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Prostate Removal
Last updated October 2004
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When Should Prostate Removal Be Performed?

Prostate removal generally is performed for one of two reasons:

For Prostate Enlargement

There are a variety of treatments for prostate enlargement (benign prostatic hyperplasia, or BPH). These treatments include medication and the use of lasers guided through the urethra to destroy excess prostate tissue.

Prostate removal is considered when:

  • The prostate gland A walnut-shaped gland of the male reproductive system that is located just below the bladder. This gland provides almost one-quarter of the total volume of semen released during ejaculation. is greatly enlarged.

  • There are significant complicating factors, such as obesity.

  • The wall of the bladder The sac-like organ of the urinary tract located in the lower portion of the abdomen which stores urine prior to its elimination from the body. has been significantly damaged and requires repair.

For Prostate Cancer

Prostatectomy A surgical operation that removes part or all of the prostate gland. is effective in treating prostate cancer in men whose cancer has not spread beyond the prostate gland. Physicians use a TNM grading system One of the grading systems currently used to evaluate the clinical stage of tumors that originate in the prostate gland. to determine the best candidates for surgery.

Need To Know:

Understanding TNM Staging

To determine TNM staging, a doctor looks at:

  • The tumor An abnormal mass of tissue that results from uncontrolled cell division, which may remain benign (contained) or become malignant (cancerous) and spread to other parts of the body. size (T staging)

  • The lymph node involvement (N staging)

  • The presence of cancer in other parts of the body, or its metastasis The spread of cancer cells from one part of the body to another through the blood and lymph. (M staging)

T staging goes from T1 to T4, with some sub-stages:

  • T1 means the cancer cannot be seen or felt, but a biopsy has confirmed its presence.

    • T1a means cancer is present in five percent or less of the prostate tissue that has been examined.

    • T1b means cancer is present in more than five percent of the prostate tissue.

  • T2 means the cancer is confined to the prostate.

    • T2a means that cancer is on one side of the prostate.

    • T2b means that cancer is on both sides.

  • T3 means the cancer has spread beyond the prostate to nearby tissues and organs.

  • T4 tumors have spread to other organs, such as the bladder or rectum Less than a foot long, the last part of the colon or large intestine that ends at the anal opening..

    • T3a means cancer is not found in the seminal glands (which contribute toward the production of semen).

    • T3b means that it has spread to the seminal glands.

N staging goes from N0 to N1:

  • N0 means that cancer has not spread to the lymph nodes Clusters of small glands of the lymphatic system scattered at strategic locations throughout the body. Lymph nodes filter out foreign materials, thereby removing them as threats to the body, and store specialized white blood cells as part of the body defense mechanism..

  • N1 means that cancer has been found in the lymph nodes.

M staging goes from M0 to M1, with some sub-stages:

  • M0 means that cancer has not spread to distant tissues.

  • M1 means that cancer has been found in distant tissues.

    • M1a means it has been found in lymph nodes beyond the pelvic area.

    • M1b means it has been found in the bone.

    • M1c means it has been found in other sites.

Based on TNM staging, men whose prostate cancer is in the following stages will most likely benefit from prostatectomy:

  • Stage T1b disease, in which the pelvic lymph nodes show no evidence of the spread of cancer cells beyond the prostate gland.

  • Stage T2 (a,b,c) disease, in which the cancer is larger but still is confined to the prostate gland.

How-To Information:

What To Consider When Selecting A Surgeon

The effectiveness of the surgery is related to the surgeon's education, training, and experience. Constant practice is required to maintain effective surgical skill levels.

The patients of surgeons who perform only a handful of prostatectomies each year generally have more complications than patients of surgeons who perform more than 100 prostatectomies each year.

For this reason, it's a good idea to ask your potential surgeon about the number of prostatectomies he or she performs.

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