Radiation vs. Surgery for Prostate Cancer

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Both surgery and radiation therapy can be used to treat all stages of prostate cancer. It seems that they work equally in helping to treat this kind of common cancer in men, but they can carry some different side effects.

Factors that affect the way of how prostate cancer is treated

There is no one formula of treatment that works for all cases of prostate cancer. The treatment should be considered on case-by-case basis.

While treating prostate cancer at early stage (when the cancerous cells haven’t spread) can provide better outcome, many patients are recommended with active monitoring, too. This option means that the treatments are not immediately necessary, but the cancer is continuously monitored.

This watchful waiting option is often recommended because many cases of prostate cancer grow or progress very slowly. Many times, patients got their death due to other conditions – especially for those aged older than 50-60s.

But when there is any risk that the cancer might begin to spread or become aggressive, it must be treated immediately!

image_illustration271There are several factors that can affect the way of how this cancer is treated. If you are diagnosed with it, your healthcare providers will look at all of these factors before going to determine the most effective treatments. Some of these factors include:

  1. The stage of the cancer. In general, it is divided into 4 major stages; I, II, III, and IV. More advanced stage, more difficult to treat the cancer.
  2. Gleason score. It is a parameter used to analyze the look of cancer cells. If they look very different to the normal cells, the Gleason score is high. If they look almost similar to healthy /normal cells, the Gleason score is low. High Gleason score means the greater chance for the cancer to grow and spread aggressively!
  3. Another variable that can help your doctor analyze the progression of your prostate cancer is with a blood test to check the PSA level. PSA stands for prostate specific antigen. It is reliable enough to check whether or not your cancer is aggressive.
  4. The age factor. In younger men, the treatment is usually immediately necessary since there is greater chance for the cancer to grow within their lifetime. On the other hand, in elderly men, the active monitoring is often suggested since some cases of prostate cancer grow very slowly, less likely to affect their lifetime. And prostate cancer occurs more often in elderly men.
  5. General health of patient, some patients cannot take certain treatments!

There are several options to cope with prostate cancer. But the main treatments include radiation therapy, surgical-treatments, and hormone therapy.

Each treatment carries the risk of some side effects. Doctor can recommend delaying the treatment when he /she believe that you can safely do that. Again, if the cancerous cells begin to grow when you are going with active monitoring, conventional treatments for cancer such as radiation or surgery can be suggested.

Radiation therapy vs. surgery for cancer of prostate

Commonly, the use of radiation therapy (radiotherapy) can substitute the use of surgical-treatment option – and vice versa. But sometime, doctors /specialists may need to use them together.


Radiation therapy is a method that radiates high-energy rays to kill cancerous cells. Unfortunately, there is a chance for this treatment to affect healthy cells around the cancerous cells, too – causing some side effects (see more in here)!

The way to deliver the radiation into cancerous cells is divided into two major options.

  1. External radiotherapy. With this method, the radiation is delivered externally. There is no any device inserted into the body. It can be used for almost all stages of prostate cancer.
  2. Internal radiotherapy (brachytherapy). As the name suggests, the radiation is delivered internally. A special device inserted into specific area of the body to radiate high energy and hit the cancerous cells from inside the gland of prostate. It is usually used when the cancer has not spread or with lower chance to spread, because it may not reach the cancerous cells that spread to the outside of prostate gland.

When the cancer cells in the prostate have not spread yet, radiotherapy is one of options to cure the disease. This is medically called as radical radiotherapy.

The successful rate is dependent on the stage of the cancer. Radical radiotherapy tends to cure prostate cancer when the cancer is treated very early.

But when the cancer has spread, the use of radiotherapy is less likely to cure the cancer. The goal is to control the disease and ease the symptoms, not to cure the disease. For this case, there are two main ways for the use of radiotherapy:

  1. Treating and shrinking cancerous cells that have spread. Bones are common site where abnormal cells from prostate cancer to spread. External radiotherapy can help kill most of cancerous cells in the treated area, such as bone. For in-depth information about secondary bone cancers due to prostate cancer, see this section!
  2. Controlling the symptoms of advanced prostate cancer, such as pain. The use of this kind of radiotherapy is called palliative radiotherapy. Depending on the symptoms and the large of the affected area; your specialist may use low dose of external radiation in one go.


For surgical-treatment option, there are several choices – these include:


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