Prostate cancer is a disease with a long indolent course. Many patients will die of other causes than of this cancer. And the treatments, though now advanced and with minimal complications, do carry some risks and side effects. If the patient is over 70 years, the cancer is limited and is not causing any symptoms, then the disease may be observed. The patient is required to stay in follow up, given supportive therapy and followed up. Many patients do very well with this approach and may live completely normal healthy lives. But, remember, this approach requires very careful and nuanced evaluation and your urologist will be the best person to advise you.
Surgery - Radical Prostatectomy (Open/Laparoscopic/Robot Assisted Radical Prostatectomy/RARP)
If you are diagnosed with prostate cancer, and have localized disease, which means that the cancer is limited to just your prostate gland, then you are eligible for radical prostatectomy. In radical prostatectomy, the urologist shall remove the prostate gland along with all cancerous tissues including lymph nodes.
Radical prostatectomy - line diagram
Radical prostatectomy can be done open and via a robot. When a robot is used for te surger, then the procedure is called robot assisted lap radical prostatectomy or RALP or robotic radical prostatectomy.
Earlier this procedure used to be a formidable operation, with severe blood loss and many complications, but with refinement of technique and robotic assistance, today this procedure has become simplified.
Radical prostatectomy sounds scary, and I understand it produces lot of anxiety in the patients mind. But with today's technical advancements, you are in safe hands.
The surgery usually lasts for a few hours, bleeding is usually minimal and you will be ready to go home in a 48 hours. You shall be pain after surgery. You shall have a catheter in your penis to drain urine for aout 7 to 9 days after which it shall be removed to allow you to void normally. You shall have 5 small 8 mm scars that would heal within 7 days leaving very discrete marks.
You abdomen would look something like this after a month.
The most feared complication of radical prostatectomy is incontinence or leakage of urine. But fortunately, it will occur in 5% patients. And it improves with time, and most patients will do well after 6 months. Leakage if any would usually be minimal, requiring placing a single pad for a day.
If you are young and enjoy a healthy sexual life, then I assure you that most patients who have normal erections before surgery, are able to retain erections and have intercourse after surgery too.
If your prostate cancer has spread beyond your gland, and spread to your nodes or bones, then unfortunately you are not a candidate for surgery. But, in very selected patients, and especially if you are lucky, surgery may still provide cure. But this requires careful evaluation. But if you are not, then you would require hormone therapy. Prostate cancer growth is driven by the male hormone - testosterone. This hormone is produced in your testis (balls, nuts). So, if we remove the testis, then the hormone production dies, and the cancer comes in control.
The procedure to remove the male testis is called an orchidectomy and it is a simple painless daycare procedure where you can go home the same day.
If you wish for cosmesis, a artificial testis can be placed in the same sitting.
Injectible Hormone Therapy
If you do not want your testis removed, or if you require hormone therapy only for a limited period, then injectible medicines are available. Though a bit expensive, these medications are administered 3 monthly into the stomach, are painless and will keep your cancer under control.
Examples include - Leuprolide, Goserelin, Pamorelin, GNRH Agonists and antagonists, Fermingan etc.
There exists other prostate cancer treatments and therapies which may provide benefit in patients not willing or ineligible for conventional gold standard treatments.
If you choose radiotherapy, be aware that you should get IMRT and 3D RT. In this the radiotherapy is focused only on the prostate and prevent long term problems. But radiotherapy can make your follow up difficult, makes biopsy impossible and makes detection of residual cancer difficult. It will also not cure you, and make curative surgery very very difficult. Always consult a urologist before choosng radiotherapy as a treatment option
HIFU - High Frequency Ultrasound
A new modality, with limited results, it may be of benefit in some patients. But, you require careful evaluation by a urologist before proceeding to this modality. If you are eligible for HIFU, you are most likely to be benefited by radical prostatectomy.
What is Radical Prosatectomy – Is Radical Prostatectomy in Delhi and NCR?
Radical prostatectomy is a urooncological surgery in which the diseased prostate gland is removed en toto from the body along with its draining lymphnodes. This surgery is the curative surgery for prostate cancer. A technically complex and a challenging surgery, it requires expert assessment and great care from the operating surgeon. Apart from this, choosing whether you are suitable for this surgery is a challenge, few urologist are trained in.
With the introduction of the Da Vinci surgical robot, thankfully the world class cutting edge technique of Robotic Radical Prostatectomy is now available in Delhi and Gurgaon.
What is a Surgical Robot? Is Robotic Radical prostatectomy Delhi and Robotic Radical Prostatectomy Gurgaon a reality?
A surgical robotic system is specialised cutting edge machine manufactured world over by Intuitive Surgicals, a California based company. It is supplied in India by a company called Vattikutti Institute. Specialised training is recommended before a someone is authorised to work on the console.
In this procedure the surgeon uses his wrist to manipulate the arms of a patient side robot and with high magnification and precise movements. Very intricate procedures can be performed inside the patient with very minimal scars and blood loss.
I have the good fortune to train at PGI Chandigarh, where the Da Vinci HD Si system has been operational since 2014. There I assisted in more than 50 robotic surgeries. The Da Vinci simulator was also operational and as a resident, simulator on time was provided to each of us.
Is Radical Prostatectomy possible without a robot?
Yes, Radical Prostatectomy is possible without a robot. In fact, data worldwide shows that open or laparoscopic conventional radical prostatectomy is superior. But, patient choice drives the decision. I am comfortable doing open, laparoscopic and Robotic Radical prostatectomy. The best option for you is always a decision made with consultation. What is right for you may not be right for some one else.
Who is the Best Robotic Surgeon in Delhi?
Best is a generic term. I believe the surgeon who can provide you relief from your disease in a economical ethical and caring manner is the Best Robotic Surgeon in Delhi and Gurgaon. A surgon who knows when to ask for help at the right time instead of compromising your care is the Best Robotic Surgeon in Delhi NCR.
I have my teachers and stalwarts practicing in Delhi, Gurgaon and NCR. In fron of these giants, I will always be a student. That said, it is my strong belief that prostate cancer is not a disease by a commitment. I will hold your hand through your entire journey to recover from this disease, a stronger man.
To take a free econsult, leave a message or drop a email.
Why a Urologist for Prostate Cancer Treatment in Delhi?
A urologist is the best qualified medical specialist to handle your complex condition. Due to efforts and progress in science, today prostate cancer is eminently treatable. A Urologist will not only ensure treatment but will allow you to have a great quality of life too.
Delhi being a Metro, has many Urologist. Choose a Urologist that can provide you the best prostate cancer treatment Delhi and best Prosatate cancer treatment Gurgaon.
I can provide you the best results and a comfortable Prostate cancer treatment in Delhi NCR and Gurgaon, if you do choose me as your treating urologist.
What treatment of Prostate cancer can I offer you in Delhi and Gurgaon?
PROSTATE CANCER DELHI-PROSTATE CANCER NCR-PROSTATE CANCER GURGAON
Prostate cancer is a rising problem in urban populations, especially in cities like Delhi and the National Capital Region. Gurgaon is seeing a rapid increase in population. And with it, its residents are having to face this dreaded problem.
Prostate cancer is eminently treatable. If caught early, it is completely curable and long term survival is the norm. But, prostate cancer is also an enigma of treatment paradigm. It requires very very careful and nuanced workup by a qualified urologist with significant experience in diagnosis of prostate cancer.
Why should I contact an Urologist for Prostate Cancer in Delhi?
Prostate cancer is a disease with a very long course. You will live for many many years after treatment. A urologist is the one person who is the most qualified to manage all associated complications and life issues. Other specialities may mange your cancer initially, but at some point will always require a urologist to come on board. So consulting a good urologist in your area (Delhi, NCR Gurgaon) for prostate cancer will be in your best interest
Am I competent in evaluating all the latest diagnostic modalities for prostate cancer?
I am fully qualified in evaluating and diagnosing prostate cancer in Delhi, prostate cancer in gurgaon and prostate cancer in NCR. I am comfortable in all latest diagnostic modalities like multiparametric MRI, Serum PSA and TRUS guided Biopsies and routinely offer these tests to my patients in Delhi NCR.
If you are suffering from prostate cancer Delhi, Prostate cancer NCR and Prostate cancer Gurgaon, you can take an appointment or get a free econsult via email.