Salvage radical prostatectomy for prostate cancer recurrenceSalvage radical prostatectomy after radiation therapy has failed has really only gained favor in recent years. This is because it has historically been associated with a high incidence of side effects and even the risk of death.While that seems to be slowly changing, this is still not a surgery that an average surgeon can perform. It requires the utmost skill and training. If you and your loved one are considering this option, it is imperative that you find a surgeon who not only has extensive experience in this technique, but also has a solid history of successful outcomes. Generally, this is a treatment option when doctors believe the cancer is still localized, which means it has not spread beyond the prostate gland. The challenge with this procedure is that the tissues that surround the prostate gland have undergone substantial damage from radiation. This makes it harder for the surgeon to see and cut out all of the areas that need to be removed. It may also prevent the surgeon from being able to perform a nerve-sparing procedure. Two large scale studies have demonstrated 10-year survival rates of 65% to 73% with this surgery. While it has been reported that the complication rates are similar to that of traditional radical prostatectomy, the rate of long-lasting or permanent incontinence is reported to be between 50% and 96%, depending on the type of previous radiation therapy. In another study of 41 men, the rates of incontinence and impotence were reported to be moderately higher a year after this prostate cancer surgery was performed, as compared to first-line surgery. An estimated 20% of men will require a cystoprostatectomy (which involves removal of the prostate gland and the bladder) in order for the surgeon to remove all the cancer. Seabra et al concluded from their study of 42 men who underwent salvage radical prostatectomy that it should only be offered to men who are more concerned about survival rather than quality of life. As with any prostate cancer treatment, make sure that you and your loved one thoroughly discuss all of the pros and cons of treatment with his doctor before you make a decision. Updated 10/11 Search Our Site  Custom Search Back to if cancer returns Salvage radiation Salvage cryotherapy Hormone treatment Chemotherapy Watchful waiting (or active surveillance) Return from salvage radical prostatectomy to homepage References: Bianco FJ, Scardino PT, Stephenson AJ, Diblasio CJ, Fearn PA, Eastham JA. Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy. Int J Radiat Oncol Biol Phys.;62(2):448-53. Heidenreich A, Thüer D, Pfister D. Salvage radical prostatectomy. Panminerva Med. 2010 Sep;52(3):231-8. Moul JW, Banez LL, Freedland SJ. Rising PSA in nonmetastatic prostate cancer. Oncology. 2007;21(12):1436-1454. Seabra D, Faria E, Dauster B, Rodrigues G, Fava G. Critical analysis of salvage radical prostatectomy in the management of radioresistant prostate cancer. Int Braz J Urol. 2009;35(1):43-8. Ward JF, Pagliaro LC, Pisters LL. Salvage therapy for radiorecurrent prostate cancer. Curr Probl Cancer. 2008;32(6):242-71.
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