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