What are the complications of prostate cancer surgery?

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Cancer occurs when abnormal cell growth disrupts the body’s normal functions. Prostate cancer develops when abnormal cells grow in the prostate gland. Not all abnormal growths or tumors are cancerous. Tumors may be:

1. Benign (non-cancerous): Growths such as benign prostatic hyperplasia (BPH) are not life-threatening. They do not invade nearby tissues or spread to other body parts. These growths can be removed and may grow back slowly (but often do not).
2. Malignant (cancerous): Cancerous tumors, such as prostate cancer, can invade nearby tissues (for example, the bladder and rectum) or spread to distant parts of the body (metastasize). Even if removed, malignant tumors can grow back. Prostate cancer can be life-threatening, especially when it spreads beyond the prostate (metastatic disease).

Treatment options for prostate cancer:

1. Active surveillance: It is ideal for small, slow-growing cancers. This involves close monitoring with regular tests such as:

1. PSA (prostate-specific antigen) blood tests.
2. Biopsies.
3. MRIs (magnetic resonance imaging).

Active surveillance helps avoid urinary, sexual, and bowel side effects associated with more aggressive treatments. Many men on active surveillance never require further treatment. If PSA levels rise or a biopsy reveals cancer progression, more definitive treatments like surgery or radiation therapy may be considered.

2. Watchful waiting: This approach involves less frequent monitoring without routine PSA tests or biopsies. However, the main risk is that cancer could grow or spread between follow-ups. It is typically used for:

1. Older men with early-stage prostate cancer are likely to die of other causes.
2. Men with significant health issues make surgery or radiation difficult.

3. Surgery: Radical prostatectomy involves removing the prostate, seminal vesicles, and surrounding tissues. Pelvic lymph nodes are often removed as well. While surgery aims to cure cancer, it has potential complications:

1. Anesthesia-related issues (cardiac arrest, respiratory depression).
2. Hemorrhage.
3. Urinary incontinence (stress, overflow, or urge).
4. Erectile dysfunction.
5. Pain during orgasm or diminished sexual intensity.
6. Delayed complications such as lymphedema and inguinal hernia.

4. Radiation therapy: Radiation therapy is often a better option for older individuals or those who may not tolerate surgery. It offers similar success rates to surgery and avoids some surgical risks. You should discuss this option with a urologist or oncologist.

For symptoms like fatigue, hot flashes, and irritability, the following medications may help:

1. Cholecalciferol (vitamin D3): 2000 IU once weekly for six months.
2. Calpro-D (Calprotectin): One tablet at night for two months.

Follow your doctor’s recommendations. They will conduct regular follow-up tests and intervene promptly if the cancer progresses. Treatments like active surveillance aim to preserve quality of life for as long as possible. If definitive treatment becomes necessary, options like surgery or radiation therapy can be discussed to determine the best approach. Rest assured, the healthcare team is monitoring the situation closely.

I hope this helps.

Thank you and take care.