Overview: Removal of the prostate, or radical prostatectomy, significantly increases the odds of surviving prostate cancer. However, the overall low fatality risk from prostate cancer, the risks built into any surgery, and the potential side effects of the procedure, such as erectile dysfunction (ED), will generally preclude removing the entire prostate except for extremely advanced cancers.
Does Removing the Prostate Shorten Life Expectancy for Men?
We’re not sure where this myth came from, but there’s simply no truth to it. That said, there is conflicting research on whether men may actually live longer.
According to a ten-year study of patients from 1989 and 1998, 83 percent of otherwise healthy men who underwent the surgery were still alive ten years later. Another study found that men gained three years of life after having a radical prostatectomy.
We should also note that in that same ten-year study, 75% of men who underwent radiotherapy were alive ten years later, and 72% of men who simply monitored their condition were alive as well. This may make doctors hesitant to recommend a partial or radical prostatectomy, as it may not improve a patient’s life expectancy. But there is absolutely no evidence that the surgery will shorten it.
The Risks of Prostatectomy
Surgery, especially prolonged surgery, always has a degree of risk for the patient, which doctors will consider before recommending it. This is especially true of older patients, and 60% of prostate cancer diagnoses are in men 65 and older. And unless prostate cancer spreads, patients have an almost 100% chance of surviving five years after diagnosis.
Another consideration is the term “otherwise healthy.” If a patient has heart disease, diabetes, or other conditions that need to be actively managed or are a greater risk to their health, doctors are more likely to consider monitoring the cancer while actively treating the other conditions.
Finally, there are the side effects to consider. Prostatectomy has a high risk of causing both urinary incontinence and erectile dysfunction, due to the risk of damage to sensitive nerves and tissues that surround the area.
In short, unless there’s a clear danger to your life, a doctor is unlikely to recommend a prostatectomy. If they do, though, it will be a question of managing the symptoms.
ED After Prostatectomy
If you do undergo surgery, first you’ll need to heal and get a sense of any possible changes to your body. Though up to 85% of men will have erectile dysfunction (ED) following radical prostatectomy, some men never experience it.
If you do find you’re experiencing a degree of ED, first discuss it with a doctor. In many cases, the body simply needs to heal and you’ll recover function over time, generally within a year.
As you heal, you should talk about ED treatment with a medical professional. Medication, in particular, can be effective in restoring blood flow to the penis. Generally this will be an oral medication, and recent research found Viagra to be the best treatment for ED following prostate surgery. If you are one of the few who can’t take Viagra or other ED medications, injectable versions also have a good success rate.
Finally, take care of your emotional health. Any surgery is going to have an impact on your mental health, so working with your partner, support groups, and other resources can help you manage those effects and stay healthy after surgery.
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Dan is a long-time freelance writer focusing on technology, science, health, and medicine, with a lifelong interest in physics, biology, and medicine. His work has taken a particular focus on scientific studies “beyond the headlines,” reading the study to more closely examine the results.