Choosing Surgery or Radiation to Treat Prostate Cancer

One in eight men will develop prostate cancer in their lifetimes, but thanks to an increase in screening, most prostate cancers will be diagnosed early while the tumor is still small and has not spread. At this stage, prostate cancer is highly treatable, and patients may weigh their options as they consider different treatments.

How is Surgery Used to Treat Prostate Cancer?

The primary type of surgery used to treat prostate cancer is called a radical prostatectomy. This surgery removes the entire prostate gland, and, sometimes, some of the surrounding tissue to eliminate the cancer cells in those areas. A surgical incision is made through the abdomen or the skin between the scrotum and the rectum, and a catheter is put in place to remove urine from the body until the area heals. After surgery, patients will need to stay in the hospital for 2-3 days to monitor vital signs. Patients may experience incontinence and/or impotence, but the incidence of long-lasting side effects from surgery is low.

How is Radiation Therapy Used to Treat Prostate Cancer?

Radiation therapy uses high-energy waves to destroy cancer cells while minimizing damage to nearby healthy cells. This kind of therapy can be used to treat prostate cancer at different stages and in combination with other treatment plans. It may be used:

  • As the primary treatment for cancer contained in the prostate gland

  • Alongside another treatment, like hormone therapy, if cancer has spread to nearby tissues

  • To treat any remaining cancer cells or recurrence of cancer cells after surgery

  • To slow the growth of cancer cells and treat symptoms in more advanced stages of cancer

There are three main types of radiation therapy used for prostate cancer:

External beam radiation

This type of radiation therapy focuses beams of radiation on the prostate gland from a machine outside of the body. It can be used to treat early stages of prostate cancer or symptoms if the cancer has spread. This treatment is usually done five days a week in an outpatient center over several weeks and lasts about 15 minutes per session. Learn more about external beam radiation therapy.

internal radiation

Internal radiation therapy, also called brachytherapy, places small radioactive pellets the size of rice grains directly into the prostate near the tumor. The pellets are permanent, but their radioactivity decreases after several weeks. Generally used for patients with early-stage cancer, brachytherapy may be done as an outpatient procedure, or it may require an overnight stay in the hospital. For some patients with a higher risk of cancer growth outside of the prostate, brachytherapy can be combined with external radiation therapy. Learn more about internal radiation therapy.

Radiopharmaceuticals

Radiopharmaceuticals are drugs containing radioactive elements which target prostate-specific membrane antigen (PSMA), a protein found in large amounts on prostate cancer cells. These drugs attach to the PSMA and deliver radiation directly to the cancer cells. This option can be used to treat prostate cancer that has spread or in combination with hormone therapy or chemotherapy. Drugs are administered as an injection or an infusion once every six weeks for up to six doses.

Whether a patient chooses external or internal radiation therapy, recovery is typically faster than surgery. Daily activities can usually go on during treatment, and post-treatment incontinence is rare. However, there may be side effects during radiation treatment, including fatigue, urinary burning, and sore skin in the treatment area.

Which Treatment is Right for My Prostate Cancer?

Studies show that 10 years after treatment, cure rates are about the same for radiation therapy and radical prostatectomy. So how do you know which treatment is right for you?

Every person is different, and so is their cancer. Your physician may consider how far the cancer has progressed, your overall health, and what the cancer cells look like, in addition to your stated preference. Radiation therapy may be a good fit for many men with early-stage prostate cancer, older men, or those with other pre-existing health problems. Radiation treatments may also provide a less invasive option for patients who are uncomfortable with surgery.

If you are given multiple options for your prostate cancer treatment, ask your physician:

  • Is one method more effective for your type of prostate cancer?

  • What are the side effects?

  • What is the treatment time or recovery time?

  • Are there differences in out-of-pocket costs?

For more information about prostate cancer treatment, please call 401-521-9700 or visit northmainradiation.com.

Lindsey Matech