>99%
five-year survival rate
Navigating prostate cancer treatment choices: Radiation vs surgery
Understanding your prostate cancer treatment options is a key step in making confident decisions about your health and recovery.
Understanding your prostate cancer diagnosis
After receiving a diagnosis of prostate cancer, you may have a lot of questions. Prostate cancer is often slow-growing and has a five-year survival rate of >99% for localized prostate cancer, meaning more 99% of men with early-stage prostate cancer are still alive five years after being diagnosed.
Whether you’ve experienced symptoms or not, there are several options for treatment, including:
Surveillance
If your prostate cancer is less aggressive, your care team may suggest regular monitoring of the tumor using prostate-specific antigen blood tests, digital rectal exams, biopsies, and imaging tests to evaluate its progression.
Radiation
If your care team suggests treatment, they may place you on radiation therapy to shrink the size of the tumor and destroy cancer cells.
Surgery
If your cancer has not spread beyond the prostate gland, your care team may recommend a prostatectomy to remove the gland and any affected surrounding tissue.
Chemotherapy
If your cancer has spread, your care team might recommend chemotherapy or immunotherapy to shrink your tumors.
Clinical trials
Your care team might also suggest a clinical trial, which looks at new ways to diagnose and treat cancers.
Your treatment is often determined after your care team rates the aggressiveness of the cancer on the Gleason scale, which ranges from a 6 for low-grade cancer to a 10 for high-grade cancer.
“As a team, our goal is to explain their diagnosis and treatment plan as clearly as possible, connecting with them on a personal basis to ensure they feel confident in what’s to come,” says Chad Tracy, MD, urologic oncologist at University of Iowa Health Care.
No matter your score, our specialized teams of oncologists, surgeons, and radiologists will make sure you feel confident in your decisions.
"As a team, our goal is to explain their diagnosis and treatment plan as clearly as possible, connecting with them on a personal basis to ensure they feel confident in what’s to come."
Chad Tracy, MD
What you need to know about prostate cancer radiation therapy
Radiation therapy is a common treatment plan for those diagnosed with prostate cancer. This option offers you the ability to tailor your treatment to your Gleason score, pre-existing conditions, and overall wellness needs.
There are several forms of radiation therapy:
- External beam radiation uses focused radiation from a machine outside the body to target the prostate and treat early-stage cancer and more advanced cases or relieve symptoms like bone pain. Most treatments are given five days a week at an outpatient center over the span of several weeks.
- Brachytherapy (internal radiation) places tiny radioactive seeds directly into your prostate and is usually used for early-stage, lower-risk prostate cancer. It may be combined with external radiation for higher-risk cases but isn't ideal for men with urinary issues, large prostate glands, or a history of transurethral resection of the prostate (TURP).
- Radiopharmaceuticals are radioactive drugs injected into a vein that then travel through the bloodstream to target and kill cancer cells throughout the body. They deliver focused radiation to limit side effects and can treat cancer wherever it has spread.
What are the common side effects of radiation therapy for prostate cancer?
Side effects depend on the type of radiation therapy you and your care team choose. However, some include:
- Urinary problems
- Diarrhea or constipation
- Fatigue
- Erectile dysfunction
- Nausea
- Loss of appetite
Talk with a urologist today.
Whether you’re experiencing repeat urinary tract infections or want to talk with an expert about erectile dysfunction, our urologists are here to help.
What you need to know about prostate cancer surgery
Surgical intervention for prostate cancer is done through a radical prostatectomy. This procedure removes the entire prostate gland and any affected tissue to help limit the spread.
Your surgeon will take one of two approaches to remove the gland:
- Open prostatectomy
- Laparoscopic prostatectomy
What is an open prostatectomy
During an open prostatectomy, your surgeon (urologist) will place you under general anesthesia, possibly paired with epidural anesthesia, before beginning the procedure.
Your care team will choose to take a retropubic approach, where an incision is made from your belly button to your pubic bone, or a perineal approach, where an incision is made between your anus and your scrotum. While both approaches are typically successful, the perineal approach is less common as it can result in erectile dysfunction despite its shorter procedure length.
In either approach, a catheter is placed after the removal and left in for one to two weeks to assist with urination during recovery. After a brief hospital stay, you will be sent home to heal.
What is a laparoscopic prostatectomy?
A laparoscopic prostatectomy is performed through several small cuts in the abdomen. During this procedure, the surgeon will place a laparoscope, a long tube with a small camera attached to the end, through one of the cuts to help see inside the body. Thin surgical tools are placed in the remaining incisions to perform the removal.
There are two approaches to a laparoscopic prostatectomy:
- Laparoscopic radical prostatectomy, a less frequently used approach, involves the surgeon manually controlling long instruments to remove the prostate.
- Robotic prostatectomy, where the surgeon controls precise instruments from a console to operate a robotic system in removing the prostate.
“As a surgeon, I am constantly looking for ways to make treatment more effective without elongating your list of symptoms or possible complications,” Tracy says. “These less invasive approaches to prostatectomy are now a gold standard, surprising patients with the ease of care.”
While the robotic approach delivers nearly the same long-term effects as a laparoscopic and open prostatectomy, it is the most common surgical method for removing the prostate in the U.S. due to its short-term advantages, such as:
- Less blood loss during surgery
- Reduced post-operative pain
- Shorter hospital stays
- Faster recovery
- Less time with a catheter
- Lower risk of complications
Choosing your treatment path depends on several factors, such as age, overall health, and lifestyle. At UI Health Care, we will walk you through your options and support you through every step.
"As a surgeon, I am constantly looking for ways to make treatment more effective without elongating your list of symptoms or possible complications. These less invasive approaches to prostatectomy are now a gold standard, surprising patients with the ease of care."
Chad Tracy, MD
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