Deciding Between Radiation and Surgery for Localized Prostate Cancer

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The prostate

Deciding Between Radiation and Surgery for Localized Prostate Cancer

What is localized prostate cancer?

Prostate cancer is the abnormal growth of cells in the prostate gland. Cancer that has not spread outside the prostate gland is called localized prostate cancer.

Men with localized prostate cancer have options for their care. Some men with a slowly growing cancer chooseactive surveillance. This means that their doctors will watch them closely with regular checkups and tests. If theircancer grows, then they can decide about treatment. And some men choose watchful waiting. This means theydon't want any treatment that tries to cure their cancer. Other men choose to treat their cancer right away. Theycan choose to have radiation to destroy the cancer cells in the prostate. Or they can choose to have surgery toremove the prostate (radical prostatectomy).

Tests show if a localized prostate cancer is likely to grow.

  • Low-risk means that the cancer isn't likely to grow right away. There is a chance that it may grow so slowlythat it never causes any problems.
  • Medium-risk means that the cancer is more likely to grow. Most men will likely need treatment with radiationor surgery.
  • High-risk means that the cancer is most likely to grow right away. Men will likely need treatment with radiationor surgery.

Some men may have limited treatment choices because of their health. For example, a man who has serious healthconcerns may not be well enough to have surgery. Or a man who has a serious bowel disease such as ulcerativecolitis may not be able to have radiation. Your doctor will help you know if you have options.

This information is about choosing between radiation or surgery.

What are the key points about this decision?

  • Radiation therapy or surgery may be used to treat your prostate cancer. Both treatments work well. With eithertreatment, the chance of your cancer spreading is low.
  • Both treatments can have side effects, such as bladder, bowel, and erection problems. Radiation is more likelyto cause bowel problems. Surgery is more likely to cause leaking urine or erection problems.
  • How you feel about each treatment may affect your choice. For example, you may choose surgery becauseyou want the cancer removed through an operation. Or you may choose radiation because you want to avoidmajor surgery and its risks.

Why might you choose surgery?

If your goal is to treat the cancer by having your prostate removed, then you may want to choose surgery. For some men, the idea of "getting the cancer out" brings a sense of relief. For other men, avoiding radiation may be what is important to them.

Why might you choose radiation?

If your goal is to treat the cancer and avoid the risks of major surgery, then you may want to choose radiation. For some men, preserving their sexual function for as long as possible is what they value most. Having radiation rather than surgery may help avoid erection problems.

Your decision

To make the decision that is best for you, take the time to understand your options. Sometimes the medical factswill guide your decision. But a good decision also reflects what matters most to you. This includes how you feelabout radiation or surgery and the likely side effects.

  • Find out about the treatments. What would your radiation treatment plan be like? Or if you choose surgery,how would your surgery be done?
  • Find out about the side effects. How important to you is being sexually active and being able to maintain anerection? If leaking urine is a side effect of your surgery, how much would that bother you?

Think about what you value. Then talk with your doctor.

Where can you learn more?

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