Surgical Options for Advanced or Recurrent Prostate Cancer

It has been estimated that 30% of men who are "cured" with initial treatment for early-stage prostate cancer will relapse after five years. For these men, as well as for those diagnosed with advanced-stage disease, surgical techniques other than radical prostatectomy might play a role in prostate cancer management.

Men who underwent radiation therapy as initial therapy might benefit from "salvage" prostatectomy. With this procedure, the prostate and surrounding tissues, including the tissues that had previously been irradiated, are removed. Men who had tumors that were considered potentially curable before radiation might do well with post-radiation surgery. Nevertheless, even under the best of circumstances, post-radiation surgery is a very difficult operation to perform and can result in significant side effects, so few surgeons across the country perform it regularly.

TURP, or transurethral prostatectomy, is typically performed in men with a non-cancerous enlargement of the prostate known as BPH, or benign prostatic hypertrophy. A modified version of TURP can also be performed on men with recurrent prostate cancer to relieve urinary symptoms caused by the growth of prostate cancer.

For all men, the best outcomes are seen in those men whose PSA levels are low and whose disease has not spread too far. Regular monitoring of PSA levels after primary therapy is key, as is prompt initiation of treatment upon disease recurrence. The earlier the treatment is begun, the better the likelihood of improved results.

Additional Reading:

Prostate Cancer News: Treatment and Outcomes