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Can anesthesia affect the recurrence of prostate cancer?

Your urologist Des Moines Dr. Fawad Zafar has learned from a recent study that for men having surgery for prostate cancer, the type of anesthesia used might make a difference in the chance of the cancer returning.

Researchers found that of the over 3,000 men who had prostate cancer surgery, those who were given both general and regional anesthesia enjoyed a lower risk of their cancer progressing than men who received only general anesthesia.

Over a period of 15 years, almost 5 percent of the patients who were given only general anesthesia had their cancer return in their bones or other places. That compared with 3 percent of men who also received regional anesthesia (typically a spinal injection of morphine, along with a numbing agent).

According to your urologist Des Moines, one theory is that spinal painkillers can make a difference because they curb the patient’s need for opioid drugs following surgery. These opioids affect the whole body and can decrease the immune system’s effectiveness.

That could be important because during prostate cancer surgery, some cancer cells usually escape into the bloodstream, and a fully functioning immune response might be needed to destroy them.

Today, the surgery is almost always done laparoscopically by your urologist Des Moines with the aid of robotic “arms.” Compared with traditional open surgery, laparoscopic surgery is faster and creates less stress, blood loss and post-surgery pain. (It should be noted that the men in this study all had open surgery to remove their prostate gland so it’s not clear whether the current findings extend to men having laparoscopic surgery.

The researchers also weighed other factors, such as the stage of the cancer and whether the patient received radiation or hormone therapy following the surgery. In the end, having general anesthesia alone was linked to a nearly 30 percent higher risk of a cancer recurring in distant sites in the body over the next 15 years.

Studies have found that prostate cancer patients treated by more experienced surgeons – such as your urologist Des Moines Dr. Fawad Zafar – tend to have a lower risk of recurrence and have lower rates of lasting side effects, such as erectile dysfunction and urinary incontinence.

To determine if regional anesthesia directly affects cancer patients’ prognosis, more controlled studies, which means randomly assigning some surgery patients to have general anesthesia only, while others get regional anesthesia as well, may be needed.  But for now, the decision about whether to use a spinal painkiller during surgery should be based on other factors, such as its potential to limit pain post-surgery.

 

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