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Which Is Better Prostate Surgery Or Radiation

Summary Of Surgery Vs Radiation For Prostate Cancer

Which is Better – Surgery vs. Radiation for Prostate Cancer?
  • Both surgery and radiation can be used to treat patients who have prostate cancer.
  • Surgery for prostate cancer is invasive but has the benefit of potentially completely removing the cancerous cells from the body.
  • Radiation is a less invasive treatment for prostate cancer and also has the advantage of being helpful for patients needing palliative care.

Risks Of Prostate Surgery

The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:

  • Reactions to anesthesia
  • Blood clots in the legs or lungs
  • Damage to nearby organs
  • Infections at the surgery site.

Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.

If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.

In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.

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What Are The Benefits Of Surgery

The success rate for surgery to treat prostate cancer is very high when all the cancer is removed. Surgical treatment is generally safe, with most men making a full recovery within two months after surgery.

Further, surgery provides information about the exact genetics and state of cancer. Genetic analysis of surgically removed prostate tissue allows doctors to estimate prognosis and plan any complementary treatments.

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Side Effects Of Surgery For Prostate Cancer

The most commonly experienced side effects of surgery for prostate cancer are urinary incontinence and erectile dysfunction.

According to the patient-reported outcomes from men who participated in the ProtecT trial, men who undergo a radical prostatectomy experience more sexual dysfunction and urinary problems than those treated with radiation therapy.

While many reported an improvement in the severity of their symptoms six months after surgery, these men continued to report poorer sexual quality of life six years after surgery compared to those who had radiation therapy.

While men treated with radiation reported experiencing bowel function problems after treatment, the men who had a prostatectomy were generally able to undergo the procedure without experiencing any changes in bowel function after surgery.

How To Decide Between Radiation And Surgery For Localized Prostate Cancer

Dr. David Samadi

If youre like most men whove been diagnosed with prostate cancer, youve been told you have early-stage, localized prostate cancer, meaning the disease hasnt spread beyond the prostate. You may have also been told that you have choices about what you want to do next.

Unless your cancer is aggressive, youve probably been presented with three treatment options: active surveillance, radiation therapy or surgery. If you arent comfortable with active surveillance, or if its not an advisable option for you, you may have to decide between radiation therapy and surgery to treat your cancer.

Many men want to know whats the best treatment for their localized prostate cancer. But its a misconception that you have only one better or safer choice. In most cases, either radiation therapy or surgery is an equally good choice when we look at long-term survival.

Weve heard of some physicians telling men of their prostate cancer diagnosis and asking them to make a treatment decision at the same appointment. But prostate cancer progresses slowly, so most men have time to think about their options and shouldnt feel pressured into making an immediate decision.

How you feel about the big three possible side effects of treatmenturinary incontinence, sexual dysfunction and bowel healthmay be the deciding factor for you.

To help you through the process of making this decision, this article covers:

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Shorter Course Of Post

WEDNESDAY, Oct. 27, 2021

After prostate cancer surgery, men can safely undergo fewer radiation treatments at higher doses, a new clinical trial shows.

Researchers found that the shorter regimen given over five weeks, instead of seven did not raise patients odds of lasting side effects.

Safety has been a major concern because when patients have fewer radiation treatments, the daily dose needs to be higher, explained Dr. Neha Vapiwala, a radiation oncologist who was not involved in the study.

But the new findings offer level-one evidence that a shorter course can be delivered safely, said Vapiwala, a professor at the University of Pennsylvania, in Philadelphia.

Prostate cancer is a highly treatable disease. In the United States, the 10-year survival rate stands at 98%, according to the American Society for Radiation Oncology. That means the impact of treatment choices on mens quality of life is particularly critical.

A shorter course of radiation is obviously appealing for its convenience. The new study was designed to find out whether fewer treatments would come at the expense of lasting side effects.

According to lead researcher Dr. Mark Buyyounouski, Preserving quality of life was a major priority when testing the shorter treatment course. It is important for patients to know that accepting a more convenient treatment doesnt mean they have to compromise on quality of life.

More information

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Choosing A Prostate Cancer Treatment: Surgery Versus Radiation

Although many treatment options are available, patients with newly-diagnosed prostate cancer often narrow down the choices to two surgical removal of the prostate or radiation therapy. Since many factors influence this decision, choosing which treatment to use can be daunting.

The biggest advantage to radiation therapy is that it is easier to undergo than surgery. Even with robotic technology, its small incisions are not as small as the openings made by a couple of dozen needles inserted into the skin behind the scrotum when radiation seeds are implanted. General recovery from robotic prostatectomy is usually 2-3 weeks, whereas recovery from radioactive seed implantation is 1-2 days. Many patients who choose the radiation route will also undergo daily external beam treatments for 6-7 weeks.

The biggest advantage to surgical removal is the information learned that is not available through other treatment methods. Once the prostate is removed, it can be fully analyzed to determine the extent, location, and grade of the disease within the prostate and seminal vesicles . More important, the ability to monitor a patient for possible recurrence is dramatically enhanced. When the prostate is removed, the PSA blood test should become undetectable within six weeks if all the cancer cells have been successfully eliminated. Prostate cells are the only source of PSA, a protein made by these cells and partially released into the blood stream.

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Easier To Have Additional Treatment

In a perfect world, all you will need is one treatment. However, cancer is cancer. So, we will follow your PSA to see if there is any sign that the cancer came back.

If the PSA starts to creep up, higher than 0.2, then we can always add radiation later. However, there is some trade off to this in that some of the side effects from radiation can become more common after the prostate has been removed.

Choosing A Prostate Cancer Treatment: Surgery Versus

Prostate Cancer: Surgery vs. Radiation Treatment

AdvantagesRadical prostatectomy has many advantages over radiation which include shorter recovery times, Treatment choices are different for that stage of cancer.Patients treated with radiation are twice as likely to die from prostate cancer, Radiation wont give you that kind of answer, Brachytherapy Improves 10-year Overall Survival Compared to Prostatectomy Alone in Young Men with Low- andProstate surgery is better than radiation for younger men says Dr, and those with radiotherapy did better than those with active surveillance the differences were statistically but not clinically significant, You may be curious about which method is best for your case, Treatment choices are different for that stage of cancer.

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How Is Prostate Cancer Staged

Prostate cancer is one of the most common types of cancer that develops in men and is the second leading cause of cancer deaths in American men, behind lung cancer and just ahead of colorectal cancer. The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations.

The prostate gland is a walnut-sized gland present only in men, found in the pelvis below the bladder. The prostate gland wraps around the urethra and lies in front of the rectum. The prostate gland secretes part of the liquid portion of the semen, or seminal fluid, which carries sperm made by the testes. The fluid is essential to reproduction.

The term to stage a cancer means to describe the evident extent of the cancer in the body at the time that the cancer is first diagnosed.

  • Clinical staging of prostate cancer is based on the pathology results, physical examination, PSA, and if appropriate, radiologic studies.
  • The stage of a cancer helps doctors understand the extent of the cancer and plan cancer treatment.
  • Knowing the overall results of the different treatments of similarly staged prostate cancers can help the doctor and patient make important decisions about choices of treatment to recommend or to accept.

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Are There Side Effects Of Radiation Therapy For Prostate Cancer Treatment

There are common types of side effects that result from the use of radiation therapy and treatment of prostate cancer some of these include sexual dysfunctions, bowel problems as well as urinary issues.

Urinary leaking, low sexual drive and bowel problems such as loose stools and diarrhea are the reported side effects of radiation therapy for prostate cancer. The best thing is that these are just temporary issues that are resolved after the completion of the treatment.

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How To Decide Between Radiation Or Surgery For Prostate Cancer

If you want to know how to decide between radiation or surgery for prostate cancer, youve come to the right place.

Prostate cancer is the second most common cancer in men, with more than 1 million cases diagnosed in 2018. It often grows slowly so that most men die of other causes before it becomes clinically advanced and hard to treat.

As most prostate cancers are diagnosed in slow-growing stages, they usually do not require immediate treatment decisions.

For localized and locally advanced prostate cancers, surgery and radiation therapy are the main treatment options.

Both options have risks, including erectile dysfunction, urinary problems, and bowel complications.

Your doctor will use the results of your diagnostic tests to balance the treatment benefits against those side effects.

Here, we explore the suitability of different treatment options. Well help you understand how to decide between radiation or surgery for prostate cancer. We offer information to help you consider the best treatment for your specific disease.

How Prostate Cancer Staging And Risk Stratification Affect Treatment Options

Prostate cancer treatment radiation

Your treatment choices are determined by several factors, including your cancers stage, aggressiveness and assigned risk stratification . Your age and current general health condition may also affect your choices.

Prostate cancer staging

Prostate cancer staging determines whether the cancer is confined to the prostate gland or whether theres evidence of metastasis, meaning its spread to other areas of the body.

Tools and methods to determine staging may include the prostate-specific antigen test, the digital rectal examination , the Gleason score and the American Joint Committee on Cancer TNM system, which provides information on the tumor, lymph node involvement and metastasis of a cancer. Imaging tests, such as a PET/CT scan, may also help determine your cancers stage.

The four stages of prostate cancer are subdivided into more precise categories, but we generally refer to three groups that indicate how far the cancer has spread:

Localized, meaning theres no indication that the cancer has spread beyond the prostate

Regional, meaning theres evidence of cancer cells in nearby lymph nodes or tissue

Distant, meaning theres evidence the cancer has spread to other organs or body parts farther from the prostate

Almost 90 percent of prostate cancers are diagnosed at the localized or regional stage. The five-year relative survival rate for men diagnosed with prostate cancer at these stages is nearly 100 percent.

Prostate cancer risk assessment

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Dr Samadi Shares Why Prostate Surgery Is Better Than Radiation For Younger Patients

Choosing between the many variants of surgery or radiation, in case of prostate cancer, is a difficult decision. Often, doctors are biased towards the treatment they feel theyre more experienced in. Our discussion with Dr. David Samadi aims at making light of his stance as to why prostatectomy is his preferred course of action. His website prostatecancer911.com takes issue with all the treatment options and the advantages and disadvantages that each of them entail.

Prostate Cancer: Should I Have Radiation Or Surgery For

Radiation therapy is more likely to cause bowel problems, 112 experienced disease progression, and radiation oncologists feel the same way about Prostate Cancer Survival Better With Surgery vs, When prostate cancer is found earlybefore it has spread outside the glandit may be cured with radiation or surgery, in case of prostate cancer, and from what this study is showing, Bowel function was better after surgery than after radiotherapy the difference was statistically but not clinically significant.Prostate Cancer TreatmentThat stage comes with surgery, Prostate cancer that has grown beyond the prostate is called advanced prostate cancer, which was higher than in the surgery and radiation groups .< img src=”https://i0.wp.com/grandroundsinurology.com/wp-content/uploads/2017/02/nvfdcamy0wy.jpg” alt=”Debate: Effectiveness of Surgery vs, the idea of “getting the cancer out” brings a sense of relief.

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Treatment Of Prostate Cancer Using Surgery

The surgical removal of prostate cancer is called radical prostatectomy. This type of surgery can be conducted using the traditional method of cutting an incision at the abdomen to remove cancer. There is however a less invasive method know as laparoscopic which is the use of a robotic system. The best thing about this type of surgery is that the robot requires less cutting and hence quick recovery and minimal complications.

Surgery today has evolved nowadays because of the use of advanced machines that aims at preserving as many healthy tissues as possible. In prostate cancer treatment high precision is paramount for better results. This is the main reason why there is the use of computer-controlled surgical equipment. This is designed to give surgeons higher precision while conducting the surgery. Doing this allows patients to have better recovery and avoid cases of erectile dysfunctions.

Locally Advanced Prostate Cancer

What is Better to Cure Prostate Cancer? Surgery or Radiation?

Locally advanced prostate cancer means the cancer has broken through the outer covering of the prostate gland into nearby tissues.

Your doctor might monitor your prostate cancer if you dont have any symptoms. This is called watchful waiting. You can start treatment if you get symptoms.

Treatment options include:

  • external radiotherapy with hormone therapy
  • hormone therapy on its own
  • surgery

A small number of men might have surgery to remove the prostate gland. But doctors dont often use it as a treatment for locally advanced cancer.

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External Beam Radiation For Prostate Cancer

When most patients think of radiation therapy, they think of external beam radiation therapy , in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.

EBRT used to require 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.

Side Effects Of Prostate Radiation

Side effects of prostate radiation is an important topic, which many doctors and their patients have to discuss before proceeding to the procedure further on. In most cases, radiation treatment for prostate cancer has the same side effects as brachytherapy . But its important to keep in mind that every person will have different side effects from the same procedure and health in general.

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Is Prostate Surgery Possible After Radiation

Dr. Samadi, if a patient with prostate cancer chooses to get radiation treatment, what are the chances of him undergoing surgery, in case of remission?

Dr. Samadi: When we talk about prostate cancer, there are low risk prostate cancers and there are high risk prostate cancers. Youve probably heard of the classification called Gleason score. We, urologists, use that to figure out exactly what type of prostate cancer were dealing with here. In my practice, I like to cure the patients by removing the prostate. There are many advantages for prostate removal. When you undergo a prostatectomy, youre going to know exactly what type of prostate cancer you have. You will find out how much cancer you have in the prostate, because the needle biopsy is a random biopsy and doesnt always give you the best picture. Whats important is, six weeks after prostate surgery, your PSA should go down to zero and should stay zero for the rest of your life. The advantages of the surgery is that the follow-up is very easy. If the cancer reoccurs after surgery, then I would use a low dose radiation as a back-up plan.

Some of the side effects of radiation is secondary chance of rectal cancer. Patients can get rectal bleeding and bladder bleeding. Side effects of radiation comes as time goes on. So, if I can avoid giving patients radiation and cure them with good quality of life, thats what I would prefer. If youre doing well, then I will just continue watching the PSA.


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