In general, prostate cancer is treated with either surgery or radiation. All patients with a new diagnosis of prostate cancer should have a thorough consultation with both a Urologist and a Radiation Oncologist to discuss both his surgical and radiation options.
It is important to understand that prostate cancer is not just one disease, but it has many variations and subtypes based on the extent or stage of the disease, pathologic findings on biopsy (such as the Gleason score), PSA level, etc. Much the same way no two snowflakes are the same, no two cases of prostate cancer are the same, and treatment decisions must be individualized for each and every case separately.
The Urologist and Radiation Oncologist will discuss the risks and benefits to using surgery or radiation, taking into consideration both individual disease parameters, as well as your age and general medical health.
In general, early stage prostate cancer can be cured with equal effectiveness using either surgery or radiation therapy, provided that the radiation therapy uses state-of-the-art technologies, such as those used at Advanced Radiation Centers of New York. The older technologies may be less effective. For this reason, there is not necessarily a “right” or “wrong” decision, and patients, along with their physicians and families, need to weigh the risks and benefits of every treatment to choose the option with which they feel most comfortable.
More advanced or aggressive prostate cancers, such as those with a Gleason score of 7 or higher, or a PSA of 10 or higher, may be better treated with radiation, since radiation therapy can encompass a larger area than surgery can. Sometimes hormone therapy is used in conjunction with radiation in these cases to enhance the effect of the radiation.
There are other “experimental” treatments (which are discussed in the IGRT section of this website), which remain experimental, and should not be considered for use until 10 year data becomes available. Currently the technology is very new and there is not enough data to prove that in the long run thse approaches will be as effective as radiation or surgery, which have decades of proven data records. To learn more about experimental or other treatment radiation technologies, click here.
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