Surgical treatment of carcinoma of the prostate

Prostatic cancer kills more men than any other malignant condition except that arising from the lung. "Cancer Therapy: Prognostic Factors and Criteria of Response" predicted that there would be approximately 17 500 deaths due to this disease in the United States in 1978. Surgery is only applicable in stages A and B, when the tumour, as shown by various tests, such as measurement of the acid phosphatase value, technetium scanning and radioimmunoassay, is confined to the prostate. Ideally, the lymph glands along the iliac and obturator vessels should first be removed and quick-sectioned. If malignant cells are found in the lymph glands, the disease is considered surgically incurable and the procedure should be abandoned. If, however, the glands are disease free, a total prostatovesiculectomy should be carried out. The author also discusses the place of palliative surgery, such as transurethral resection, in the treatment of cancer of the prostate.