That's why I generally don't recommend this surgery for a man whose life expectancy is less than 10 years, or for a man who is older than 75, depending on his personal and family health history.
Radical prostatectomy can be a reasonable option for select octogenarian patients, according to researchers from the Mayo Clinic, Rochester, MN.
Moreover, elderly patients also demonstrate worse postoperative recovery of continence and erectile function. As the absolute rates of both oncological and functional outcomes are still very reasonable in patients ≥75 years, a radical prostatectomy can be offered to highly selected and healthy elderly patients.
A radical prostatectomy is a major operation with some possible side effects. You may not need this type of surgery if you're an older man with a slow growing prostate cancer. This is because your cancer might grow so slowly that you're more likely to die of old age or other causes than from prostate cancer.
Surgery — Radical prostatectomy is a surgery that completely removes the prostate gland (see 'Radical prostatectomy' above), and it has become more popular for treatment of stage III prostate cancer.
Prostate cancer is a slow-growing cancer and, more often, it is confined to the prostate gland, requiring minimal or no treatment. In some cases, it can take up to eight years to spread from the prostate to other parts of the body (metastasis), typically the bones.
After a radical prostatectomy, you no longer ejaculate semen. This is because the prostate gland and 2 glands called the seminal vesicles are removed. Your testicles will continue to make sperm cells but they will be reabsorbed back into your body.
Not being able to fully empty the bladder can raise the risk of infection in the urinary tract. If you often get UTIs , you might need surgery to remove part of the prostate. Bladder stones. These are most often caused by being unable to fully empty the bladder.
Patients with a history of extensive abdominal surgery, radiation, pre-existing heart or lung disease, morbid obesity, or bleeding tendencies may not be the best candidates for robotic prostatectomy. Patients with known metastatic or recurrent prostate cancer are not candidates for robotic prostatectomy.
The USPSTF does not recommend screening for prostate cancer in men, including men with a family history of prostate cancer, older than 70 years.
A healthy adult prostate weighs around 20 to 25 grams and is approximately 4 cm wide, 3 cm high and 2 cm thick.
The incidence of prostate cancer increases dramatically with age. However, many health authorities advocate the cessation of routine prostate cancer testing in men older than 75 because of the belief that most patients will have a clinically insignificant cancer and will not benefit from therapy.
But because enlarged prostate, or benign prostatic hyperplasia (BPH), is a common condition that affects men as they age, it's important to know the facts. About 50% of men between the ages of 51 and 60 have BPH, and that number jumps to 70% among men aged 60 to 69 and around 80% of men over 70 years of age.
According to Table 3, the normal range of PSA (95th percentile) increased by age (from 4.89 ng/mL in the age group of 60–64 years to 33.17 ng/mL in the 85+ age group).
Guidelines from the American Urological Association (AUA) recommend that all men undergoing a radical prostatectomy—a type of prostate cancer surgery that removes the the prostate—should expect incontinence after this surgery. Still, for most, urinary function gradually returns to normal over time.
Most men who have normal sexual function and receive treatment for early prostate cancer regain erectile function and can have satisfying sex lives after robotic prostatectomy.
Viagra is an effective treatment for impotence in men who have their prostate removed. For men whose nerves have been spared, the Viagra improves the ability to have an erection by nearly 60%, but the effectiveness drops to 20% in those with no nerves spared.
Radical prostatectomy survival rates
The research showed that between 5 and 20 years after having the surgery, only 3% of the patients died of prostate cancer, 5% saw their cancer spread to other organs, and 6% had a localised recurrence.
If prostate cancer spreads to other parts of the body, it almost always goes to the bones first. These areas of cancer spread can cause pain and weak bones that might break. Medicines that can help strengthen the bones and lower the chance of fracture are bisphosphonates and denosumab.
In many cases, prostate cancer is relatively slow-growing, which means that it can take years to become large enough to be detectable, and even longer to metastasize outside the prostate. However, some cases are more aggressive and need more urgent treatment.
The 5-year relative survival rate for prostate cancer in the United States is 97%. The 10-year relative survival rate is 98%. The survival rates for prostate cancer vary based on several factors. These include the stage and grade of the cancer, a person's age and general health, and how well the treatment plan works.
2.5-3.5: Normal for a man 50-60 yrs. 3.5-4.5: Normal for a man 60-70 yrs. 4.5-5.5: Normal for a man 70-80 yrs.