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Is Radiation Better Than Surgery For Prostate Cancer

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Side Effects Of Radiation For Prostate Cancer

Which is Better – Surgery vs. Radiation for Prostate Cancer?

The primary potential side effects of radiation treatment for prostate cancer include bowel problems, urinary problems and sexual function issues.

According to patient-reported outcomes measuring quality of life from men who participated in the 10-year, randomized Prostate Testing for Cancer and Treatment trial, men who were treated with radiation reported little increase in urinary leakage after radiation therapy. They also reported less sexual dysfunction when compared to men who were treated with surgery. However, men treated with radiation reported a higher incidence of bowel problems, such as loose and bloody stools. These side effects are often short-term for most patients, but some experience long-term side effects.

Why Is It Important To Know The Risk Level Of Your Cancer

Knowing whether your cancer is low-risk, medium-risk, or high-risk is important when you are making treatment choices.

The risk level of your cancer is based on the results from your tests and exams, such as the PSA test, digital rectal exam, and prostate biopsy.

  • Low-risk means that the cancer isn’t likely to grow right away. There is a chance it may grow so slowly that it never causes symptoms.
  • Medium-risk means that the cancer is more likely to grow. Most people will likely need treatment with radiation therapy or surgery.
  • High-risk means that the cancer will most likely grow right away. People will likely need treatment with radiation therapy or surgery.

Your doctor can help you understand your test results and the risk level of your cancer. Then you can compare your treatment options and make the choice that seems best to you.

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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Choosing A Prostate Cancer Treatment: Surgery Versus

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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Treatment Of Prostate Cancer Using Surgery

CyberKnife Systems

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.

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Locally Advanced Prostate Cancer

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

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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Are There Complications Or Side Effects Of Prostate Cancer Surgery

Similar to radiation therapy for the treatment of prostate cancer erectile dysfunction and urinary problems are the main side effects experienced. It is however important to note that according to research conducted on men who have undergone these two types of surgeries, those who had radical prostatectomy had higher urinary inconsistencies and erectile dysfunction compared to those who had radiation therapy.

This however should not worry you because a large number of men reported having an improvement of these side effects in about 6 months after the surgery. Bowel issues are however minimum for men who have undergone radical prostatectomy.

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What Is Prostate Cancer Ablation

To begin, its important to understand what ablation is. Ablation means the removal of diseased body tissue such as cancerous tumors. Image-guided ablation is performed by applying thermal energy that physically destroys the cancer. For prostate cancer, ablation is an alternative to surgery or radiation.

Thermal ablation for prostate cancer has two main advantages over surgery:

  • Same day outpatient procedure
  • Very rapid recovery time and return to normal activities

Ablation also has a unique advantage over surgery and radiation, which are both whole-gland treatments. Ablation can be done as a focal treatment with added benefits:

  • Targets only the tumor plus an extra safety margin
  • Avoids damage to healthy prostate tissue
  • Greatly reduces the risk of impaired urinary and sexual function as compared to surgery

Today, focal treatment for prostate cancer is recognized as an excellent option for patients who are accurately diagnosed and determined to be appropriate for a focal approach. Besides being clinically qualified, psychologically they desire high quality of life after treatment and are committed to actively participating in their doctors follow-up monitoring protocol using PSA blood tests and multi-parametric MRI scans at prescribed intervals.

Frequent Urination Burning With Urination And Difficulty Urinating

Side Effects of Surgery Vs Radiation for Prostate Cancer

These are the most common complaints. Occasionally the urinary stream will weaken. Generally these symptoms are managed with medications to help the bladder function better or eliminate burning. Rarely, your doctor may order a urine test. Symptoms will resolve after the end of treatment. Contact your doctor if you see blood in your urine or if you are unable to urinate.

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How To Decide Between Radiation And Surgery For Localized Prostate Cancer

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:

What Is This Post All About

This is a hard decisionsurgery or radiation?

Now remember, what I am going to talk about here is for prostate cancer that hasnt spreadLOCALIZED prostate cancer.

From a 30,000-foot view, surgery and radiation or both EXCELLENT treatment choices for prostate cancer. In general, you can pick and choose certain studies to support one treatment over the other but by and large they are both EQUAL in terms of cancer control.

Now remember, I am a urologist. I try my hardest to provide as unbiased as an opinion as I can but its impossible to remove the fact that I am urologist when providing this information. This is why I will always have my patients meet with a Radiation Oncologistas well as me to hear from them about what radiation is all about as I talk to them about what surgery is all about.

If you wanna learn about the ins and outs of a robotic prostatectomy then click over here. On the flip side, if you wanna learn more about the ins and outs of radiation then click here.

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Need Of Radiation Therapy For Prostate Cancer

Generally, radiation therapy or radiotherapy for prostate cancer is given to the cancer patient at different points during the treatment routine. This treatment can be provided

  • As the first treatment for men with low-grade cancer or when the cancer is in the early stage and is contained within the prostate gland.
  • As a part of the first treatment in combination with other treatments like hormone therapy to patients whose cancer has grown and spread into nearby tissues outside the prostate.
  • As a post-surgery to prevent cancer recurrence.
  • Symptomatic relief to the patient if prostate cancer has advanced and spread outside the prostate.
  • Intensity Modulated Radiation Therapy

    Costly new prostate cancer treatment pushed on billboards and websites

    IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.

    Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.

    A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.

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    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. Comparing modern radiotherapy vs surgery for prostate cancer, we argue the following points: Head-to-head comparisons have shown modern radiotherapy to be much better than surgery in terms of urinary and sexual function.

    While bowel toxicity has historically been moderately worse after radiotherapy, this decline in function can now be mitigated largely by using modern radiotherapy techniques, such as image guidance and possible additional rectal spacing.

    Quality of life following radiotherapy has continued to improve as advances have been made in radiotherapeutic techniques, whereas prostate surgery-despite the availability of newer, once-promising techniques such as laparoscopic or robot-assisted radical prostatectomy-remains largely unchanged in regard to long-term impacts on quality of life. Thus, radiotherapy is the better choice for treatment of prostate cancer.

    Financial Disclosure: Dr. Yu and Dr. Hamstra have served as paid consultants to Augmenix, Inc. Dr. Hamstra has also received grant funding from Augmenix, Inc.

    Which Treatment Is Best For You

    The exact type of treatment that is best for you can depend upon many factors, such as the stage of the cancer, where in the prostate the cancer is located, and individual factors. These are all taken into account by the treating healthcare team when creating a personalized treatment plan.

    When you meet with your healthcare provider, they will give you the options that will be the most effective in treating your case of prostate cancer.

    For stage 1 prostate cancer, treatment may include:

    • Watchful waiting or active surveillance
    • Hormone therapy
    • Radical prostatectomy with pelvic lymphadenectomy
    • Radiation after surgery
    • Transurethral resection of the prostate

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    How Prostate Cancer Staging And Risk Stratification Affect Treatment Options

    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

    Will Radiation Therapy Make Me Tired

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

    Everyone has their own energy level, so radiation treatment will affect each person differently.

    People often feel fatigue after several weeks of treatment. For most, this fatigue is mild. But some people lose a lot of energy and need to change their daily routine.

    If your doctor thinks you should limit how active you are, theyll discuss it with you.

    To minimize fatigue while youre receiving radiation treatment:

    • Get enough rest.
    • Pace yourself, and plan rest breaks throughout your day.

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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.

    Surgery Or Radiation: Which Is Better For Early 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.

    “I was very lucky because I immediately found a support group and started talking to people who had been through treatment,” he tells WebMD. “I was aware of the potential side effects of therapy, so I was better able to deal with them. I decided on surgery, which, at the time, was the best treatment option for me.”

    Approximately 180,000 men in the United States are diagnosed with prostate cancer each year, and almost 90% have clinically localized disease, meaning that the cancer has not spread to other parts of the body. While some patients with the cancer localized to the prostate, particularly older men, are advised to take a watch-and-wait approach with no therapy given, most will have to decide between therapeutic options.

    NCI researchers studied long-term treatment side effects in close to 1,600 men with localized prostate cancer from all over the country and found that those treated with surgery had more urinary and sexual problems, while those treated with radiation had greater declines in bowel function. None of the patients included in the study had radioactive seed implant therapy.

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    Getting Help With Treatment Decisions

    Making such a complex decision is often hard to do by yourself. You might find it helps to talk with your family and friends before making a decision. You might also find it helpful to speak with other men who have faced or are currently facing the same issues. The American Cancer Society and other organizations offer support programs where you can meet and discuss these and other cancer-related issues. For more information about our programs, call us toll-free at 1-800-227-2345 or see Find Support Programs and Services.

    Itâs important to know that each manâs experience with prostate cancer is different. Just because someone you know had a good experience with a certain type of treatment doesnât mean the same will be true for you.

    You might also want to consider getting more than one medical opinion, perhaps even from different types of doctors. For early-stage cancers, it is natural for surgical specialists, such as urologists, to favor surgery and for radiation oncologists to lean more toward radiation therapy. Doctors specializing in newer types of treatment may be more likely to recommend their therapies. Talking to each of them might give you a better perspective on your options. Your primary care doctor may also be helpful in sorting out which treatment might be right for you.

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