Is Radiotherapy More Advantageous Than Surgery in the Treatment of Early-Stage Prostate Cancer?

The results of a long-running study conducted in the United States have shown that, in the short term, radiotherapy administered to patients with early-stage prostate cancer improves quality of life more than surgery, but that there is no significant difference between the two treatments in the long term.

Prostate cancer is a type of cancer with treatment success rates reaching %90’s when detected at an early stage and treated appropriately. At this point, choosing the right treatment is very important. Treatment options for early-stage prostate cancer include surgery, active surveillance without immediate intervention, and radiotherapy. Although each of these is known to have various advantages and disadvantages, it has still not been clearly established which is the ideal option. Since the cancer is already at an early stage in these patients, no major differences in survival have been demonstrated among the treatment options. All have high success rates. At this point, the importance of possible side effects and quality of life after treatment becomes even greater when choosing the treatment to be administered.

In many studies conducted to date, these treatment options have been compared with one another from different perspectives. One such comparison has examined surgery and radiotherapy in terms of quality of life after treatment. Surgery is the removal of the prostate gland and seminal vesicles. Radiotherapy, on the other hand, is a treatment method that aims to kill cancer cells using high-energy radiation. Many studies have been conducted on this subject, but they do not adequately reflect the long-term outcomes of the treatments. However, this is a long-term, effective study reflecting outcomes over the 15-year period after treatment.

In this study, 1164 underwent surgery and 491 underwent radiotherapy; 55-74-year-old 1655 men were followed for 15 years to evaluate their quality of life after treatment. The results at 2, 5, and 15 years were analyzed. In the analyses at 2 and 5 years, problems such as urinary incontinence and decreased sexual function were more common in the surgery group; however, in the 15-year analysis, no significant difference was observed between the groups.

In conclusion, multiple treatment options are available for early-stage prostate cancer. To make the right choice, it is necessary to closely follow all developments and have a good understanding of the advantages and disadvantages of these options. Surgical procedures always carry possible side effects. In addition, many patients are apprehensive about undergoing surgery. Furthermore, factors such as the fact that surgery does not provide a significant survival advantage over radiotherapy and that effective treatment with few side effects can be achieved using modern radiotherapy techniques make radiotherapy more preferable to surgery in the treatment of early-stage prostate cancer. However, as we have stated previously, prostate cancer treatment is an individual decision. All aspects of the treatment options should be evaluated, and the decision should be made together with the patient.