Posted on Feb 01, 2014

Radiation for prostate cancer has demonstrated that it leads to more complications than surgery.

Men with prostate cancer who have to decide between radiation and surgical removal of the gland can be overwhelming. It is hard to weigh out the different risks of the two options.

Prostate cancer is the second most common malignancy, second only to skin cancer. Every year, doctors diagnose more than 240,000 men in the United States with the disease. This data translates to 1 in every 6 men is affected by prostate cancer.

Men faced with the decision between radiation and surgery need to take time to do their research on how radiation really works and the side effects they will have to live with.

There are two kinds of radiation: external beam and brachytherapy which involves radioactive material inside the prostate.

Robotic prostatectomy results in minimal bleeding, 95 percent to 97 percent continence rate, and an overall better quality of life. However, most men are weary of having robotic prostatectomy because of the temporary side effects such as leakage, and erectile dysfunction.

Radiation treatment results in frequent hospital visits, bleeding from the bladder or rectum, and a risk of a second cancer.

Last Thursday, a new study was published in the Lancet Oncology Journal. The study found that “men treated with radiotherapy had fewer minimally invasive urological procedures compared to those who chose surgery. However the radiation group had a higher proportion of hospital admissions, rectal or anal procedures, related surgeries and secondary cancers.”

The study also discovered that radiotherapy complication rates were 2 to 10 times higher than complication rates in men who were treated with robotic prostatectomy.

Choosing surgery after undergoing radiation makes the surgery more complicated. The radiation destroys the surrounding healthy tissue resulting in the prostate being embedded in scar tissue. The scare tissue makes the surgery more complex than operating on tissue that has not been affected by radiation.

Once the prostate is removed, surgeons monitor the prostate-specific antigen (PSA) levels to ensure that the cancer doing come back. If radiotherapy was performed before the surgery, the PSA levels fluctuate due to radiotherapy and pieces of the prostate that were not removed, making the monitoring process more difficult.

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Gerry Oginski
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