If you’re one of the 230,000 men diagnosed with prostate cancer every year, you’re probably dealing with a dilemma of which treatment option to choose. Your doctor has likely spoken with you about radiation and surgery, but how do you choose?
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Surgery
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Radiation
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| Length of Treatment |
- One-time treatment for 1-2 hours, on average
- 1-2 night hospital stay, on average
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- EBRT is typically administered 5 days a week for 5-6 weeks
- CyberKnife® is typically done over the course of 1-5 treatments/days
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| Accuracy of Treatment |
- Very accurate: prostate is visualized and removed
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- Not accurate: radiation is targeted at prostate based on imaging data, dosage and location is approximated
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| Side Effects During Treatment |
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- Fatigue, skin inflammation, frequent/difficult/uncomfortable urination, rectal bleeding or irritation, hemorrhoids, diarrhea
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| Hormone Therapy Necessary? |
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- Lupron is given along with RT, which has its own panel of side effects, similar to menopause
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| Cancer Staging |
- Very accurate because entire specimen can be analyzed
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- Not accurate: exact type of prostate cancer not known, extensity not known, seminal vesicle and lymph node involvement not known
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| PSA Follow-Up |
- Testing begins at 6 weeks post-op
- PSA remains <0.1
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- Testing begins ~2-3 months post-op
- Will not reach lowest point for 18-24 months
- Majority of men experience a “PSA Bounce” (a temporary rise in PSA) where the PSA rises ~15% post-treatment, then declines again
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| Side Effects After Treatment |
- Impotence and incontinence
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- Bowel dysfunction
- Impotence and incontinence
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| Risk of Impotence and Incontinence |
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| Secondary Therapy Possible? |
- Yes: radiation is possible after surgery
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- No: surgery is very difficult to do after radiation
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| Increased Risk for Second Cancer? |
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- Yes: a 5% increased risk of rectal or bladder cancer
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Patients diagnosed with prostate cancer must weigh their treatment options with their personal treatment goals. Regardless of therapy, strongly consider physician experience. Choose wisely: it is with the robot that a surgeon completes the surgery, not the robot itself. The experience of the surgeon is one of the most important factors to consider. Please visit www.roboticoncology.com or www.smart-surgery.com for more details.
