If your cancer is in the early stages or localized to your prostate, your doctors may recommend surgery to remove your prostate (prostatectomy) to try to cure the disease.
Surgery for SCCA patients is performed at University of Washington Medical Center by experienced UW Medicine surgeons who are leaders in prostate cancer surgery.
The experience level of your surgeon can affect your results. We recommend choosing a surgeon who has done at least 250 prostatectomies total and who does at least 40 a year. Read more about choosing your prostate cancer surgeon.
The most common surgery for prostate cancer is a radical prostatectomy — removing the entire prostate gland, some lymph nodes and other nearby tissue, such as the seminal vesicles.
This offers a very good chance for a cure and gives your doctors detailed information about your cancer, including how aggressive it is, which can help guide other treatment decisions.
Your SCCA team will:
- Talk with you in detail about what to expect.
- Carefully consider the risk of side effects from surgery.
- Plan ways to reduce any risks you may face.
- Provide advice and care to support your recovery.
Typically patients stay in the hospital overnight after surgery and then need to recuperate at home for one to four weeks before returning to work.
Nerve-sparing prostate surgery
Your SCCA surgeon will try to save the tiny bundles of nerves, one on each side of your prostate, that control your ability to have an erection (nerve-sparing surgery). If your cancer is growing into or very close to the nerve bundles, these nerves may need to be removed.
Open surgery vs. robot-assisted laparoscopic prostatectomy
Your surgeon may operate using one of these approaches:
- Through an incision in your lower abdomen (retropubic prostatectomy)
- Through an incision between your anus and scrotum (perineal prostatectomy, less common)
- Laparoscopicaly, meaning through multiple very small incisions using special instruments and cameras
The potential advantages of laparoscopic surgery include faster recovery, less pain, less blood loss and lower risk of infection than with a conventional (open) retropubic or perineal procedure.
If you are having laparoscopic surgery, your UW Medicine surgeon may use a robotic surgery system. This is sometimes called robot-assisted or robotic prostatectomy. With the da Vinci Surgical System, your surgeon uses hand and foot controls to move robotic arms that hold a laparoscope (camera) and surgical instruments. The system allows your surgeon to perform very precise, complex motions and helps prevent fatigue.
Your SCCA surgeon will talk with you about the approach they recommend for you and why and will answer all your questions about your options.
Cryosurgery for prostate cancer
If you have early-stage prostate cancer or your cancer recurred after radiation therapy, your team may recommend cryosurgery. In this procedure, your surgeon makes a small incision to insert probes that freeze and kill prostate tissue. Your surgeon may use ultrasound imaging, along with a catheter and precise temperature monitoring of nearby tissues, to help target your prostate and minimize any damage to healthy tissue.
Choosing a prostate cancer surgeon
When you are choosing a surgeon to treat your prostate cancer, it is important to select someone you trust and have confidence in. He or she should have enough experience to not only perform the operation you need but also to make an informed clinical judgment and change course, if necessary.
The prostate cancer experts at Seattle Cancer Care Alliance recommend choosing a surgeon who has done at least 250 prostatectomies (prostate removals) total and who does at least 40 a year.
As you consider your options, you might want to ask your surgeon these questions.
- Which procedure does your surgeon prefer and why?
- What type of surgery does he or she recommend for you?
- Is nerve-sparing surgery an option?
- How many of these surgeries has he or she performed?
- How many of these surgeries does he or she do each year?
- What are the statistics on incontinence and impotence for your surgeon’s patients?