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cover of Walsh's book

A selection from
Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
by Patrick C. Walsh, M.D., and Janet Farrar Worthington

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last week's game -- to see whether I could identify any differences in men who are continent and potent immediately after surgery, versus men who aren't. This has proven to be another good tool in improving the quality of men's lives after surgery.

In this chapter, we cover everything about radical prostatectomy and the complications that can occur in the months after the operation. But what about the long-term outlook, and the biggest question of all -- has your cancer been controlled? For a detailed discussion of the results of all forms of treatment for localized disease -- surgery, radiation, and cryotherapy -- see Chapter 10.

Radical Prostatectomy - the "Gold Standard"

Never underestimate prostate cancer; it is a formidable adversary. In its own way, prostate cancer is much like the Hydra, the many- headed, hard-to-kill monster of Greek myth. It's what scientists call "multifocal" -- which means it springs up in several places at once inside the prostate. A cancerous prostate has, on average, seven separate tumors growing inside it. Thus, to cure the disease, we can't just take out a few of these spots of cancer; we must eliminate the entire prostate. If cancer is confined to the prostate, there is no better way to cure it than radical prostatectomy. The goal of all other forms of treatment for prostate cancer is to be as good as the "gold standard," radical prostatectomy. (Note that when we talk about radical prostatectomy in this book, unless otherwise stated, we are referring to the anatomic radical retropubic procedure.)

Having said that, we must add right away that radical prostatectomy is not for everybody. It is intended for the younger man with curable disease, the man otherwise healthy, who can reasonably expect to live for at least another fifteen years. In other words, it is for the man who is not only curable, but who's going to live long enough to need to be cured. It is not something that an older man, or one burdened by other health problems, should have to put himself through. What if you're somewhere in the middle of these two ends of the spectrum? What if you're a young, otherwise healthy man, and the Partin Tables say there's a 50/50 chance your cancer can be cured? If surgery is the best way to cure you, then you should do it. What if you're a man in his early seventies, in excellent health, with curable disease and a family history of longevity? There is no question that older men are

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