Prostate Laser Surgery – Benign Prostate Hypertrophy

Benign prostatic hypertrophy or BPH is a medical condition that causes obstructive urinary symptoms in most men, especially in their old age as they pass 70 and approach 80. The symptoms of the disorder include reduced urine flow, increased frequency and urgency, dribbling, hesitancy, incontinence, and excess urination at night. There are instances in fact in which the disease affects men younger than 40, although that isn’t too common.

Also called prostate enlargement, one of the best known treatments for the condition is the transurethral resection of the prostate (TURP), in a surgical instrument called the endoscope or cytoscope is inserted in order to cut away the excess tissue. However, due to the limitations of that procedure, and to technological advancements that are meant to make everything that much easier, other techniques have been found to improve on the TURP. 

Prostate laser surgery is a minimally invasive therapy that is used these days for the treatment of BPH. Just like with the TURP procedure, in this operation a portion of the prostate is removed; however this time it is done by the aid of a specialized laser. With this surgery, the man being treated is afforded better urinary retention than previously; and he may undergo the procedure in the event of medical therapy failure, a recurrent infection, and renal insufficiency.

Incidentally, prostate laser surgery may be employed also for the treatment of various other conditions that generally affect the male urinary and reproductive systems, such as bladder stones, and prostatic bleeding. During the procedure, an anesthetic is given to the patient to help him relax for the length of the operation. The cystoscope is then inserted along with a specialized laser fiber in order to remove the portion of the prostate blocking the bladder’s drainage. Because of the loss of continence that result from the trauma to the region, a catheter is left in the bladder just long enough for the man to regain control of his bladder fluids – the catheter is usually removed the next day.

Some of the important advantages of prostate laser surgery, especially over TURP include the aforementioned minimal invasiveness of the surgery in dealing with bladder outlet obstruction, and a shortened recovery period, which most men can appreciate if they have to get back to work in a hurry. Certainly, because of the improved precision of the process, the patient also experiences lower blood loss than if he had to undergo the conventional prostate surgery. There are side effects still, though, and they include some initial discomfort with voiding after the procedure; however, this fades within days. Some patients also take longer to recover their bladder control, but again, that fades. And with fewer scars, the man certainly has a lot to be thankful for

Prostate Cancer Treatment Brachytherapy – Advantages and Disadvantages

Radiation therapy, or radiotherapy, is a procedure in which ionizing radiation is employed from a controlled source in order to treat certain diseases in the human body.

In prostate cancer treatments, radiation therapy makes use of beams of x-rays or gamma rays to destroy or damage the DNA of cancer cells in the body – wherever they may have progressed to in the body. This allows for radiotherapy to be useful in treating all stages of the condition. Incidentally, other cells (normal ones) in the body are also damaged in the process; but whereas they can recuperate and regenerate, the cancerous cells cannot and die off. 

Brachytherapy is a form radiation therapy that makes use of an internal source of radiation in order to kill the cancer, usually used when the prostate cancer cells are still in the prostate gland and have not spread (or metastasized) to other locations across the body.

Brachytherapy for prostate cancer is administered using “seeds,” small radioactive rods implanted directly into the tumor. Also referred to as permanent implant brachytherapy, it actually is a popular treatment choice for patients who have low risk features of the disease or of relapse. Men with intermediate risk features may also be treated by it though.

Brachytherapy is a process in which about a hundred small ‘seeds’ of radioactive material are placed inside of the prostate gland with the aid of a needle through the skin of the perineum, and directly into the tumor while it is still in the prostate gland. The radioactive materials normally used in this procedure are iodine-125 or palladium-103, although there are others that have similar effects in the therapy. The operation may be carried out under a spinal anesthetic, but if the patient desires it or the surgeon thinks it is necessary, general anesthetic may be used also.

The seeds, once inserted in the prostate, carry on to emit lower-energy x-rays that typically travel only a short distance within the organ without doing a lot of damage to other organs or cells in the body. The seeds do eventually become inert, but they remain in the prostate gland permanently on permanent residency. But the risk of radiation exposure to others from patients treated with the implanted seeds is generally not thought to be significant enough to cause worry.

Advantages/Merits of Brachytherapy

One of the many merits of brachytherapy, especially over conventional external beam radiotherapy (EBRT) is that it can be performed on an outpatient basis.

Another advantage is that the procedure is associated with good 10-year outcomes while also guaranteeing relatively low morbidity.

However it is only applicable in early stage disease: later stages may employ a combination therapy of both EBRT and radiation therapy.

Disadvantages/Side Effects Of Brachytherapy

The side effects of both are similar – radiation proctitis, impotence, and incontinence; and typically they were off as the radiation does as well.

Treatment of Advanced Prostate Cancer

Advanced prostate cancer is when the malignancy of the cells of the prostate gland is no longer just the malignancy of the cells of the prostate gland but a malignancy that is spreading (freely?) through the body with the aid of the bloodstream and the lymphatic system. They don’t mean to help – they are just doing their jobs of sustaining body functions – but the cancerous cells get into these body fluid systems when the tumor has (matured?) in the prostate and is ready to metastasize.

Advanced prostate cancer may be locally advanced, located in the prostate and in the pelvic region. (likely the lymph nodes would be swollen by this time); advanced prostate cancer proper is typically characterized by an extensive spread of the disease to various locations around the body, especially in the skeletal system. Curing the cancer at this time is often out of the question, but treatment may be offered in order to provide palliative care to the patient.

The treatment of advanced prostate cancer therefore is in the interest of delaying the disease’s progression as well as its symptoms, managing bone pain and metastasis, improving the quality of life of the patient, and prolonging his life.

Palliative care does this by focusing on extending life and relieving the symptoms of the metastatic adenocarcinoma. To that effect, some treatments already in use such as hormonal therapy, chemotherapy, and radiation therapy, that can slow disease progression and yes, relieve the symptoms that the patient is suffering from to some degree. However others are needed in order to further improve the outcomes of the treatments.

Abiraterone acetate is one such procedure that is showing some promise in late phase research for treating advanced prostate cancer. The drug causes the PSA levels in a patient to drop dramatically while also reducing the size of a prostate cancer tumor. 70% of the patients with aggressive advanced-stage prostate cancer that were treated with this mediation showed remarkable improvement. Chemo may slow disease progression and postpone symptoms, especially if used with corticosteroids.

Bisphosphonates are ideal for the prevention of fractures in bone metastasis. Zoledronic acid for instance has been shown to delay such skeletal complications and even the need for radiation therapy. It is most applicable then when a patient turns up who has hormone-refractory metastatic prostate cancer, one of the worst forms of the disease. For reducing pain, improving quality of life, and pr prolonged patient survival times, reduced pain and improved quality of life, alpharadin is the new alpha emitting pharmaceutical that will do the trick.

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