prostate cancer treatment

Prostate Cancer Treatment – Radiation vs. Surgery

Being diagnosed with prostate cancer may be a cause of distress for the entire family. Many questions pop-up in a man’s mind when being told that he is now a prostate cancer patient.

He may be asking:

  • How severe is my situation?
  • Will I be cured?
  • What type of treatment should I choose?
  • What would the side-effects be?
  • Will I recover fast?

When it comes to deciding which prostate cancer treatment option is the best, corresponding to the specific, situation, many doubts and worries may arise.

Dr. David B. Samadi has treated over 7.000 prostate cancer patients so far and explained in the following video which treatment option is considered to be most efficient for most patients.

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Prostate cancer treatment options for low-risk patients

Well, if you have low-risk prostate cancer, something called watchful waiting or closed surveillance would be a very good option. Close surveillance means that you would be coming every 3 months for a check-up. We would be looking at your PSA and we would be examining you. Every other year we will make an MRI or a biopsy to make sure that the cancer is not advanced. This is for people who are compliant, they have low-risk prostate cancer, they may be older and they may have a lot of co-morbidities that w may not want them to be too aggressive. 

Prostatectomy vs. radiation – What to choose?

In general, there are 2 major treatment options for prostate cancer. On one side you have the surgery, on the other side, I call it “The whole other bucket of treatments” that include: proton beam, cyberknife that is very advertised – that goes in the bucket of radiation. Seed implant, external beam radiation, HIFU, Cryotherapy – all of them go into one bucket and surgery goes in the other bucket and you are right at the fork. So, what is the difference, what are the pros and cons, and what are some of the advantages?

When it comes to surgery, we are removing the entire prostate, we are removing the sample lymph nodes and the seminal vesicles. You will be able to get a very accurate stage and answers to these questions:

  • How much cancer do I have?
  • What type of cancer is it?
  • Where is it located?

That stage comes with surgery. Radiation won’t give you that kind of answer. 

The other advantage of surgery is that your PSA after surgery should be zero or undetectable. It is a piece of mind for the family to know that the cancer is gone and you are cured from this disease. 

A lot of times after radiation there could be a couple of years, 18 months to 24 months that the PSA can fluctuate and that can be a major source of emotional distress for your family. 

With radiation, the prostate still remains in the body so that patient may continue to need some biopsies whereas the person who has had surgery may not need another biopsy. 

The main advantage of prostatectomy

This is a very important comment I am gonna make right now. If your cancer ever comes back after surgery, the idea of having a plan B of having low-dose radiation after surgery is feasible. If you start with radiation and cancer comes back, surgery would be very difficult and challenging. So, I want you to know this because not too many people are aware of this. 

Again, one more time. If you start with surgery, you still have the radiation as an option. If you start with radiation, surgery would be very difficult because the tissue becomes like a cement attached to the rectum and the surrounding tissues and it would be very difficult to do that operation. 

As you get older, because we have removed the prostate with the surgery, you do not have to worry about the old-man disease, an enlarged prostate. With radiation may be some consequences with bleeding from the rectum or bleeding from the bladder. Certainly, in the hands of an experienced radiation oncologist, the results are better. We have superb doctors at St. Francis Hospital. One of my colleagues, Dr. Jay Bosworth, whom I am looking forward to interviewing him at this program, is a fine radiation oncologist and you will have what to learn from him. So, the risks of side-effects in the hands of an experienced radiation oncologist would be less. But there is a small chance of having secondary cancers such as rectal cancer or bladder cancer at some point down the road after radiation. 

I think it is important for you to get tested, talk to your doctor, understand your PSA, make sure to put them on a graph, and get the trend of them. Always get a second opinion. 

What to do if you are diagnosed with prostate cancer

If you re diagnosed with prostate cancer, understand what your Gleason score is, how much cancer you have, and then we will look at options. 

The main surgical treatment that we are offering to patients is called robotic surgery. You may know it as Da Vinci robotic surgery. 

This is a minimally invasive surgery I have devoted my whole carrier to. Over the last 2 decades, I have done over 7 thousand of these operations with superb outcomes. These outcomes are: less blood loss, faster recovery, excellent sexual function, urinary control is superb and with time it gets better. We certainly can discuss this option with you.

This surgery typically takes about one hour and a half. There is no incision, key-whole openings will bring in these fine instruments, and with magnification, better lighting, and maneuvering around the prostate we are able to do a beautiful nerve-sparing. This not only cures them from cancer but also improve their quality of life, which is also important. 

I hope that you study this. If you have questions about anything related to elevated PSA or men’s health, send them to me. I encourage women out there to ask their boyfriends or husbands:

  • Do you know what your PSA is?
  • Why are getting up in the middle of the night?
  • Do you know what your testosterone level is?
  • Why are you not interested in sex?

All of these play a big role. 

If have been diagnosed with prostate cancer, call us! I am happy to give a second opinion. 

In the future, we are going to have many other doctors coming in to talk about colon issues, reflux, diet, nutrition.

Send us all your questions and we are looking forward to having you on the show. 

Dr. David Samadi | Robotic Prostate Surgeon

About is a resource created by Dr. David Samadi in order to raise awareness and get more men to receive prostate cancer treatment. The information is strictly general and you should always discuss with your doctor issues concerning your health.


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