Sunday, March 3, 2024

Surgery Vs Radiation Prostate Cancer

Side Effects Of Surgery For Prostate Cancer

Which is Better – Surgery vs. Radiation for Prostate Cancer?

The most commonly experienced side effects of surgery for prostate cancer are urinary incontinence and erectile dysfunction.

According to the patient-reported outcomes from men who participated in the ProtecT trial, men who underwent a radical prostatectomy experienced more sexual dysfunction and urinary problems than those treated with radiation therapy.

While many reported an improvement in the severity of their symptoms six months after surgery, these men continued to report poorer sexual quality of life six years after surgery compared to those who had radiation therapy.

Although men treated with radiation reported experiencing bowel function problems after treatment, the study participants who had a prostatectomy were generally able to undergo the procedure without experiencing any changes in bowel function after surgery.

Robotic Prostatectomy Or Radiotherapy For Localised Prostate Cancer

Overview by Professor Christopher Eden Consultant Urological SurgeonThe Royal Surrey County Hospital

Prostatectomy or radiotherapy for prostate cancer

Prostate cancer is a unique disease in that the choice of treatment is usually devolved to the patient, although the care-giver discussing treatment options may steer patients in a certain direction depending on age, obesity and co-existing medical conditions.

Active surveillance is a valid option for patients with a low volume of Gleason 6 or 7 prostate cancer but the burden of follow-up together with the uncertainty regarding outcome persuades approximately 1/3 of patients on AS to opt for active treatment within 3 years, joining another 1/3 of patients who show evidence of tumour progression or spread in having treatment.

Surgery or radiotherapy?

Although experimental options exist in the form of focal high-intensity focused ultrasound therapy and whole-gland phototherapy follow-up is short and what follow-up we do have in published series shows that patients treated in this way trade off fewer side-effects against cancer control.

Long term survival

For more details see the link below.

Are Surgery And Radiation Therapy Ever Used Together

In some cases, your care team may use both surgery and radiation therapy as part of your prostate cancer treatment plan. Typically, radiation therapy is delivered after surgery to target remaining cancer cells or that came back. However, in some situations, doctors may recommend radiation therapy first to kill cancer cells in tissues near the prostate gland before performing the prostatectomy.

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Does Msk Offer Proton Therapy For Prostate Cancer

Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.

Surgery For Prostate Cancer

Prostate Cancer Treatment Side Effects Comparison

A radical prostatectomy is the surgical removal of the prostate. This procedure may be performed through traditional open surgery, which involves one large incision in the abdomen. Laparoscopic surgery using the robotic daVinci® Surgical System is a minimally invasive alternative. Robotic surgery only requires a few small incisions in the abdomen, which may result in reduced pain, lower risk of infection and a shorter hospital stay after surgery.

The technology associated with the robotic surgical system is designed to give the surgeon greater precision and control, which may help spare healthy tissue and one or two of the nerve bundles on the sides of the prostate. This often allows the patient to have better erectile functionin both the short term and long term.

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Comparison Of The Leading Techniques Of Rp And Ebrt: Rarp Versus Vmat

A retrospective study has recently been published in Radiotherapy & Oncology, which reports comparative outcomes of RARP and VMAT, as the leading respective techniques of RP and EBRT . RARP is a novel, gold standard, surgical procedure for localized PC using the da Vinci Surgical System and has been reported to reduce blood loss complications and positive surgical margin rates, resulting in improved safety and feasibility . VMAT represents a sophisticated EBRT technique based on rotational IMRT, which delivers a highly conformal beam from a rotating radiation source to the target while avoiding risky organs such as the rectum in a short time, by computerized optimization. VMAT has been reported to reduce complications and improve oncological outcomes .

If Treatment Does Not Work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

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How To Decide If You Want Radiation Or Surgery For Prostate Cancer

There is still a debate on selecting the best options to go by. Research that has been conducted on the outcomes of both procedures shows that both of them are effective in the treatment of prostate cancer and the choice of either of these depends on your underlying health conditions and is different from person to person.

To better decide on the treatment option to follow, it is important to first understand the disease itself. You can also gather as much information about the recovery experiences on either of these methods. Having a deep understanding of what it takes during and after the surgery or radiation therapy will help you to make a solid decision on which path to follow.

Making the right decision comes down to understanding the options that you have and how each of them can affect the outcomes you get. That is the main reason why it is always important first to undergo intensive diagnosis and pre-screening. This helps you to make the right decisions based on the results from the tests.


Tools To Help You Decide

Radiation vs. Surgery for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

The Predict Prostate tool can help you decide between monitoring and more radical treatment. It is for men whose prostate cancer hasnt spread.

It cant tell you exactly what is going to happen in the future, but it gives you an idea about the differences in survival between the different treatment options. The tool works less well for men with a very high PSA or those with a fast growing or large tumour.

To be able to use the tool you need to know the following about your cancer:

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Are There Complications Or Side Effects Of Prostate Cancer Surgery

Similar to radiation therapy for the treatment of prostate cancer erectile dysfunction and urinary problems are the main side effects experienced. It is however important to note that according to research conducted on men who have undergone these two types of surgeries, those who had radical prostatectomy had higher urinary inconsistencies and erectile dysfunction compared to those who had radiation therapy.

This however should not worry you because a large number of men reported having an improvement of these side effects in about 6 months after the surgery. Bowel issues are however minimum for men who have undergone radical prostatectomy.

Dr Samadi Shares Why Prostate Surgery Is Better Than Radiation For Younger Patients

Choosing between the many variants of surgery or radiation, in case of prostate cancer, is a difficult decision. Often, doctors are biased towards the treatment they feel theyre more experienced in. Our discussion with Dr. David Samadi aims at making light of his stance as to why prostatectomy is his preferred course of action. His website takes issue with all the treatment options and the advantages and disadvantages that each of them entail.

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Prostate Surgery Leads To Better Survival Vs Radiation

A recent clinical update on prostate cancer in the Urology Times journal discusses new data on the survival benefits of surgical treatment of prostate cancer vs. radiation therapy.

Radical prostatectomy, which is nowadays almost always performed using a robotic surgical platform, may result in a reduced risk of developing an aggressive type of metastatic prostate cancer known as Castration-Resistant Prostate Cancer .

After any treatment for localized prostate cancer, the cancer may recur. One of the initial treatments for recurrent cancer with signs of spread, is hormonal ablation, also known as Androgen Deprivation Therapy .

A recent research study found that 32% of patients who chose radiation as their initial treatment, ended up developing the more aggressive type of advanced prostate cancer. The study also showed that men who received radiation alone had 77% higher overall mortality after developing metastatic disease.

As prostate cancer rates continue to increase, it is important for patients to be well informed regarding their options. Many physicians who do not have access to a highly trained robotic surgeon may only offer radiation therapy as a primary treatment modality.

Prostate Cancer Surgery Or Radiation Which Is Better

Brady Urology at Johns Hopkins Hospital: Journal Spotlight: Surgery vs ...

The only other thing I was drinking in the first 6 months after my diagnosis was green tea. I would drink about 4 glasses of green tea daily to go along with the increased water intake. I wasnt putting any other liquid into my body for the first 6 months. This was a big help in starting my road to recovery.

Once I started feeling better then I added organic soy milk to my diet as well. Soy milk isnt much like regular milk but once you get used to it then its not bad at all. To this day these are the only 3 liquids I have in my diet. To recap the 3 liquids I drink today are purified water,green tea,& organic soy milk. I put no other liquids into my body period.

Now, I want to chat a little more about meat & other aspects of a proper diet. As I said we dont need meat to live. I thought cutting or limiting meat in my diet would be to hard to accomplish. Well again my thinking was wrong. Was it easy? No! However, after a couple weeks then things were starting to get easier. I didnt cut all meats out of my diet but I did cut certain meats & eat moderate amounts of all others.

One meat that needs to be completely cut or at least very minimized is red meat . Too much Red meat consumption is not good for prostate health. I was eating a lot of fast food burgers & also red meat at home. I will say to at least cut red meat completely out of your diet until you get your prostate health back.

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Choosing A Prostate Cancer Treatment: Surgery Versus Radiation

Although many treatment options are available, patients with newly-diagnosed prostate cancer often narrow down the choices to two surgical removal of the prostate or radiation therapy. Since many factors influence this decision, choosing which treatment to use can be daunting.

The biggest advantage to radiation therapy is that it is easier to undergo than surgery. Even with robotic technology, its small incisions are not as small as the openings made by a couple of dozen needles inserted into the skin behind the scrotum when radiation seeds are implanted. General recovery from robotic prostatectomy is usually 2-3 weeks, whereas recovery from radioactive seed implantation is 1-2 days. Many patients who choose the radiation route will also undergo daily external beam treatments for 6-7 weeks.

The biggest advantage to surgical removal is the information learned that is not available through other treatment methods. Once the prostate is removed, it can be fully analyzed to determine the extent, location, and grade of the disease within the prostate and seminal vesicles . More important, the ability to monitor a patient for possible recurrence is dramatically enhanced. When the prostate is removed, the PSA blood test should become undetectable within six weeks if all the cancer cells have been successfully eliminated. Prostate cells are the only source of PSA, a protein made by these cells and partially released into the blood stream.

Quality Of Life Is Better After Modern Radiotherapy Compared With Surgery

For decades, organ preservation has been an abiding principle of radiotherapy, with the underlying belief being that a person with preserved native anatomy has better physical functioning than one who has undergone surgical removal of organs followed by reconstruction. Comparing modern radiotherapy vs surgery for prostate cancer, we argue the following points: Head-to-head comparisons have shown modern radiotherapy to be much better than surgery in terms of urinary and sexual function.

While bowel toxicity has historically been moderately worse after radiotherapy, this decline in function can now be mitigated largely by using modern radiotherapy techniques, such as image guidance and possible additional rectal spacing.

Quality of life following radiotherapy has continued to improve as advances have been made in radiotherapeutic techniques, whereas prostate surgery-despite the availability of newer, once-promising techniques such as laparoscopic or robot-assisted radical prostatectomy-remains largely unchanged in regard to long-term impacts on quality of life. Thus, radiotherapy is the better choice for treatment of prostate cancer.

Financial Disclosure: Dr. Yu and Dr. Hamstra have served as paid consultants to Augmenix, Inc. Dr. Hamstra has also received grant funding from Augmenix, Inc.

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A Large Role For Radiation Therapy

People diagnosed with localized prostate cancerthat is, disease that hasnt spread outside the prostate regionhave many potential treatment options, depending on the stage and grade . Some may have surgery alone. Others may only have radiation therapy.

And some may have a combination of the two. This often happens when theres concern that surgery hadnt removed all the tumor tissue. Or, if someones prostate-specific antigen levels start to rise months or years after surgery, radiation therapy may be recommended even if imaging hasnt been able to identify tumor growth.

Hypofractionated radiation therapy is already an accepted treatment option for some people undergoing radiation therapy alone to treat prostate cancer. But whether this type of radiation therapy is appropriate for use after surgery has been unclear.

When radiation is used after surgery, it’s delivered to a larger area of the body, including sensitive areas in the bladder and rectum, Dr. Buyyounouski explained. This raises the possibility that the higher doses used in hypofractionation may cause long-term side effects that could outweigh the benefit of two fewer weeks of treatment for these patients.

And a lot of people do have some urinary complications after surgery, said Dr. Citrin. So even a small increase in urinary or bowel symptoms that persist after treatment with one regimen versus the other could be quite impactful in terms of quality of life.

How Prostate Cancer Staging And Risk Stratification Affect Treatment Options

Side Effects of Surgery Vs Radiation for Prostate Cancer

Your treatment choices are determined by several factors, including your cancers stage, aggressiveness and assigned risk stratification . Your age and current general health condition may also affect your choices.

Prostate cancer staging

Prostate cancer staging determines whether the cancer is confined to the prostate gland or whether theres evidence of metastasis, meaning its spread to other areas of the body.

Tools and methods to determine staging may include the prostate-specific antigen test, the digital rectal examination , the Gleason score and the American Joint Committee on Cancer TNM system, which provides information on the tumor, lymph node involvement and metastasis of a cancer. Imaging tests, such as a PET/CT scan, may also help determine your cancers stage.

The four stages of prostate cancer are subdivided into more precise categories, but we generally refer to three groups that indicate how far the cancer has spread:

Localized, meaning theres no indication that the cancer has spread beyond the prostate

Regional, meaning theres evidence of cancer cells in nearby lymph nodes or tissue

Distant, meaning theres evidence the cancer has spread to other organs or body parts farther from the prostate

Almost 90 percent of prostate cancers are diagnosed at the localized or regional stage. The five-year relative survival rate for men diagnosed with prostate cancer at these stages is nearly 100 percent.

Prostate cancer risk assessment

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Conditions Treated With Proton Therapy

Proton therapy is considered the most technologically advanced radiation delivery method for cancerous tumors. With this powerful, precise technology, tumors are more accurately targeted so healthy tissues and organs get less unnecessary radiation.

Proton therapy is commonly used to treat tumors in sensitive areas where traditional X-ray or photon radiation may not be the best option. Depending on your particular diagnosis, proton therapy may be a treatment option for cancers of the brain and central nervous system, breast, esophagus, head and neck, liver, lung, lymphatic system, eyes, pancreas, prostate, bone and others. It is particularly beneficial for many pediatric cancers.

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