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How effective is radiation versus surgery for prostate cancer?

Marc B. Garnick, MD
Hematology & Oncology
In comparisons of radiation to surgery for prostate cancer, brachytherapy (radiation from a source placed inside the body) rates about the same as prostatectomy (surgery for prostate cancer) in terms of resulting quality of life. For example, a Harvard study in The Journal of Urology found little difference in quality of life (for up to five years) between men who had brachytherapy and those who had radical prostatectomies for localized prostate cancer. The men who received the seeds enjoyed better sexual function and fewer urinary symptoms than the ones who had a radical prostatectomy, although they had worse bowel function. Another study, which also appeared in The Journal of Urology, reported similar findings. However, men who underwent nerve-sparing prostatectomy enjoyed the highest sexual function.

In terms of effectiveness, preliminary data suggest brachytherapy is about as effective as external beam radiation or surgery for low-grade cancers, but less effective for higher-grade tumors. A study of 126 men with localized prostate cancer found that brachytherapy was as effective as radical prostatectomy and external beam radiation in keeping men disease-free for at least five years. However, for men with tumors at an intermediate or high-risk stage, a Harvard study of 1,872 men published in The Journal of the American Medical Association indicated that radical prostatectomy or external beam radiation therapy probably is the better choice. The study found that seed implants are much less effective than had been thought, and it questioned their use in men with intermediate or late-stage tumors.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.