What are the advantages and disadvantages of radiation therapy vs. surgery for localized (stage 1 and 2) prostate cancer?

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HowardSandlerMD (Physician - Oncology - Radiation (Verified) ) - 10 / 03 / 2012

Advantages of radiation therapy include: its non-invasive nature, very low risk of urinary incontinence, better retention of sexual function compared with surgery, no risk of post-operative complications such as pulmonary embolism. Disadvantages: Can take 2 months of daily treatments, low risk of rectal injury leading to occasional episodes of rectal bleeding

Advantages of surgery include: additional information can be obtained by having the whole prostate to examine rather than just a biopsy, very low risk of rectal injury. Disadvantages: Can affect urinary control, has the risks associated with major surgery.

Note that both surgery and radiotherapy have very high cure rates, but if the first treatment does not cure the cancer, the other treatment can be offered as a back-up treatment. Occasionally, one hears that surgery cannot be performed after radiation therapy, but there are many urologists who are comfortable performing such procedures.

Finally, one should remember that some patients with localized prostate cancer are candidates for active surveillance with the hope that treatment can be avoided totally or perhaps delayed for a number of years.
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