Why Hormone Therapy Is an Effective Supplement to Prostate Cancer Surgery for Some Patients?
By Dr. Anup Ramani
Prostate cancer is one of the most common cancers affecting men globally and with the advent of robotic surgery for prostate cancer treatment, patients now have access to more precise and effective treatment options. This minimal invasive surgery for prostate cancer not only allows for quicker recovery but also reduces complications compared to traditional surgery. However, for some patients, especially those with advanced prostate cancer, hormone therapy plays a pivotal role in complementing prostate cancer surgery to improve outcomes. In this article, we explore why hormone therapy is an effective supplement to robotic prostate cancer surgery for certain patients.
Table of Contents
Robotic Surgery for Prostate Cancer Treatment
Robotic surgery for prostate cancer, commonly referred to as robotic prostatectomy, has significantly advanced the treatment landscape. It is particularly beneficial for those undergoing prostate cancer surgery in India, where medical technology is continuously improving. This minimal invasive surgery allows for precise removal of the prostate while minimizing tissue damage, leading to fewer complications and a faster recovery.
One of the significant advantages of robotic prostate cancer surgery is its ability to reduce the risk of erectile dysfunction and incontinence, as it is a more precise procedure that can spare vital surrounding tissues like nerves. This means patients can recover with improved quality of life post-surgery, making it one of the most sought-after treatments for prostate cancer in India.
However, prostate cancer surgery alone may not always be enough for patients with advanced stages of cancer. That’s where hormone therapy comes in to provide crucial support.
Hormone Therapy and How It Work in Prostate Cancer Treatment?
Hormone therapy, also known as androgen deprivation therapy, is an essential part of the treatment strategy for certain prostate cancer patients. This therapy works by reducing the levels of male hormones that can fuel prostate cancer growth. It is particularly important for patients who are not candidates for surgery due to the advanced stage of their cancer.
In cases of advanced prostate cancer, hormone therapy can help shrink tumors, making them more manageable for surgery. When combined with robotic prostate cancer surgery, hormone therapy ensures that the surgery targets the tumor more effectively. In many cases, patients may receive an injection of hormone therapy every three months and a daily oral medication. These treatments are well-tolerated and side effects are typically minimal.
By reducing the presence of testosterone, hormone therapy helps slow the growth of cancer cells, making prostate cancer surgery more successful and reducing the chance of recurrence after surgery. This makes it a crucial supplement for some prostate cancer patients undergoing robotic prostate cancer surgery.
The Role of Hormone Therapy in Prostate Cancer Surgery Recovery
After undergoing robotic prostate cancer surgery, the recovery process can vary depending on the stage of cancer and whether additional treatments are used. For patients who have advanced or high-risk prostate cancer, the role of hormone therapy in recovery is significant.
For instance, hormone therapy can help minimize the risk of cancer recurrence. By lowering the levels of testosterone, hormone therapy reduces the chances of residual cancer cells in the prostate or elsewhere in the body. This makes it particularly useful for patients who have positive surgical margins, large tumors that may not be completely eradicated through surgery alone.
In addition to improving surgical outcomes, hormone therapy also plays a role in managing the long-term recovery of prostate cancer patients. By suppressing cancer growth post-surgery, it enables patients to enjoy a better quality of life after the operation.
When is Hormone Therapy Most Effective as a Supplement to Prostate Cancer Surgery?
Hormone therapy is not universally required for all prostate cancer patients. The decision to incorporate hormone therapy into the treatment plan depends on the individual case. However, it is particularly beneficial for:
- Advanced prostate cancer: For patients whose cancer has spread beyond the prostate, surgery may not be sufficient on its own. Hormone therapy helps reduce cancer growth before surgery and prevents recurrence after surgery.
- Aggressive or high-risk prostate cancer: Those with high PSA levels, large tumors or high Gleason scores benefit from the combination of robotic surgery for prostate cancer and hormone therapy.
- Cancer with positive margins: For patients whose cancer has spread or whose tumors are at high risk of recurring, hormone therapy can provide additional protection by suppressing remaining cancer cells after surgery.
For these patients, hormone therapy works alongside robotic prostate cancer surgery to ensure the best chance of remission and long-term survival.
What are the Benefits of Hormone Therapy in Combination with Robotic Surgery?
When combined with robotic prostate cancer surgery, hormone therapy provides a range of benefits:
- Tumor shrinkage: For some patients, hormone therapy can shrink tumors before surgery, making it easier for the surgeon to remove the cancerous tissue, especially in minimal invasive surgery for prostate cancer.
- Prevention of recurrence: Hormone therapy plays a critical role in lowering testosterone levels, which can fuel cancer growth. This helps reduce the likelihood of cancer cells returning after robotic prostate cancer surgery.
- Minimizing the need for chemotherapy: By controlling cancer growth with hormone therapy, patients may delay or avoid chemotherapy, which can have more intense side effects.
- Reduced side effects and faster recovery: Hormone therapy tends to have fewer side effects compared to other treatments like chemotherapy. When paired with prostate cancer surgery, it helps improve recovery outcomes with less physical strain.
Ultimately, this combination of treatments offers a more holistic approach to prostate cancer management, making it one of the best options available in prostate cancer surgery in India.
Hormone Therapy in Prostate Cancer Surgery: What are the Risks and Side Effects?
While hormone therapy is generally considered safe, there are some side effects that patients should be aware of. These include:
- Hot flashes: Many men on hormone therapy report experiencing hot flashes, similar to what women go through during menopause.
- Bone thinning: Long-term use of hormone therapy can lead to osteoporosis, increasing the risk of fractures.
- Fatigue: Some patients may feel tired or fatigued during treatment, which can affect daily activities.
Despite these side effects, hormone therapy remains a key part of prostate cancer treatment and is considered an important supplement to robotic surgery for prostate cancer.
Conclusion
Robotic prostate cancer surgery offers numerous advantages, including precise tumor removal, smaller incisions and faster recovery times. However, for patients with advanced or high-risk prostate cancer, hormone therapy acts as a critical adjunct to enhance surgical outcomes. By reducing testosterone levels, hormone therapy helps slow cancer progression, reduce the risk of recurrence and improve post-surgery recovery.
For many prostate cancer patients, the combination of robotic surgery for prostate cancer and hormone therapy offers the best chance for long-term survival and a better quality of life. This comprehensive approach ensures a more personalized and effective treatment plan, offering hope for those affected by this disease.
FAQs About Prostate Cancer Surgery
Is hormone therapy safe after prostate cancer surgery?
Yes, hormone therapy is generally safe and helps reduce the chance of cancer recurrence. It is well-tolerated by most patients.
How long will I need hormone therapy after robotic prostate cancer surgery?
The duration depends on the cancer stage and the patient’s response. Some patients may need hormone therapy for months or years.
What are the side effects of hormone therapy for prostate cancer?
Side effects can include hot flashes, reduced libido, bone thinning and fatigue, but they are generally manageable.
Can hormone therapy be used before surgery for prostate cancer?
Yes, hormone therapy is often used before surgery to shrink tumors, making robotic prostate cancer surgery more effective.
Is hormone therapy effective for all prostate cancer patients?
Hormone therapy is most effective for patients with advanced, aggressive or high-risk prostate cancer, particularly those not eligible for surgery alone.
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PARTIAL PENECTOMY
- Partial penectomy is done in cases where glans and distal penis is involved with carcinoma.
- Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
- Patients who develop stones in the kidney or ureter, often experience severe pain.
- This condition usually needs a procedure to remove the kidney stones.
- This procedure is called ureteroscopy and is performed very commonly.
- It does not require any cuts and hence it is painless.
- The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
- The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
- The procedure takes about 40-50 minutes.
- A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
- Patient is mobile and walking in the room the same evening.
- Hospital stay is one night and patient is discharged the next day after removal of the catheter.
- Patient has to come back after six weeks to remove the stent in the kidney.
- Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
- We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
- Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
- This procedure is called TURP and is performed very commonly.
- It does not require any cuts and hence it is painless.
- The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
- The overgrown prostate is dissolved with a laser bloodlessly.
- The procedure takes about 40 minutes.
- A catheter (urine pipe) is kept after the procedure to drain the bladder.
- Patient is mobile and walking in the room the same evening.
- Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
- Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
- We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR
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Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
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Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.
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The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
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Dr. Ramani then sits in the controlling console to perform the surgery.
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On an average, a robotic adrenalectomy takes one hour.
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The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
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A urine catheter and bag to drain the bladder is inserted during surgery.
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A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.
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Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
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The drain pipe, if kept, is removed in the room on day 2 after surgery.
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The catheter is removed on day two after surgery.
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Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).
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Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.
Heavy activities like running, weight lifting can be resumed after a month
FOLLOW UP AFTER SURGERY
Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
Local patients usually meet Dr. Ramani after two weeks to discuss report.Outstation patients are counselled on a phone consultation.
ROBOTIC SURGERY FOR BLADDER CANCER
- Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
- Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
- Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
- The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
- Dr. Ramani then sits in the controlling console to perform the surgery.
- On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
- The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
- A urine catheter and bag to drain the new bladder is inserted during surgery.
- Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
- Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
- The drain pipes are removed in the room on day 3-5 after surgery.
- Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
- Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
- On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
- Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY
Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.
Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.
Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.
If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.
ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
- Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
- relatively easier but still requires significant experience to consistently deliver results.
- Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
- The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
- Dr. Ramani then sits in the controlling console to perform the surgery.
- On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
- The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
- A urine catheter and bag to drain the bladder is inserted during surgery.
- A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
- Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
- The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
- Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
- Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
- On the day of discharge, patient is totally self- sufficient.
- They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
- Almost all patients are back to work within 2-3 weeks of surgery.
- Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
- Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
- Local patients usually meet Dr. Ramani after two weeks to discuss report.
- Outstation patients are counselled on a phone consultation.