With prostate cancer being one of the leading cancers in men, finding the best way to treat it has become increasingly important. A new study points to why surgery might be the best long term treatment option, especially for men with localized prostate cancer. Researchers from Odette Caner Centre, Sunnybrook Research Institute, (University of Toronto, Canada) conducted a meta-analysis of 19 studies comparing the success/survival rates of surgery vs. radiation. All in all, this added up to about 120,000 men who received either surgery or radiation as treatment for their localized prostate cancer. What researchers found was that patients were twice as likely to die from prostate cancer if they were treated with radiation over surgery, and about 1.5 times more likely to die sooner than those treated by surgery.
These results point not only to the efficacy of surgery as a principal mode of treatment and first line of defense against prostate cancer, but also as a way to extend the life of men affected by prostate cancer. Through surgery, specifically robotic prostatectomy, my goal has always been to extend quality of life as well as longevity for my patients. Studies such as this bolster confidence patients have in this treatment option, and give them the information they need to choose the best long term treatment option for themselves - along with the guidance of their physicians of course. It is also important to note that radiation includes the following treatment methods: external beam radiation therapy, three-dimensional conformal radiation therapy, intensity modulated radiation therapy, proton beam radiation therapy, and stereotactic body radiation therapy. Although stereotactic body radiation therapy is often referred to as CyberKnife surgery, and is often advertised as surgery, it is by no means a surgical intervention but radiation.
Past studies have sited various complications associated with radiation treatment. For example, statistics show that about a third of radiation patients develop acute symptoms of proctitis or cystitis, and about 5-10% develop permanent bowel, bladder, and urethral function disorders. Similarly, about half of patients that receive radiation treatment for prostate cancer develop erectile dysfunction. Numerous studies also show increased risk of secondary bladder and rectal malignancies. One study comparing the risk of metastasis among surgical and radiation patients, found that men had a 65% lower risk of metastasis when opting for surgical intervention over radiation.
Prostatectomy is the only option which removes the entire prostate, and therefore allows for more accurate staging and grading. This means your doctor can create a better long term plan of care for each individual patient. Furthermore, quality of life tends to improve over time rather than get worse – which you can often see in radiation patients. The most important aspect however, is that radiation is still possible as a secondary treatment after surgery. So patients have yet another way of combating their cancer if necessary. Surgery after radiation poses a major challenge, and for the majority of patients is not a viable option.