Oncologist Questions Prostate Cancer

Is surgery the only way to treat prostrate cancer?

I am a 47 year old man and I am suffering with prostrate cancer. The oncologist has suggested a surgery to treat the condition. I want to understand if surgery is the only way to deal with prostrate cancer or is there any other way out.

2 Answers

All too often, a younger man is recommended surgery for prostate cancer and not radiation. The most common talking point among Urologic Surgeons is "your too young and you should have surgery...if you have radiation you cannot have surgery and you will have burned your bridges". This is pure nonsense, a scare tactic and unsubstantiated by mountains of data. The rates of incontinence and erectile dysfunction is relatively high with surgery and using the Davinci Robotic surgery, even within the hands of the top 2 surgeons is complicated by incontinence, ED and most importantly recurrence. Understand that when surgery is performed, prostate tissue is always left behind (leaving cancer) and blood is spilled into the cancer arena co-mingling the cancer with your normal blood which can spread the cancer. This is not the case with state of the art radiation. Most will agree that over time (2-5 years), patients develop gradual ED with "full course radiation' i.e 8-10 weeks. This is not the case, however, with combining radiation with seeding aka brachytherapy whereby you get a little bit of each rather than a lot of both. A meta-analysis in Br J Urol 2012 looked at 15,000 studies comparing ALL prostate treatments and the most curative with the least side effects was indeed combining radiation with seeding and irrespective of age. Moreover, the local control rates are > 95% and so surgery will never likely be necessary (but could be if necessary...the Urologist will then say "no problem"). Please do your homework and don't be fooled by scare tactics!
Biopsy is almost unavoidable. They used to say surgery was the only way for young with early stage, but currently, RT best modern machines, very experienced. Get se results, at least a consult is appropriate.