So, you’ve been diagnosed with localized prostate cancer and are considering surgery or radiation. You’re ready to move forward, having navigated PSA tests and come to terms with your diagnosis. You’ve researched your options and created a treatment plan with your doctor. You are looking ahead to recovery and getting back to your life.
Then, a global health situation arises, causing delays.
Across many hospitals, non-emergency procedures, including prostate cancer treatments, might be postponed. This can understandably cause stress and worry, making you feel like the cancer is progressing rapidly.
It’s important to understand that a short delay will not jeopardize your chance of a cure. Let’s take a moment to consider this calmly:
Firstly, immediate surgery for localized prostate cancer is never the standard practice. There’s always a necessary waiting period. This is because your prostate needs time to heal after the biopsy. The biopsy procedure creates tiny punctures, weakening the tissue, much like perforated paper. Operating on a prostate in this state increases the risk of tearing, making surgical removal more challenging. Furthermore, the biopsy causes inflammation, which can affect how the prostate responds to radiation and complicates surgery. Swelling and tissue adherence to the rectum – common and temporary post-biopsy effects – can also increase the risk of surgeons inadvertently leaving cancer cells behind. The inflammation and punctures need time to heal properly. Therefore, a minimum of 6 to 8 weeks after the biopsy is typically required before surgery or radiation can be administered.
“Close-up microscopic view of prostate cancer cells, illustrating cellular detail relevant to prostate cancer diagnosis and treatment planning.“
Dr. Patrick Walsh, a renowned urologist from Johns Hopkins, explains, “We have studied hundreds of patients who underwent surgery and evaluated the delay between diagnosis and cure. With long follow-up, we found no significant difference in the 10-year cancer control rates of these men.” This is very reassuring. “There is no immediate urgency to perform surgery after you are diagnosed with prostate cancer, especially if you have stage T1c disease and a biopsy Gleason score lower than 7.” This highlights that for many, especially those with early-stage prostate cancer, a slight delay is not detrimental.
Secondly, all the positive statistics you’ve seen about prostate cancer cure rates already account for typical waiting times. The men included in those statistics generally waited weeks or months for treatment and still achieved excellent outcomes. Many men undergo repeat biopsies, seek second opinions, and take time to process their diagnosis. Despite these delays, their cancer was successfully treated. If your diagnosis was prompted by a PSA level change, there’s more encouraging news: PSA screening provides a significant 5- to 10-year head start in diagnosis. Historically, prostate cancer was often diagnosed only when it was large enough to be felt during an exam or when symptoms appeared. Early detection through PSA screening means you are already ahead in the treatment timeline.
“Doctor explaining prostate cancer diagnosis and treatment options, emphasizing patient education and shared decision-making in prostate cancer care.“
Thirdly, the average prostate tumor has been developing for years by the time of diagnosis. Prostate cancer typically grows very slowly within the prostate gland. It has a slow doubling time. Even in cases of aggressive cancer requiring prompt treatment, remember that it has likely been present and developing for a considerable period. It’s not going to suddenly progress rapidly in the next few weeks. You are on track to receive treatment; the timing is just slightly adjusted.
Two additional factors to consider: Stress negatively impacts prostate health. You can learn more about this connection here. Anxiety about treatment delays is counterproductive. Finally, if you are overweight, this brief waiting period can be used to your advantage to lose weight. The prostate’s location deep in the pelvis makes it somewhat challenging to access, even under optimal conditions. Excess belly fat can further complicate surgery, potentially impacting the surgeon’s ability to perform a precise cancer operation, preserve urinary continence, and maintain erectile function.
“Infographic illustrating obesity and surgical challenges, highlighting the impact of excess weight on prostate surgery outcomes and recovery.“
Dr. Edward Schaeffer, director of urology at Northwestern University, advises, “The best advice I can give an overweight man seeking radical prostatectomy is to lose weight through a healthy program of diet and exercise.” For severely overweight individuals, robotic surgery becomes significantly more complex and should only be performed by highly experienced surgeons. In men with morbid obesity, anesthesiologists may face difficulties ventilating the lungs due to abdominal weight pressing on the diaphragm. If you are overweight, utilizing this time to improve your diet and exercise habits is beneficial, in addition to ensuring you choose a surgeon with extensive experience. For broader wellness guidance, download our wellness guide and revisit PCF.org for more resources.
It’s important to note that not all prostate cancer is localized, and some cases require immediate treatment. If you believe your situation is urgent, discuss your concerns and options with your doctor. Exploring alternative medical centers that can provide quicker treatment, possibly within driving distance, might be an option. If you are currently undergoing radiation or chemotherapy, treatment postponement may not be feasible. Your healthcare team is dedicated to continuing your cancer care while prioritizing your safety from infection. Don’t hesitate to ask questions and voice your concerns.
