Deciding Between Radiation and Surgery for Localized Prostate Cancer

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What is localized prostate cancer?

The prostate

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.

This cancer can often be cured. But choosing the best treatment for you can be confusing.

Tests will show if your cancer is likely to grow.

  • Low-risk cancer isn't likely to grow right away. If you have low-risk cancer, you can choose to wait and see if the cancer gets worse. This is called active surveillance.
  • Medium-risk cancer is more likely to grow. Some men with this type of cancer may be able to choose active surveillance. Others will likely need to choose surgery or radiation.
  • High-risk cancer is most likely to grow. If you have high-risk cancer, you will likely need to choose between radiation and surgery.

This information is about choosing between radiation or surgery. Getting another opinion can also help you with the decision. You might talk with a medical oncologist. You also can talk with your partner or other men who have had treatment for prostate cancer.

What are the key points about this decision?

  • Radiation therapy or surgery may be used to treat your prostate cancer. One treatment may be better for you than the other because of your age, your other health problems, and how you feel about each treatment.
  • Both treatments have side effects. In the first few years, surgery usually causes more problems with erections and leaking urine. And radiation usually causes more bowel problems, such as an urgent need to move your bowels. But over the long term, the chance of any of these problems is about the same with either treatment.
  • Surgery may be a better choice if you want to find out right away that all the cancer has been taken out. Surgery to remove the prostate will take out any cancer that is in your prostate. And after your surgery, you can find out if all the cancer is gone.
  • Radiation treatment may be the better choice if you are older than 80 or have other serious health problems, such as heart disease. In those cases, surgery may be too risky.

Why might you choose surgery?

  • You are in good health and expect to live at least 10 more years.
  • Your cancer hasn't spread outside the prostate. This means it's more likely that all the cancer can be removed.
  • You don't have other health problems that add to the risks of major surgery.

Why might you choose radiation?

  • You have health problems that make surgery too risky.
  • You are over 80 years of age.
  • You already have bladder, bowel, or erection problems.

Your decision

One treatment may be better for you than the other because of your age, your other health problems, or how you feel about each treatment. You and your doctor can talk about your options.

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.

Where can you learn more?

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