Orchietomy For Prostate Cancer Treatment

Orchietomy is a radical prostate cancer treatment in which the testicles are completely removed. This is done because most cases of prostate cancer develop and progress because of the presence of male sex hormones, or more specifically testosterone and this hormone is produced by the testes. This type of prostate cancer treatment is a form of hormone therapy which works by manipulating the hormone levels in the body so that the cancerous cells stop growing and dividing. While this therapy is known to have a positive effect on the cancer you must realise that the operation is non-reversible and the chances of your sex life being affected are virtually 100%. Men who have undergone this form of prostate cancer treatment often report that their libido decreases and so does their desire to have sex. Unfortunately even when they do have the desire for sexual intercourse they may find themselves to be impotent and this can lead to psychological problems in the long term. These side affects of orchietomy are very common and you should take them in to account and discuss them with your partner before you decide to undergo this form of prostate cancer treatment. Other side effects of this radical prostate cancer treatment are associated with the unbalancing of the male and female hormone levels within the body. By removing the testicles the concentration of testosterone in your body will be reduced by around 90% however the concentration of oestrogen, the female hormone will remain the same. This means that on occasion breast tenderness, growth of the breast tissue and osteoporosis can develop. Other side effects include anaemia, weight gain, and depression and fatigue however your oncologist will be able to explain each of the side effects in much more detail. Before deciding for or against this form of prostate cancer treatment you need to decide what exactly you want to get out of the treatment. If you want to eliminate the cancer from your body then an orchietomy is a possibility however there are other ways to remove the cancer totally and these alternative treatments have fewer and less severe side effects. If however you are 60+ and do not want to have surgery then this procedure is not for you and radiation therapy can be used to simply control the growth of the cancer. Similarly if you are still relatively young and do not want to be plagued with impotence and lack of sex drive then, again, an orchietomy is probably not the prostate cancer treatment for you. Because impotence is a major side effect of this radical prostate cancer treatment you should think long and hard before agreeing to anything. Talk to your partner and your oncologist and look into the alternative forms of treatment. There may be a better one for you that only has temporary side effects so that after a few weeks or months you can once again enjoy a full sex life.

About Author: Your prostate health is important for cancer prevention. For more information, resources and support, please click http://www.prostate-cancer-treatment-hub.com.

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Life After Prostate Cancer - The Benefits Of Nerve Sparing Prostatectomy

When facing the diagnosis of prostate cancer, for most patients, the overwhelming focus is on eradicating the disease. However once the cancer has been successfully treated, the side-effects of treatment can have a major impact on quality of life.

I have seen many patients following a prostatectomy who are very distressed by their inability to resume normal sexual intercourse. Yet frequently, at the time of diagnosis, these patients did not view impotence as a major concern when they made their choice of treatment.

It would seem that we need to do more to understand patients and their preferences when they are choosing treatment for prostate cancer and offer them a wider range of options to meet their needs.

Radical prostatectomy, which involves the complete removal of the prostate, is the treatment of choice for 30-50% per cent of patients with organ confined prostate cancer. Its appeal lies in the degree of certainty it offers in terms of removing the disease in one strike.

A traditional radical prostatectomy is undertaken using wide margins around the prostate, damaging the nerves which control the blood supply to the penis. This has been understood to be the safest way of eradicating cancer but causes impotency.

Specialised urological surgeons have been carrying out nerve-sparing prostatectomies for over 10 years. The task of safely removing all cancer cells without harming the hair-thin adjacent nerves demands a very high level of technical skill.

It is hard to measure outcomes in a very precise way - several different assessments of sexual function are used and the outcome for each patient will depend on a range of factors, not all related to the surgery itself.

Not surprisingly then, the reported outcomes from treatments vary widely. For example, following bracytherapy, rates of impotency are reported at between 14 and 61 per cent. Some of the widest variations occur in rates reported following prostatectomy. Impotency is reported in 26 to 100 per cent of patients and intact function from 9 to 86 per cent.

This makes it all the more important for each hospital unit to carefully measure and audit its own results.

Improvements in the techniques of specialist surgeons who undertake a large number of prostatectomies mean we are getting closer to obtaining the perfect result for patients - cure, continence and potency.

Although there are other factors which play their part in the recovery of erections (neurogenic, vascular and psychosexual), the results show patients do have better results following nerve-sparing surgery compared with non nerve-sparing.

The nerve-sparing techniques I have developed during the past 6 years, undertaking over 700 procedures, mean that 73 per cent of my patients who have had 'high quality' nerve-sparing prostatectomy's have "good" erectile recovery (defined as being able to have an erection sufficiently rigid for vaginal penetration).

Achieving this is dependent upon extremely good technique throughout the whole procedure. Key elements include control of the dorsal vein complex after apical dissection of the prostate, accurate dissection of Denonvillier's fascia, a three stage dissection of the neurovascular bundle (NVB), avoidance of energy, avoidance of traction and careful placement of anastomotic sutures.

However, despite the progress which has been made in recent years in nerve-sparing surgery, studies suggest that up to 73 per cent did not continue their treatment.

In many cases, the effectiveness of the treatment was below the expectations of the patients. This was cited as one of the main reasons for giving up on the treatment along with loss of interest in sex.

The Birmingham Prostate Clinic have established a dedicated Erection Clinic to recognise the needs of these patients and address some of the problems which have been identified. By combining established erectile dysfunction treatments with the right specialist support, we see patients return to more effective erectile function over time as they recover from surgery.

Medication alone is not sufficient to overcome all potential problems. Men need to have individually-tailored care and support to ensure they keep up with their treatment and effectively address the psycho-sexual factors which they face as they recover from surgery and return to normal life.

Alan Doherty is a Consultant Urologist and Medical Director of The Birmingham Prostate Clinic. A centre of excellence for Prostate Cancer Treatment and Nerve Sparing Prostatectomy

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