developed specifically for men suffering from prostate problems. So does this study mean that we should stop taking supplements?
No. First, the study clearly shows that the problem only arises in men who exceed the normal daily dose of multi-vitamins and there is no evidence to suggest any risk as long as you keep your intake within recommended levels. Second, because the study looked only at multi-vitamins it is not possible at this point to say just which component (or components) causes the problem. At this point further study will clearly be necessary to isolate the true root of the problem.
On balance, if you need to supplement your diet with vitamins, then the benefits will almost certainly outweigh any risks. Just be careful and take no more than you need and which your doctor recommends.
Visit http://ProstateProblemCenter.com for information on a range of prostate problems from benign enlargement to advanced prostate cancer.
Web Site Helps Men Evaluate Risk of Prostate Cancer
In 2007, more than 218,000 American men will be diagnosed with prostate cancer, and more than 27,000 men will die from the disease, according to the American Cancer Society. While it is estimated that one man in six will suffer from prostate cancer in his lifetime, only one man in 34 will die from it. The earlier the disease is diagnosed and treated, the more likely it is for patients to survive and remain disease-free.
A Web site published by Little Company of Mary Hospital and Health Care Centers in Evergreen Park, Illinois, near Chicago (http://www.PursuingPainFreeCancer.org), encourages men to learn more about prostate cancer and to take a free confidential on-line risk test to evaluate their prostate cancer risk. The Web site's prostate cancer risk test evaluates a man's risk based on certain genetic and lifestyle factors that scientists believe affect one's prostate cancer risk.
Knowing one's risk can significantly increase a man's chance for surviving prostate cancer. When the disease is still confined to the prostate, the five-year relative survival rate is nearly 100 percent. Men whose cancer is diagnosed early may be candidates for any of the accepted prostate cancer treatments, and typically suffer from fewer side effects. Some of the treatment options available to prostate cancer partients include radiation therapy and surgery. Little Company of Mary Hospital is the only hospital in the entire greater Chicago area to offer both High Dose Rate (HDR) brachytherapy for prostate cancer treatment and the da Vinci robotic prostatectomy.
High dose rate brachytherapy provides the most precise delivery of radiation possible in the treatment of prostate cancer. Unlike permanent seed implants, patients have temporary placement of radioactive catheters which can be custom tailored to deliver precision internal radiation and better avoid the urethra, rectum, and nerves to reduce overall toxicity without being radioactive and exposing family members to radiation. It is a one-day procedure where patients can go back to work the very next day. HDR brachytherapy is generally more precise and less toxic than conventional seed implants.
The da Vinci robotic surgical system is a state-of-the-art minimally-invasive technology which allows surgeons to perform complex surgeries through tiny openings. Patients who undergo daVinci prostatectomies typically enjoy fewer overall side effects, shorter hospital stays, and earlier returns to full activities. In addition, nerves and valves are more easily preserved using this technique, offering the patient improved urinary control and preservation of sexual function without compromising cancer control.
At its earliest stages, prostate cancer does not present with any symptoms. Therefore knowing one's risk and early detection for prostate cancer are a man's best defenses. Little Company of Mary's on-line prostate cancer risk test is free to the public at http://www.PursuingPainFreeCancer.org
