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The Pros and Cons of Prostate Cancer Treatment Options

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The standard treatment options for prostate cancer are active surveillance, radical prostatectomy, external beam radiation therapy, and brachytherapy. Here’s a look at the advantages and disadvantages of each, in brief. 

Active surveillance for prostate cancer 


• Avoids side effects from radiation therapy or radical prostatectomy

• No hospitalization or surgical risks 


• Requires close monitoring (regular digital rectal exams, PSA tests, and prostate biopsy) to monitor for signs of progression

• May be psychologically stressful knowing that the prostate cancer will not be actively treated until it progresses 

Radical prostatectomy for prostate cancer 


• Proven to reduce prostate cancer death rates

• Removed tissue allows accurate staging

• PSA levels reliably predict recurrence

• Fewer bowel/rectal problems than with EBRT

• Less urinary urgency and frequency than with EBRT or brachytherapy 


• General risks of surgery

• Hospitalization required

• Catheter in place for 1-2 weeks

• Recovery period: at least 1 month

• Incontinence: 5-20% (mostly stress incontinence)

• Erectile dysfunction: 30-50% at 5 years (with nerve preservation) 

External beam radiation therapy (EBRT) for prostate cancer 


• No hospitalization or surgical risks

• Activities unrestricted

• Low risk of urinary incontinence (1-2%)

• Less urinary retention than with brachytherapy 


• No post-treatment staging information

• Daily treatments for 6-8 weeks

• Fatigue may occur when treatment ends

• Erectile dysfunction: 30-50% at 5 years

• Bowel/rectal problems: 5-10% (urgency, pain, diarrhea, or bleeding) but typically improve after treatment

• Bladder irritation: 5% (urinary frequency, urgency, discomfort) 

Brachytherapy for prostate cancer 


• No hospitalization or surgical risks

• Less radiation damage to healthy tissue

• One treatment

• Low risk of urinary incontinence (1-2%) 


No post-treatment staging information

• Less favorable option for men with intermediate- or high-risk prostate cancer

• Urinary retention, urgency, and frequency more common than with other treatments, especially in men with lower urinary tract symptoms before treatment 

Posted in Prostate Disorders on March 24, 2011

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer

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