Will surgery cause prostate cancer to spread?

summer99
summer99 Member Posts: 8 Member
edited October 2022 in Prostate Cancer #1

Hi, I have been following discussions on this site for a couple of weeks. All the information is very helpful. Now I have a question and need your help.

My husband, 70 years old, was diagnosed with localized prostate cancer in June, high risk, Gleason score 4+4=8 in 3 cores. He is not suitable for RP because of easy bleeding and has decided to go for RT (EBRT) combined with ADT. However, he also has urination difficulty due to BPH. The RT oncologist wanted him to improve the urination problem before RT. So, my husband consulted his urologist and tried few medications but the side effects are not well tolerated. Instead of mediation, he needs to have a laser procedure to vaporize and remove obstructive prostate tissue for urination improvement. Now, my question is: Is it possible that this laser surgery will scatter the cancer cells around and cause his prostate cancer to spread? Maybe this is a stupid question but I am really worried! Please let me know your input. Thanks so much.

Comments

  • Clevelandguy
    Clevelandguy Member Posts: 1,180 Member
    edited September 2022 #2

    Hi,

    You should talk to his Urologist and find out what tissue they are removing, inside the urethra or actually removing Prostate tissue. The laser should kill whatever tissue it touches so I doubt if it would advance the spread of his cancer. Depending on where the cancer is located he could have healthy Prostate issue that is being removed if that is what the procedure is doing.

    Dave 3+4

  • summer99
    summer99 Member Posts: 8 Member
    #3

    Dave, thanks for your reply. My understanding is that this procedure will remove excess prostate tissue to improve the urine flow. It doesn't target any cancer location nor does it get around cancer spots, only to open up the urination passage.  It is done using laser, bleeding may be minimal but there are still wounds to heal. Most likely this is a non-issue and I am just overly concerned.

  • JJO
    JJO Member Posts: 22 Member
    #4

    I have prostate cancer although I am on active surveillance because it doesn't yet need treatment. I had a procedure to remove prostate tissue for BPH issues and my doctor said it would not cause any problems with my present cancer or future potential treatments. While it was a different procedure (aquablation) I don't see why a procedure removing prostate material should cause a risk of cancer spreading.

  • summer99
    summer99 Member Posts: 8 Member
    #5

    JJO, thank you for your comments. It is very helpful. The procedure is scheduled for next week. Hope the pre-surgery test goes smoothly this week. Thanks again!

  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    edited September 2022 #6

    I agree with above survivors opinions. The prostate is like a shell and the laser treatment is done from the inside. Their insert the probe via the urethra reaching the area of the restriction. There is a risk of incontinence with this sort of intervervention.

    Best wishes and luck in his ebrt.

    VG

  • Old Salt
    Old Salt Member Posts: 1,505 Member
    #7

    We all agree! 😀

  • J69
    J69 Member Posts: 35 Member
    #8

    Summer, it is great you are advocating for your husband. I also was diagnosed with a Gleason score of 8. I had urinary issues before I was diagnosed. I had a TURP procedure done before radiation treatment. I haven’t heard of a laser or TURP treatment causing any spread. I would be more concerned with the 4+4 Gleason 8. That represents the beginning of aggressive cancer. I would think that your urologist would get your husband on hormone therapy quickly to beat down the progression. Your husband has many years ahead as long as you both self advocate for no delays. I am also 70 and have completed radiation. Both the radiation and the hormone treatments have knocked my PSA down to undetectable. Keep us informed and ask any questions that come up to your doctors.

  • centralPA
    centralPA Member Posts: 322 Member
    edited September 2022 #9

    I am on AS, but plan to have RT if/when the day comes. I also had BPH, which contraindicates RT.

    Past tense on that, because I had a HoLEP procedure (holmium laser) to treat the BPH. It did, and well too! No urinary problems now, and my prostate went from 140 cc to an estimated 40 cc, since they removed 100 grams of tissue. My PSA went from 5.7 to 0.4, to boot. They got a really good look at the pathology of my prostate in the process.

    The laser cauterizes tissue as it goes, so by my reckoning any cancer cells that might be loosed are fried in the process. Minimal bleeding for the same reason. no incisions, everything is continually flushed out of the urinary tract.

    They remove most of the inside of the prostate, leaving the peripheral zone, which is unfortunately where most PCa is. If any is in the central or transit Al zone, out it goes.

    The urologist recommended 3-6 months between a procedure and radiation. It took a while for all the SEs to go away, so I think that makes sense. Much smaller prostate to irradiate now.

    I would recommend the BPH procedure that removes the most prostate, since you know it is cancerous. That would be a HoLEP.

    Best of luck!

  • way1955
    way1955 Member Posts: 5 *
    #10
    https://csn.cancer.org/discussion/comment/1700002#Comment_1700002

    DAVE WHY WOULD YOU HAVE THIS PROCEDURE DONE. HERE YOU ARE HOLDING YOUR OWN WITH THE CANCER AND THIS WAY YOU HAVE DO SIDE EFFECTS. BUT NOW YOU ARE GOING TO HAVE A DOCTOR DO A TURP WHICH IS THE WORST SURGERY FORSIDE EFFECTS. YOU WILL HAVE LEAKING AND ED PROBLEMS AND ALSO RETRO EJACULATION

    THERE ARE OTHER PROCEDURES YOU CAN HAVE WHERE THEY DO NOT CUTTING. I HAD A UROLIFT DONE 9 YEARS AGO AND NO SIDE EFFECTS. LOOK INTO SOMETHING ELSE AND NOT GET RUSHED. IF YOUR GOING TO HAVE A TURP YOU MAY AS WELL HAVE THE PROSTATE REMOVED.

    A TURP IS NPOT WORTH THE PROBLEMS YOU WILL HAVE AFTER THE SURGERY.

  • way1955
    way1955 Member Posts: 5 *
    #11

    SORRY THAT WAS FOR SUMMER 99

  • way1955
    way1955 Member Posts: 5 *
    #12
    https://csn.cancer.org/discussion/comment/1700019#Comment_1700019

    Also ED problems and retro ejaculation. Why add more problem to the cancer

  • way1955
    way1955 Member Posts: 5 *
    #13
    https://csn.cancer.org/discussion/comment/1700111#Comment_1700111

    I'm sorry but that makes no sense to have a procedure that will cause you problems and still leave most of the cancer. I'm sorry but I would not do that. Leaking and the ED would cause me a problem. And retro sucks

    Why put yourself through 2 surgery when removing the prostate will do the job. It will most of the time get rid of the cancer and the BPH but will get you the leaking and the ED problems. Also retro. With the first surgery. No man should have to go through 2 major surgery.

  • Old Salt
    Old Salt Member Posts: 1,505 Member
    edited October 2022 #14

    This discussion is moot because the patient did have the BPH procedure. At least that's what I understand from a more recent thread started by summer99.

    Bleeding and Urinary Blockage after TURP — Cancer Survivors Network

  • way1955
    way1955 Member Posts: 5 *
    #15

    I'm sorry I have to comment to all.

    I do a lot of research been over 20 years and this is the first time that I have hear to do one surgery for BPH before the prostate is removed.

    Never heard of it. A Turp any Turp no matter which way they do it is major surgery. It comes with all of its sides effects. Removing the prostate is major surgery. It comes with the same side effects. Why would you do that to yourself.

    My Urologist does maybe 3 to 5 Turps a year because there are so many other procedures that have less side effects. Ans he considers it a last resort treatment.

    He did 2 last month to take care of the damage that the Rezum procedure did to these guys. The damage tissue had to be removed. They went for the Rezum procedure for BPH so they would not have to have a Turp and deal with the side effects but ended up having one anyway.

  • centralPA
    centralPA Member Posts: 322 Member
    edited October 2022 #16
    https://csn.cancer.org/discussion/comment/1700903#Comment_1700903

    @way1955 , I agree no man should have to go through two major surgeries. A HoLEP or TURP or Green Light followed by an RP would not be good. But if the BPH surgery can eliminate the need for an RP by making RT suitable, all the better.

    @summer99 's husband is having a heck of a time with his Green Light recovery, though. It's not risk free.

  • summer99
    summer99 Member Posts: 8 Member
    #17

    Thanks to all for your comments. Sorry I wasn't able to respond it sooner.

    My husband had urinary blockage after the GreenLight Laser procedure. It is all over now. He is in recovery mode but it was a very stressful month to say the least.

    With hindsight we are not sure if we should have done a 2nd opinion before the procedure. But the reason behind it was that my husband is very easy to bleed for any type of surgery so he decided to go for RT + ADT for his PCa. RO suggested urinary flow improvement before RT. My husband tried a couple of oral medications prescribed by his urologist but none was well tolerated. That's why the GreenLight Laser procedure was recommended. Since it was "Laser" and supposed to be "bleeding friendly" my husband went for it without much hesitation. Obviously we have learned the lesson and will be very careful about the future treatments in this PCa journey.  

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