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.
Full Answer
Is radiation therapy better than surgery for prostate cancer?
Surgery better than radiation, hormone treatments for some prostate cancer, study shows. Surgery for localized prostate cancer offers a significantly higher survival rate than either external-beam radiation or hormonal therapies, according to a new study led by researchers at UCSF.
How to decide between radiation or surgery for prostate cancer?
Your treatment options and which treatment you choose may depend on several things, including:
- how far your cancer has spread
- how quickly your cancer may be growing
- the advantages and disadvantages of each treatment
- what each treatment involves
- the possible side effects of each treatment
- practical things, such as how often you would need to go to hospital, or how far away your nearest hospital is
- your own thoughts about different treatments
What is the most effective treatment for prostate cancer?
These include:
- Cryotherapy
- Cyberknife: A Robotic Linear Accelerator designed to give External beam radiation. ...
- HIFU
What is the best prostate cancer surgery?
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- your general health
- whether the cancer has spread to other parts of your body
What's better for prostate cancer radiation or surgery?
Younger men tend to opt for surgery, while those who are at higher risk for surgery because of their age or other medical problems tend to choose radiation. Radiation is a good option for most prostate cancer patients, regardless of age, whose disease has progressed to a point where intervention is necessary, Dr.
Which is better radiation therapy or surgery?
"We have evaluated all the good-quality data comparing surgery and radiotherapy, and the results are pretty conclusive; in general, surgery results in better mortality rates than radiotherapy."
What is the most successful prostate cancer treatment?
Radiation therapy is a good choice for many men with early-stage prostate cancer. It is also the best treatment for older men or those who have other health problems. There are different types of radiation therapy: External beam radiation.
How successful is radiation after prostate surgery?
The median time from surgery to radiation was 2.1 years (range 0.3–7.4 years). After a median follow-up time of 12.2 years, the 5- and 10-year BPFS was 35 and 26%, respectively, and OS was 86 and 67%, respectively. The median biochemical-free survival after SRT was 2.3 years (26).
What are the disadvantages of radiation therapy?
What are the disadvantages? Radiotherapy can cause side effects, including tiredness, sickness and runny poo (diarrhoea). If you have chemoradiotherapy, you may get side effects from the chemotherapy.
Why can't you have your prostate removed after radiation?
Cancer that is thought to still be in or around the prostate After radiation therapy: If your first treatment was radiation, treatment options might include cryotherapy or radical prostatectomy, but when these treatments are done after radiation, they carry a higher risk for side effects such as incontinence.
What is the newest treatment for prostate cancer?
The treatment, called 177Lu-PSMA-617, uses a molecule that selectively seeks out and attaches to a specific protein on the cancer cell surface called PSMA (prostate-specific membrane antigen). The technology delivers radiation that damages DNA and destroys the cancer cell.
What is the life expectancy after prostate radiation?
Based on the natural history of localized prostate cancer, the life expectancy (LE) of men treated with either radical prostatectomy (RP) or definitive external-beam radiotherapy (EBRT) should exceed 10 years.
What are the chances of prostate cancer returning after radiation?
And a study comparing the outcomes of 393 men who received different doses of external beam radiation therapy for prostate cancer, published in the Journal of the American Medical Association, found that 19.6% of those who underwent high-dose radiation therapy experienced biochemical recurrence within five years, while ...
Which is better radical prostatectomy or radiation?
In conclusion, modern radiotherapy is superior to prostatectomy in terms of a patient's post-treatment quality of life. Obsolete comparisons of older forms of radiotherapy and prostatectomy do not reflect current knowledge.
What should PSA level be after prostate surgery?
Ideally, your post-prostatectomy PSA will be undetectable, or less than 0.05 or 0.1 nanograms of PSA per milliliter of blood (ng/mL). If that's the case, your doctor may call it a remission.
Do tumors grow back after radiation?
Normal cells close to the cancer can also become damaged by radiation, but most recover and go back to working normally. If radiotherapy doesn't kill all of the cancer cells, they will regrow at some point in the future.
What About The Data On The Relative Side Effects Of Proton Therapy Vs Imrt
We pooled our data with various cancer centers in order to study about 1,000 patients who had been treated for prostate cancer with Proton Beam Therapy and compared their Quality of Life scores with those of a control group of men who had no treatment .
Prostate Cancer Surgery Vs Prostate Cancer Radiation
After being diagnosed with prostate cancer, many men are confused about their treatment options. They probably wonder: Do I go for radiation? Do I go for surgery? Well-intended people may give certain suggestions or recommendations.
Quality Of Life Is Better After Modern Radiotherapy Compared With Surgery
For decades, organ preservation has been an abiding principle of radiotherapy, with the underlying belief being that a person with preserved native anatomy has better physical functioning than one who has undergone surgical removal of organs followed by reconstruction.
How Can I Choose From Among The Options
In addition to talking with family and friends, you will need a team of physicians to help advise you. You should meet with everyone involved in your treatment planning before choosing a treatment, including:
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
What The Research Shows About Radiation Vs Surgery
The ProtecT trial was a 10-year, randomized clinical study designed to compare radical prostatectomy, external-beam radiotherapy and active surveillance for the treatment of localized prostate cancer.
Table 1 Why A Low Psa Does Not Mean You Are Cancer
The Prostate Cancer Prevention Trial included a provision that men randomized to receive placebo undergo a prostate biopsy at the end of the study, even if they had normal PSA levels and digital rectal exams. To their surprise, investigators found that many of these men had prostate cancer in some cases, high-grade prostate cancer.
What is the advantage of surgical removal of the prostate?
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 (and lymph nodes if necessary).
How to choose prostate cancer treatment?
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.
What are the factors that determine the best treatment for prostate cancer?
These include pre-existing symptoms, extent/volume of disease, Gleason grade, PSA level, age, and emotional factors. Whether choosing surgical removal or radiation therapy, extensive experience of the treating physician is essential in order to maximize a good outcome. Of course, there is no substitute for a direct conversation with your doctor. In the end, comfort with your decision is as important as the decision itself.
What are the disadvantages of prostate removal?
The most significant disadvantage to removal of the prostate is the small possibility of long-lasting bladder control problems. For those below age 65, less than 5% will have any significant post-operative bladder problems. The risk of incontinence following radiation is 1-2%.
What happens when you get radiation therapy?
With radiation therapy, three things must happen – the cancer must be confined to the treatment area (as with surgery), the cancer cells must respond by dying, and the entire normal portion of the prostate must die (eliminating any future source of prostate cancer). Sometimes age can be a consideration in the treatment decision.
How long does it take for a prostate test to be undetectable?
When the prostate is removed, the PSA blood test should become undetectable (<0.1) within six weeks if all the cancer cells have been successfully eliminated. Prostate cells (normal or cancerous) are the only source of PSA, a protein made by these cells and partially released into the blood stream. Following radiation, the PSA in some cases may ...
How long does it take to recover from a prostatectomy?
General recovery from robotic prostatectomy is usually 2-3 weeks, whereas recovery from radioactive seed implantation is 1-2 days.
How likely is radiation to kill prostate cancer?
Findings from 15 of the studies showed that those who received radiation therapy were twice as likely to die from prostate cancer as those who had surgery. Findings from 10 of the studies also showed that men who had radiation therapy were 50 percent more likely to die sooner of any cause, compared to those who had surgery.
How likely is it to die from prostate cancer after radiation?
Findings from 15 of the studies showed that those who received radiation therapy were twice as likely to die from prostate cancer as those who had surgery.
What is the best treatment for prostate cancer?
The most common treatments for localized prostate cancer are surgery and radiation therapy .
What percentage of prostate cancer cases are localized?
This type of "localized" prostate cancer is the most common form of the disease, accounting for about 80 percent of cases, said a team led by Dr. Robert Nam of the Odette Cancer Centre at Sunnybrook Research Institute in Toronto.
What is the only option to remove a prostate?
He said that surgical removal of the prostate "is the only option which removes the entire prostate, and therefore allows for more accurate staging and grading [of the tumor]. This means your doctor can create a better long-term plan of care for each individual patient."
Does surgery have an edge in survival?
Analysis of 19 studies suggests surgery has an edge in survival, but experts say each case may be different
What's needed to answer the surgery-versus-radiation question?
According to Haas, what's needed to answer the surgery-versus-radiation question is a "prospective randomized trial using state-of-the-art medicine."
How long does radiation therapy take for prostate cancer?
The other option, external radiation therapy, in which high-energy rays are used to kill cancer cells, is usually given five days a week over a six-week period. A newer type of radiation involving the implantation of radioactive pellets or "seeds" into the prostate gland has also become popular over the past few years. This was the treatment recently chosen by New York Mayor and prostate cancer patient Rudolph Giuliani, who had the pellets implanted just over two weeks ago.
When did Hank Porterfield get prostate cancer?
Oct. 3, 2000 -- When Hank Porterfield learned he had prostate cancer in 1992, he was faced with a critical choice that more than 100,000 men in the U.S. make each year -- whether to treat the cancer with surgery or radiation. Then in his mid-60s, the Illinois man says he was told the treatments were equally effective.
Does radiation therapy minimize side effects?
Urologist James Eastham, MD , of New York's Memorial Sloan-Kettering Cancer Center, says the NCI findings are intriguing but may minimize the actual side effects of radiation therapy. And for surgery, he says the rates of total incontinence and impotence reported in the study are higher than rates reported at centers like Memorial Sloan-Kettering, where large numbers of prostate cancer patients are treated each year.
Does radiation cause bowel movements?
Most men having this side effect voiced complaints such as frequent or painful bowel movements. Among the radiation group, 8% had bowel movement difficulties compared with just 3% of those who were surgically treated.
Is radical prostatectomy the best treatment for prostate cancer?
Sometimes the situation may just come down to who you ask. "It is true that most urologists believe that radical prostatectomy is an excellent choice of therapy for clinically localized prostate cancer, and radiation oncologists feel the same way about the treatment that they offer," Eastman says. "There [is] really no good randomized study that have compared the two therapies with regard to treatment outcome, so it really is a matter of opinion."
What is the best treatment for prostate cancer?
What Is the Best Prostate Cancer Treatment: Surgery or Radiation ? Determining whether to opt for surgery or radiation is largely a matter of a man’s personal preference. Some may prefer the one-shot removal of their tumor offered by surgery, while others feel more comfortable with weeks of radiation treatments.
What are the side effects of prostate cancer surgery?
The most common complications of surgery include leakage of urine or stool, impotence and shortening of the penis, according to the National Cancer Institute.
How long does prostate radiation treatment take?
It typically consists of five treatments a week over an eight-week period. Each treatment takes 15 to 25 minutes.
How many cuts are needed for prostatectomy?
If you opt for surgery, you can typically choose between an open incision radical prostatectomy and a newer robot-assisted procedure, performed through five or six tiny “keyhole” cuts in the lower abdomen.
How many rice seeds are implanted in prostate?
This procedure, called brachytherapy, involves making an incision under general anesthesia to implant pellets into the prostate gland that release low doses of radiation slowly over a period of months. About 40 to 150 rice-size seeds are implanted, and they lose their radioactivity over the course of a year.
When is prostate cancer surgery?
Feb. 5, 2019, at 4:07 p.m. Prostate Cancer: Surgery or Radiation? More. While a growing number of men diagnosed with early-stage, slow-growing prostate cancer opt for no immediate treatment beyond active surveillance, many men diagnosed with the cancer – especially those under age 60 who are in good health with a long life expectancy – choose ...
Can radiation cause impotence?
Radiation treatment for prostate cancer can also cause impotence and urinary incontinence, but whether these occur at equal or lesser frequency than for surgery remains unknown. Rates of these side effects can vary based on the expertise of the surgeon or radiologist. “Treatment specialists should be able to tell you their rate ...
What type of radiation is used for prostate cancer?
The main types of radiation therapy used for prostate cancer are: External beam radiation. Brachytherapy (internal radiation) (Another type of radiation therapy, in which a medicine containing radiation is injected into the body, is described in Treating Prostate Cancer Spread to the Bone .)
What is the best treatment for prostate cancer?
Brachytherapy (internal radiation therapy) 1 Brachytherapy alone is generally used only in men with early-stage prostate cancer that is relatively slow growing (low-grade). 2 Brachytherapy combined with external radiation is sometimes an option for men who have a higher risk of the cancer growing outside the prostate.
How does proton beam therapy work?
Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.
Why do you put a balloon between your prostate and your rectum?
Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum. Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis.
What is EBRT radiation?
In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.
What is IGRT prostate?
Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy (IGRT), lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming.
Can brachytherapy be used for prostate cancer?
Brachytherapy alone is generally used only in men with early-stage prostate cancer that is relatively slow growing (low-grade). Brachytherapy combined with external radiation is sometimes an option for men who have a higher risk of the cancer growing outside the prostate.
Surgery For Prostate Cancer
A radical prostatectomy is the surgical removal of the prostate. This procedure may be performed through traditional open surgery, which involves one large incision in the abdomen. Laparoscopic surgery using the robotic daVinci® Surgical System is a minimally invasive alternative.
What Affects My Treatment Options
Your treatment options will depend on whether your cancer is contained within the prostate gland , has spread just outside of the prostate or had spread to other parts of the body .
To Cut Or Not To Cut: Radiation Vs Surgery For Prostate Cancer
Since prostate cancer is a slow growing disease, the value of treatment is often questionable. While many patients can be managed with active surveillance, those who do require treatment often have radiation and surgery presented as their two options.
Factors To Consider Before Treating Prostate Cancer
Your doctor will guide you toward the best treatment plan available at your medical center. One factor to consider is that doctors at other medical centers may provide additional options.
Who Was In The Study
The study included 2,550 men from across the United States with localized prostate cancer. All the men started the study within six months of being diagnosed. Of these, 74 percent were white, and 26 percent were other races. The average patient age was 64, and all were younger than 80.
Prostatectomy Vs Radiation What To Choose
In general, there are 2 major treatment options for prostate cancer. On one side you have the surgery, on the other side, I call it The whole other bucket of treatments that include: proton beam, cyberknife that is very advertised that goes in the bucket of radiation.
Treatment Options For Localized Or Locally Advanced Prostate Cancer
A man diagnosed with localized or locally advanced prostate cancer has 3 major treatment options: Active Surveillance, surgery, and radiation therapy. For patients whose cancer appears more aggressive, combination treatment may be recommended.
What is the treatment for prostate cancer?
Many men with prostate cancer who have a radical prostatectomy (prostate removal) receive radiation therapy afterward to wipe out any residual cancer cells.
How many men had a radical prostatectomy?
To do the study, researchers combined data from three randomized trials, involving a total of more than 2,000 men who had undergone a radical prostatectomy. The men were assigned either to receive immediate radiation or to be monitored and given radiation only if signs of cancer emerged.
Is there a benefit to radiation?
According to the findings of an analysis published online Sept. 28, 2020, by The Lancet, there is no clear benefit of immediate radiation over monitoring with later radiation therapy as necessary.
Advantages
- 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, ...
Diagnosis
- 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 (and lymph nodes if necessary). More important, the ability to monitor a patient for possible recurrence is dr…
Prognosis
- Following radiation, the PSA in some cases may never become undetectable since the prostate is still present in the body. Furthermore, even with a fully successful cure, the PSA can dramatically fluctuate for the first several years following the radiation treatment. Although most properly selected patients can be cured with either surgery or radiation therapy, detecting the minority of …
Risks
- The most bothersome possible disadvantage to radiation therapy involves difficulty emptying the bladder. In severe cases, patients can experience debilitating frequent urination (including multiple disruptions of sleep), decreased urinary flow, and pain with urination. The urinary complications of radiation therapy occur in a small minority of patients on a permanent basis, b…
Treatment
- So, which treatment is better at curing prostate cancer? To determine this, we would need to conduct a very large study of patients (many thousands) willing to have their treatment chosen by the flip of a coin. Since that is not possible, several theories have been proposed. With radiation, since the areas around the prostate also receive a dose, cancer cells that have just penetrated th…
Management
- Sometimes age can be a consideration in the treatment decision. By no means is the life of a 40 year-old more valuable than a 70 year-old. However, since prostate cancer is usually slow-growing, treatment failures can often be managed in older patients. In the younger patient, surgical removal provides an improved knowledge of disease status with potentially better and more timely back …