Dr. Adam Kibel discusses how both surgery and radiation are highly effective treatments for localized prostate cancer, explaining that while radiation offers a noninvasive option, surgery may provide greater long-term durability for younger patients by removing the prostate and preserving more future treatment options.
Dr. Adam Kibel:
One of the things I remind patients is that the ultimate minimally invasive approach, which doesn't require an incision and that patients recover very, very, very well from, is radiation. Radiation is amazing. It cures the vast majority of patients that get it. I'm not saying everybody should have radiation, but if you're really nervous about surgery, we have a proven technology which we have long-term data, which we know makes patients live longer.
So radiation therapy is always a good option in somebody who's nervous about surgery. So one of the real advantages I think of surgery over radiation is the prostate is removed and the treatment therefore tends to be much more durable. So with radiation, you have some failures because the radiation doesn't work and you have some failures because the prostate's still in and the cancer can recur.
And then the patient, if it's a young patient who is in his 50s and he has 30 years of thread left, 35 years of thread left, he wants to live to be 90 and he's 55, that's a lot of years to have that prostate in there where we already know he's predisposed to cancer because he developed cancer. And if he recurs, we really have a limited bag of tricks to go ahead and successfully treat him. In contrast, if you do surgery, you remove the prostate, it's gone.
Admittedly, we have to be a little concerned about the side effects associated with surgery in a younger man, but we can fix most of those problems. Incontinence tends not to be an issue in a younger man. Potency, they're much more likely to get good erections because they're younger. It's simply because they're younger. And they're much more motivated to take drugs, try injection therapy if they do have problems with erections.
They have partners that are much more engaged in sexual activity. So I find they actually do much better after the surgery than you would think on the basis of their concerns beforehand.