Prior to the operation
MRI
If your cancer was diagnosed by Mr Thyer you will most likely have undergone MRI prior to the biopsy. If you have been referred from another urologist you may require prostate MRI to ensure the cancer is able to be treated successfully with surgery
Staging
- To ensure the prostate cancer is contained within the prostate a PSMA PET scan is usually required
- Occasionally no scan is required for low grade disease, particularly if the PSA is very low
- PSMA PET can be expensive, so a bone scan and CT are a cheaper option although not considered to be as accurate as PSMA PET
Discussion about options for treatment
- Generally low risk prostate cancer can be observed and does not require treatment
- Surgery and radiotherapy have roughly equivalent rate of cure for prostate cancer
- Surgery for prostate cancer is favoured for younger men with prostate confined cancer
- Radiotherapy is favoured for older men particularly if the prostate cancer looks to be growing outside of the prostate on MRI
- Hormone therapy is recommended for older men where the cancer has spread to lymph nodes, other organs or bone
- Men with high risk prostate cancer will likely require a combination of surgery, radiotherapy and possibly hormonal therapy for cure
Waiting for surgery
After prostate biopsy the inflammation around the prostate will take about 6-8 weeks to settle. For safety reasons surgery to remove the prostate needs to wait until this period has elapsed.
Risks
Risks of radical prostatectomy (these are the main risks and this is not an exhaustive list):