Prostate cancer: surgery is not necessarily required

One of the most "dreaded" life-saving surgeries for men is radical prostatectomy, i.e. the surgical removal of the prostate. Fearing this intervention, many people tend to postpone screening tests, even though it is possible that in the case of confirmed prostate cancer, no surgery will be performed, only the development of the disease must be closely monitored. We talked with Dr. Zsolt Domján, a urologist at the Duna Medical Center, about modern methods of treating prostate cancer.
Prostate cancer: surgery is not necessarily required

How serious are men about early prostate cancer screening? Do they undergo screening tests?

I am very happy that more and more people are taking part in screenings, and men are no longer only coming to the examinations to persuade their partners. The screening is based on a physical examination and a so-called blood test. It consists of a PSA test. In case of any suspicion, the investigation is started: first, a histological sample is taken, and then the attending physician decides on further treatment.

When is a radical prostatectomy, i.e. removal of the prostate, performed?

Medicine has changed a lot: in the past, surgery was performed in almost all cases - today it is more common to believe that certain prostate cancers do not necessarily need to be operated on, because it is not certain that slowly developing prostate cancer will lead to the patient's death. This may be important in older patients, especially those who may have serious co-morbidities.

If someone has a life expectancy of more than 10 years, is in generally good health, the process is localized to an organ or is locally advanced, medium or high risk, then the results may be better if we immediately decide on the surgical solution and, if necessary, add oncological treatment to the therapy.

In the case of clinically insignificant prostate cancer (low-risk based on pre-operative examinations), only observation may be carried out, thereby ensuring adequate quality of life until intervention becomes necessary.

What are the advantages and disadvantages of surgery?

There is nothing to beautify: in the case of prostate cancer, whatever form of intervention we choose, it will definitely worsen the quality of life. The older the surgery, the higher the incidence of incontinence. This may be temporary, but may persist to some extent. In the case of younger people, the ability of the barrier muscle to regenerate allows the ability to retain urine to remain of adequate quality.

Appropriate patient selection and precise surgical technique significantly reduce the rate of these complications, the so-called and with a "nerve-sparing" procedure, it is even possible to preserve the ability to have an erection.

In our institute, several doctors with great experience perform these modern laparoscopic procedures at a high level.

If you have further questions or would like to take part in a consultation, make an appointment!

Get to know our doctor:

Dr. Zsolt Domján