Treating prostate cancer, Part IV: Surgery
About 186,320 American men will be diagnosed with prostate cancer this year. Most cases will be diagnosed by PSA (prostate-specific antigen) screening, with transrectal ultrasound-guided prostate biopsies. And most patients will have early disease that appears confined to the prostate itself.
Men with early prostate cancer face a choice of management options. The major choices are active surveillance, radiotherapy, and surgery. More often than not, men choose surgery. That means a radical prostatectomy to remove the entire gland. It's an obvious choice for men who want to "get it all out" and a reasonable option for any generally healthy man with a life expectancy greater than 10 years.
Most American urologists view the radical prostatectomy as the "gold standard" therapy for localized prostate cancer. But before a man submits to the knife, he should understand the advantages and disadvantages of surgery. And in the increasingly complex world of prostate cancer, he may be offered a choice of surgical techniques.