Raena Morgan: Hi, I'm Raena Morgan with iHealthTube. We're visiting with Dr. Aaron Katz. He is the author of Prostate Health, and we are getting information, very vital information about prostate health. Welcome Dr. Katz!
Dr. Aaron Katz: Thank you, great to be here.
Raena Morgan: One of the things that I'd like to ask you the viewers that I'm sure would like to know is that sometimes traditional medicine recommends that a man have prostate surgery. Could you address that, and also talk about some of the side effects?
Dr. Aaron Katz: Sure. Many of the men in this country that are diagnosed with early stage prostate cancer do undergo radical prostatectomy, which is defined as the removal, the complete removal of the prostate, the seminal vesicles, which are the glands underneath the prostate and the nearby adjacent pelvic lymph nodes. This can be done openly with a knife and open surgical approach or nowadays it can be done with a robot, robotically or laparoscopically through very small, skinny incisions.
Raena Morgan: Okay.
Dr. Aaron Katz: This is done quite commonly in United States by many urologists, and there are probably over 100,000 performed yearly. There can be side effects from this operation. Because the nerves for the erection run very close to the prostate, there are men that can suffer from erectile dysfunction following the surgery, although some of the oral agents like Viagra, Cialis or Levitra can be helpful.
Men also can experience some urinary difficulties. Urinary incontinence where men have to wear pads for a brief period of time, sometimes 3 months, 6 months, sometimes longer.
Now, there are other treatments beyond surgery that men can choose from if they have early stage prostate cancer such as radiation which is performed with an external beam, where patients have to go everyday for 5 days a week for usually 8-9 weeks, or they can have internal seed pellets placed in their prostate, that's called Brachytherapy, that's also radiation where radioactive seeds are placed throughout the prostate gland.
The other alternative is to have a freezing procedure of the prostate which we commonly do at our institution at Columbia called cryosurgery where needles are placed in the area of the tumor and the tumor is frozen with an argon gas. I think that men need to understand that if they have surgery, that they're not going to be available to have or not a candidate to have cryosurgery if their surgery fails, if they're PSA relapses.
If they have radiation and their PSA relapses, they're not going to be able to have surgery, because of the scarring from the radiation, but they could have cryosurgery. And if the PSA should come back after radiation and surgery, then men would be a candidate for the last route which would be a systemic approach which is known as hormone therapy, or hormonal ablation.
That's another approach that we typically use just for men with advanced prostate cancer, where the cancer has spread to the lymph nodes or bone. That's no longer an early stage disease. But, if men have treatment for early stage, like surgery, radiation or cryo and they failed those treatments, they can be salvaged with the hormone therapy.
Raena Morgan: Alright. Thank you Dr. Katz, very much.
Dr. Aaron Katz: Thank you.
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