Castration for prostate cancer benefits and harms

Is there a need for surgical castration for prostate cancer

One of the types of surgical intervention in the treatment of prostate cancer is orchidectomy (from the Greek qwir - testicle) or castration. This operation is part of hormone therapy. It is aimed at a radical decrease in the level of testosterone in the body of a man, and, consequently, slowing down the growth of the tumor. Without this hormone, up to 90% of which is produced in the testicles, Prostate cancer cells are unable to continue growing at the same rate.

Tumor dependence on testosterone and two modes of action

Prostate cancer still has an unusually high mortality rate. And the earlier the disease is detected, the higher the probability, if not a complete cure, then at least a noticeable prolongation of the patient's life.

In a healthy male, prostate growth is regulated and stimulated by testosterone. As long as its amount is normal, this hormone does not pose any danger. But as soon as the hormonal background is disturbed and an excess of testosterone appears, the risk of developing prostate cancer increases many times over. An excess amount of the hormone causes prostate cells to divide uncontrollably, turning into a malignant tumor. It is possible to significantly slow down or even stop the growth of a neoplasm by depriving it of nourishment. This is achieved by removing the source of testosterone - the testicles. In other words, castration.

There is a chemical or drug castration, when the function of testosterone production is blocked by the use of special preparations (a noticeable effect is observed approximately three weeks after the start of treatment). This method has an undeniable plus - the reversibility of the procedure. After stopping the medication, the functioning of the testicles is restored.

However, with prostate cancer, surgical castration has become more common. Despite its irreversibility, such an operation has a much greater and faster effect (the amount of hormone in the blood drops after 12 hours) than the drug method. Statistical studies conducted show that with chemical exposure, the life of a cancer patient is extended by six to six and a half years, and with the physical removal of the testicles, this period increases by another year. In addition, the cost of the surgeon's services will be much cheaper. A significant obstacle in choosing surgical castration is a psychological barrier, which for many men becomes difficult to overcome.

Types of orchiectomy and concomitant treatment

Surgical castration can be performed on patients diagnosed with prostate cancer at all stages of the disease. The operation is unilateral or bilateral, when one or both testicles are removed, respectively. The procedure is carried out under general, epidural or local anesthesia at the discretion of the doctor and depending on the condition of the patient.

In case of early stage cancer (1 or 2) and in the case when the tumor affects only the prostate, medical intervention may be limited to orchiectomy only. In the later stages of the disease and / or in the presence of metastases, the removal of the testicles is necessarily accompanied by chemotherapy or radiation therapy.

Preparation

Like any treatment, in general, and the intervention of a surgeon, in particular, surgical castration cannot be performed without a series of preliminary studies and procedures. Before removing the testicles, the patient undergoes the following studies:

• general urinalysis and complete blood count;
• blood biochemistry;
• ECG of the heart;
• fluorography;
• blood is tested for clotting rate;
• blood test for infectious and venereal diseases;
• HIV test.

The results help to assess the general condition of the patient, avoid unnecessary risks during surgery and choose the method of anesthesia. If the surgeon has any doubts, he directs the patient for an additional consultation with a specialized specialist: an endocrinologist, a cardiologist or another. Castration is not carried out until all obstacles and indicators are eliminated.

Medicines given for cancer have dangerous side effects that can be especially detrimental to an orchiectomy patient. The surgeon must know what medications the patient took during the seven days prior to the operation. If necessary, castration is postponed until the body is cleared of unwanted drugs. For the last eight hours before surgery, the patient should not eat or drink.

Operation progress

Surgical castration lasts approximately 20 minutes and does not fall into the category of complex operations. Anesthesia is carried out - local or by the introduction of the drug into the spine (epidural). In rare cases, the condition of a patient with prostate cancer requires the use of general anesthesia.

A 5-centimeter incision is made in the scrotum area, through which the testis, together with the spermatic cord, is pushed outward. Stitching, bandaging and dissection of the ligament descending the testicle is performed. The vas deferens and other elements of the spermatic cord are also tied up and dissected. After that, sutures are applied to the initial incision.

For a better cosmetic effect, a more complex castration technique can be applied, when the protein coat of the testicle is preserved.

Postoperative period

After the removal of the testicles for prostate cancer, the patient spends some time in the surgical department under observation. In most cases, no complications occur, and after the complete withdrawal of anesthesia, the man returns home or continues treatment in his department.

All possible postoperative complications are minor and limited to:

• temperature increase;
• swelling or slight suppuration of the sutures;
• pain at the incision site.

To prevent and overcome them, a course of antibiotics is mandatory. The patient is prohibited from physical activity, and it is recommended to drink plenty of water. If the patient follows all the recommendations, then the postoperative period passes quickly and painlessly.

Consequences of the operation for the male body

Any surgical intervention is stressful for any person. But for a man, the removal of the testicles due to prostate cancer is often a very strong psychological problem. Many patients treat this loss as a serious injury. To overcome this condition, it is recommended to resort to the help of a psychologist. It is important to convince the patient that despite the serious loss, the positive effect of orchiectomy and prolongation of life is much more important.

In addition to psychological problems, a global decline in testosterone levels in men causes loss of muscle mass and can provoke obesity. There is instability in the emotional state, impotence and, of course, infertility.

Prophylactic and cosmetic recommendations after surgery

In the long term, men who have their testicles removed for prostate cancer may experience some dangerous changes. For example, bone density may decrease quite significantly. It is important to identify such problems in time and take preventive measures. To do this, all patients who have undergone treatment for a malignant tumor of the prostate gland are strongly recommended to undergo examinations at least once a year.

Prosthetics can be one way to overcome the psychological consequences of an orchiectomy. Medicine has modern silicone or plastic implants that do not cause a rejection reaction and take root very quickly. After their implantation, the scrotum acquires its natural appearance, and the testicles do not differ at all from the real ones. Such a cosmetic operation is simple and painless, and the psychological effect for the patient is quite significant.

Today, orchiectomy has no alternative in terms of effectiveness in the treatment of prostate cancer.

Surgical castration for prostate cancer

Surgical castration or removal of the testicles is one of the methods of surgical treatment for prostate cancer in men, which is used at a certain stage of the disease.

What does the operation achieve?

Mortality from prostate cancer still occupies a leading position. If the disease is detected at the initial stage, then the probability of its cure is very high, but if we are talking about advanced stages, then procedures aimed at suppressing testosterone production help to slow down the spread of malignant cells.

Malignant formation of the prostate gland occurs as a result of hormonal imbalance in men. Namely, an increase in testosterone in the blood leads to the development of this disease. This hormone in a normal amount stimulates the growth of the prostate gland, and when it is overabundant, it contributes to the development of malignant cells. More than 90% of prostate tumors have been proven to be hormonally sensitive. Therefore, by depriving them of nourishment, we fight the disease.

The production of testosterone occurs in the testicles, therefore, the rapid decline in their performance is one of the ways to treat prostate cancer. Surgical removal of the testicles in men (orchiectomy) helps stop the production of a hormone that stimulates the growth of malignant cells by 95 percent.

The effectiveness of this method of treatment has been proven by numerous studies. If we take into account the statistical data, then the use of a drug method for the treatment of prostate cancer can extend the patient's life to 6.5 years, and orchiectomy increases this figure to 7.5.These results of the study were published in the journal of the National Cancer Institute. At the same time, it should be noted that surgical intervention will cost much less, which is also important.

Steps of the operation

If a man is diagnosed with prostate cancer, then surgical castration is considered the most effective. It is usually prescribed for patients with a type of cancer that is localized only in the prostate area. If metastases are found in other organs, then along with orchiectomy, other methods of treatment (chemo- or radiation therapy) are used. Depending on the stage of development of prostate cancer, both two and one testicle can be removed. Bilateral castration is prescribed at stage 4 of the disease as an additional method to a complex of anti-cancer measures. For local cancer of stages 1 and 2, bilateral orchiectomy can also be prescribed.

The operation itself is simple in its technique.

Removal of the testicles (castration) in men occurs under local or epidural anesthesia, which is selected by doctors.

Preparations

Like any surgical intervention for cancer, castration requires preparatory measures for the patient. Usually their essence lies in a standard set of laboratory tests that help clarify the general condition of the patient, the degree of risk. An additional examination helps determine the method of anesthesia during surgery. If the testicle is to be removed, the man must undergo the following studies:

If necessary, if there are reasons for that, the surgeon can refer the patient for a consultation with a general practitioner, cardiologist, endocrinologist. If the results of the patient's tests do not allow castration, then measures are taken to eliminate the identified factors. And only after the normalization of the indicators, surgical intervention is performed.

For 8 hours before the operation, it is forbidden to eat and drink. It is also very important to report the entire list of drugs that have been used by the patient during the last week. Very often, many of the drugs have side effects, and it may be necessary to postpone surgery until the body is completely cleared.

Performing an operation

In terms of its technique, the operation to remove the testicle in men is quite simple. The patient is given anesthesia. These are usually local anesthetics or an epidural technique. The latter involves the introduction of the drug into the patient's spine. General anesthesia is rarely used.

The surgeon makes an incision about 5 cm in size in the scrotum. Only a section of the skin and subcutaneous tissue is dissected. The testicle and spermatic cord are pushed out into the resulting gap. The surgeon stitches, bandages and cuts the ligament that is responsible for the descent of the testicle. The operation lasts about 20 minutes on average.

The castration itself can be carried out using several techniques. One of them allows you to save the protein shell of the testicle, and this, in turn, gives a better cosmetic result.

Postoperative period

After the operation to remove the testicles, the men are left for a certain time in the surgical department under the supervision of a surgeon and an anesthesiologist. After the anesthesia is removed, the patient can go home or for further treatment. With prostate cancer, castration is one of the ways to stop the development of a malignant tumor. But often one operation is not enough, and chemotherapy and radiation therapy are prescribed. Sometimes doctors prescribe treatment with drugs that completely block the production of the hormone.

Minor complications may occur in the postoperative period:

• increase in body temperature;
• pain in the incision area;
• swelling and suppuration in the area of sutures.

But, if the patient complies with all prescriptions, the healing process is very fast and without complications. In the postoperative period, antibiotic therapy is prescribed. It is also important to drink enough water, avoid physical exertion.

The overall impact of the operation on the condition of the man

The very word "castration" causes panic in most men, which is associated with a negative perception of this word in society. But in most cases, prostate cancer is one of the most effective treatments. And if the attending doctor insists on its implementation, you should listen. For some, it is very difficult to decide on such a step, and even psychological help may be needed. But it is worth remembering the positive aspects of such a surgical intervention.

The operation is less traumatic and takes a little time for rehabilitation. It helps to reduce the level of testosterone in the patient's body as quickly as possible, within 37 hours after the operation, which stops the development of cancer cells and maximizes the positive results from drug treatment of a malignant tumor.

The period of rehabilitation and the possibility of correcting external defects after surgery

It is very important to understand that the patient will completely change the hormonal background in the body. This can lead to deterioration and external changes:

• sudden mood swings;
• tides;
• fluctuations in blood pressure;
• erective dysfunction;
• a significant increase in body weight;
• breast augmentation

Many patients experience a significant decrease in bone density over time.

Therefore, after curing a malignant tumor of the prostate gland, men are recommended to undergo examinations once a year. This will help to notice the problem in time and start the right effective treatment.

After a complete cure for prostate cancer, a man can be offered a cosmetic solution to the problem. This sometimes helps to bypass psychological trauma. Medicine today also conducts a lot of experiments in the field of prosthetics. For this, special implants are used. They are made of materials that, when inserted, quickly take root and are not rejected by the body - silicone or plastic. The implant is inserted into the scrotum and visually the testicles do not differ from the real ones.

Orchiectomy is the most effective treatment for prostate cancer today.

One of the types of surgical intervention in the treatment of prostate cancer is orchidectomy (from the Greek qwir - testicle) or castration. This operation is part of hormone therapy. It is aimed at a radical decrease in the level of testosterone in the body of a man, and, consequently, slowing down the growth of the tumor. Without this hormone, up to 90% of which is produced in the testicles, prostate cancer cells are unable to continue growing at the same rate.

Prostate cancer still has an unusually high mortality rate. And the earlier the disease is detected, the higher the probability, if not a complete cure, then at least a noticeable prolongation of the patient's life.

In a healthy male, prostate growth is regulated and stimulated by testosterone. As long as its amount is normal, this hormone does not pose any danger. But as soon as the hormonal background is disturbed and an excess of testosterone appears, the risk of developing prostate cancer increases many times over. An excess amount of the hormone causes prostate cells to divide uncontrollably, turning into a malignant tumor. It is possible to significantly slow down or even stop the growth of a neoplasm by depriving it of nourishment. This is achieved by removing the source of testosterone - the testicles. In other words, castration.

There is a chemical or drug castration, when the function of testosterone production is blocked by the use of special preparations (a noticeable effect is observed approximately three weeks after the start of treatment). This method has an undeniable plus - the reversibility of the procedure. After stopping the medication, the functioning of the testicles is restored.

However, with prostate cancer, surgical castration has become more common. Despite its irreversibility, such an operation has a much greater and faster effect (the amount of hormone in the blood drops after 12 hours) than the drug method. Statistical studies conducted show that with chemical exposure, the life of a cancer patient is extended by six to six and a half years, and with the physical removal of the testicles, this period increases by another year. In addition, the cost of the surgeon's services will be much cheaper. A significant obstacle in choosing surgical castration is a psychological barrier, which for many men becomes difficult to overcome.

Types of orchiectomy and concomitant treatment

Surgical castration can be performed on patients diagnosed with prostate cancer at all stages of the disease. The operation is unilateral or bilateral, when one or both testicles are removed, respectively. The procedure is carried out under general, epidural or local anesthesia at the discretion of the doctor and depending on the condition of the patient.

In case of early stage cancer (1 or 2) and in the case when the tumor affects only the prostate, medical intervention may be limited to orchiectomy only. In the later stages of the disease and / or in the presence of metastases, the removal of the testicles is necessarily accompanied by chemotherapy or radiation therapy.

Preparation

Like any treatment, in general, and the intervention of a surgeon, in particular, surgical castration cannot be performed without a series of preliminary studies and procedures.Before removing the testicles, the patient undergoes the following studies:

• general urinalysis and complete blood count;
• blood biochemistry;
• ECG of the heart;
• fluorography;
• blood is tested for clotting rate;
• blood test for infectious and venereal diseases;
• HIV test.

The results help to assess the general condition of the patient, avoid unnecessary risks during surgery and choose the method of anesthesia. If the surgeon has any doubts, he directs the patient for an additional consultation with a specialized specialist: an endocrinologist, a cardiologist or another. Castration is not carried out until all obstacles and indicators are eliminated.

Medicines given for cancer have dangerous side effects that can be especially detrimental to an orchiectomy patient. The surgeon must know what medications the patient took during the seven days prior to the operation. If necessary, castration is postponed until the body is cleared of unwanted drugs. For the last eight hours before surgery, the patient should not eat or drink.

A new way to treat prostatitis in 2017 that you don't know about yet! Click for details -

Operation progress

Surgical castration lasts approximately 20 minutes and does not fall into the category of complex operations. Anesthesia is carried out - local or by the introduction of the drug into the spine (epidural). In rare cases, the condition of a patient with prostate cancer requires the use of general anesthesia.

A 5-centimeter incision is made in the scrotum area, through which the testis, together with the spermatic cord, is pushed outward. Stitching, bandaging and dissection of the ligament descending the testicle is performed. The vas deferens and other elements of the spermatic cord are also tied up and dissected. After that, sutures are applied to the initial incision.

For a better cosmetic effect, a more complex castration technique can be applied, when the protein coat of the testicle is preserved.

Postoperative period

After the removal of the testicles for prostate cancer, the patient spends some time in the surgical department under observation. In most cases, no complications occur, and after the complete withdrawal of anesthesia, the man returns home or continues treatment in his department.

All possible postoperative complications are minor and limited to:

• temperature increase;
• swelling or slight suppuration of the sutures;
• pain at the incision site.

To prevent and overcome them, a course of antibiotics is mandatory. The patient is prohibited from physical activity, and it is recommended to drink plenty of water. If the patient follows all the recommendations, then the postoperative period passes quickly and painlessly.

Prostate cancer is a disease in which castration can rarely do without accompanying procedures and prescriptions. In some cases, doctors consider it necessary to use drugs to completely block the production of testosterone. To combat cancer metastases, radiation or chemotherapy is indispensable.

Consequences of the operation for the male body

Any surgical intervention is stressful for any person. But for a man, the removal of the testicles due to prostate cancer is often a very strong psychological problem. Many patients treat this loss as a serious injury. To overcome this condition, it is recommended to resort to the help of a psychologist. It is important to convince the patient that despite the serious loss, the positive effect of orchiectomy and prolongation of life is much more important.

In addition to psychological problems, a global decline in testosterone levels in men causes loss of muscle mass and can provoke obesity. There is instability in the emotional state, impotence and, of course, infertility.

Prophylactic and cosmetic recommendations after surgery

In the long term, men who have their testicles removed for prostate cancer may experience some dangerous changes. For example, bone density may decrease quite significantly. It is important to identify such problems in time and take preventive measures. To do this, all patients who have undergone treatment for a malignant tumor of the prostate gland are strongly recommended to undergo examinations at least once a year.

Prosthetics can be one way to overcome the psychological consequences of an orchiectomy. Medicine has modern silicone or plastic implants that do not cause a rejection reaction and take root very quickly. After their implantation, the scrotum acquires its natural appearance, and the testicles do not differ at all from the real ones.Such a cosmetic operation is simple and painless, and the psychological effect for the patient is quite significant.

Today, orchiectomy has no alternative in terms of effectiveness in the treatment of prostate cancer.

A new way to treat prostatitis in 2017 that you don't know about yet! Click for details -

Castration for prostate cancer

It would seem that medicine has made a huge leap forward over the past few years, but to this day there are diseases that terrify humanity. One such disease is prostate cancer. If the pathology is detected in the initial stages, you can choose gentle, but quite effective methods of treatment, it is much worse when the disease is at an advanced stage.

The sex hormone testosterone is responsible for stimulating the growth of the prostate gland. However, its presence in excess can cause the formation of cancer cells. Reducing the level of sex hormone is one of the effective methods of treating prostate cancer.

Testosterone is produced in the testicles, so removing them helps reduce the growth of damaged cells. The positive result of this method has been scientifically proven and is used in many advanced countries for the successful treatment of cancer.

According to statistics, drug treatment makes it possible to extend the patient's life up to 6 years, but amputation increases this figure up to 8 years. It would seem that the numbers are still negligible, but for a person who is given such a terrible diagnosis as cancer, they are a great opportunity to enjoy life.

During drug treatment, the production of the sex hormone is blocked with special preparations. This method shows positive dynamics already after three weeks of treatment. The disadvantage of such therapy is the reversibility of the process. After the onset of remission, the drugs are stopped, the functionality of the testicles returns to normal and the cancer cells begin to develop again.

In medical practice, there have been cases when the period of remission in patients was quite long, but in most cases the patient has to start treatment again. In addition, drug treatment is quite expensive, so doctors strongly advise patients to Castration for prostate cancer.

After amputation of the testicles, testosterone levels instantly drop. A decrease in performance can be seen after 12 hours, rather than when taking testosterone-blocking drugs. However, a big obstacle in choosing this method of treatment is the psychological state of the man. Not everyone can overcome such a difficult barrier for him, so much attention is paid to psychotherapeutic measures.

Castration for prostate cancer can be performed at all stages of the disease. Depending on the lesion with cancer cells, one or both testicles are amputated. Surgical measures are performed under local anesthesia. If the patient has chronic diseases, the anesthesiologist decides to perform the operation under epidural anesthesia, the principle of which is to administer an anesthetic between the lumbar vertebrae.

If a patient has stage 1-2 cancer or only prostate cancer, specialists limit themselves to one amputation. In the treatment of later stages with metastasis, chemotherapy is additionally used.

Preparation

The operation is not difficult and is completed within 20-30 minutes. Nevertheless, it is still considered a surgical intervention in the work of the male body and requires certain preparatory measures.

The following examinations are assigned to the patient:

• general analysis of urine and blood;
• blood for RW, HIV and hepatitis;
• cardiogram of the heart;
• fluorography;
• biochemical blood test;
• blood clotting level.

According to these studies, specialists choose the type of anesthesia, determine the possible risks that may arise during the operation. If a patient has endocrine or cardiovascular diseases, a consultation with a cardiologist, neurologist, endocrinologist or therapist is scheduled.

As we said earlier, the operation is quite simple, so difficulties may arise due to the psychological state of the man. Before using the anesthetic, the specialist may inject an agent to cope with the patient's nervousness.

During the operation, an andrologist surgeon makes an incision in the scrotum. The length of the incision does not exceed 5 cm. The spermatic cord and testicle are pulled out through this incision. Then the bandaging and dissection of the ligament responsible for lowering the testicle is performed. After all surgical procedures, a suture is applied to the incision.

To create the best cosmetic effect, a specialist can perform more complex measures, which consist in preserving the protein coat of the testicle.

After the operation, the patient stays in the department for several days. If he quickly recovers, then he is discharged. Then begins a long period of rehabilitation and continued treatment on an outpatient basis.

Consequences

After the operation, the following complications are possible:

• temperature may rise;
• slight suppuration is formed;
• pain appears.

To prevent all these complications, the doctor prescribes antibiotics, anti-inflammatory, painkillers and sedatives. For several weeks, the patient is completely forbidden to play sports and physical labor.

After the operation, the patient may become obese or, conversely, lose weight.

To prevent depression and depression of the patient associated with the loss of his sexual functions, a psychologist is prescribed. It is important for the specialist to convince the patient that despite the loss of the genitals, his life is much more important and valuable. After an orchiectomy, the patient must undergo an examination every year.

To overcome psychological barriers, the patient is recommended a set of measures for prosthetics. Today, medicine offers a lot of methods for shaping the natural appearance of the scrotum and testicles. Implants take root quickly and do not differ from real ones at all.