Transurethral Resection of the Prostate (TURP) is a surgical procedure often performed to address issues within the prostate gland. Many individuals wonder if TURP could inadvertently spread prostate cancer if it is present. This article clarifies these concerns, examining the evidence and precautions taken in modern medical practice.
Understanding Transurethral Resection of the Prostate
TURP is a surgical procedure designed to alleviate symptoms caused by an enlarged prostate gland. The prostate gland, located below the bladder and surrounding the urethra, can enlarge with age, a condition often referred to as Benign Prostatic Hyperplasia (BPH). This growth can press on the urethra, making urination difficult or frequent.
During TURP, a surgeon inserts a resectoscope through the urethra to reach the prostate. This instrument uses an electric current or laser to remove excess prostate tissue, which is then flushed into the bladder and drained. While primarily used for BPH, TURP can also relieve urinary symptoms caused by prostate cancer, particularly when other treatments are not suitable.
Can TURP Spread Prostate Cancer?
The concern about TURP spreading prostate cancer stems from the theoretical possibility of cancer cells being dislodged and disseminated during surgical removal of prostate tissue. This concept, sometimes referred to as “seeding,” suggests microscopic cancer cells could potentially travel through the bloodstream or lymphatic system. Historically, this worry led to debates regarding the procedure’s safety in the presence of undetected cancer.
Current medical consensus and extensive research indicate that the risk of TURP spreading clinically significant prostate cancer is extremely low. While it is theoretically possible for some microscopic cancer cells to be released, the body’s natural immune defenses and the biological behavior of prostate cancer typically prevent these cells from establishing new, widespread tumors. Studies have shown that progression and mortality outcomes for prostate cancer patients who undergo TURP for symptom relief are similar to those who do not have the procedure, provided the cancer’s pathological stage is known. The benefits of TURP for improving urinary symptoms generally outweigh this minimal theoretical risk.
Minimizing Risks and the Importance of Diagnosis
Medical professionals employ several measures to minimize potential risks associated with TURP, particularly concerning prostate cancer. A thorough pre-operative diagnostic work-up is standard practice before TURP, especially if prostate cancer is suspected. This assessment often includes a Prostate-Specific Antigen (PSA) blood test. If PSA levels are elevated or other signs suggest cancer, a prostate biopsy may be performed.
A biopsy involves taking small tissue samples from the prostate for microscopic examination to confirm the presence and aggressiveness of any cancer. Pre-biopsy MRI scans can also provide valuable information for assessing prostate cancer before TURP. After the TURP, pathological analysis of the removed prostate tissue is routinely conducted. This analysis can reveal previously undiagnosed prostate cancer, known as incidental prostate cancer, allowing for appropriate follow-up and treatment planning. Modern surgical techniques are also designed to reduce tissue trauma and the potential for cell dissemination during the procedure.