- With Mayo Clinic urologist
Erik Castle, M.D.
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Erik Castle, M.D.
Erik Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancer.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is president of the international Society of Urologic Robotic Surgeons. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
Risk factors (2)
- Flaxseed: Does it affect risk of prostate cancer?
- Vasectomy: Does it increase my risk of prostate cancer?
Tests and diagnosis (2)
- Prostate cancer: Does PSA level affect prognosis?
- Watchful waiting and prostate cancer: What does it mean?
Complications (1)
- Prostate cancer: Can it spread to the pancreas?
Treatments and drugs (3)
- Prostate cancer brachytherapy: Can I pass radiation to others?
- Prostate cancer treatment: Is prostatectomy possible if brachytherapy fails?
- Ginger for chemotherapy-induced nausea: Does it work?
Alternative medicine (1)
- Pomegranate juice: A cure for prostate cancer?
Prevention (2)
- Prostate cancer vaccine: Is it available?
- Frequent sex: Does it protect against prostate cancer?
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Question
Prostate cancer treatment: Is prostatectomy possible if brachytherapy fails?
My husband is considering radioactive seed implants (brachytherapy) to treat his prostate cancer. We've heard that if this treatment isn't effective, he can't have a radical prostatectomy later. Is this true?
Answer
from Erik Castle, M.D.
Prostate surgery after brachytherapy (salvage prostatectomy) is only performed in certain cases due to the significantly increased risk of fecal and urinary incontinence. Although the surgery can be performed at specialized centers, it is often an option of last resort as determined on a case-by-case basis. In general, prostatectomy is not an option for men with previous brachytherapy, as other treatments may be tried before a salvage prostatectomy.
Radioactive seed implants (brachytherapy) deliver radiation internally by implanting small, rice-sized radioactive pellets directly into the prostate. Potential complications of surgery on a man who's had radioactive seed implants may include:
- Impotence
- Incontinence
- Injury to the rectum
- Failure to heal
Selecting the right treatment for prostate cancer depends on many factors, including your husband's overall health, his age, the aggressiveness of his prostate cancer, and how he feels about the potential side effects. Treatment options include radiation therapy (either through an external beam or radioactive seed implants), surgery, hormone therapy and watchful waiting. Talk to your husband's doctor about the pros and cons of each treatment option before making a decision.
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