New Study Shows Surgery Has Less Side Effects and Long-Term Issues Over Radiation for Treating Prostate Cancer

Jul 07, 2015, 05:38 ET from Dr. David Samadi

NEW YORK, July 7, 2015 /PRNewswire/ -- New study findings reveal that more complications occur in patients treated with radiation therapy versus surgery for prostate cancer.

Researchers from the University of Toronto presented their findings at the Canadian Urological Association annual meeting in Ottawa last month, which further suggest that prostate cancer patients who undergo radiation therapy have a 25-40% increased risk of requiring minimally invasive urologic procedures due to treatment complications. They analyzed over 60,000 men between the ages of 65 and 79 who has either underwent a radical prostatectomy or radiation.

"One of the issues with radiation as opposed to surgery is that many of the side effects can occur later on, which can include rectal and bladder bleeding, whereas the side effects that come along with surgery only improve as time goes on," noted Dr. David Samadi, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital in New York City.

Why should patients choose surgery over radiation? For many prostate cancers, surgery is the optimal treatment path because it's the only option that gives the most accurate staging and grading of the cancer. On top of that, the prostate gland and surrounding lymph nodes are completely removed. The patient's PSA will drop to undetectable levels.

"Moving forward, the patient will know they are cured from this particular cancer. If the cancer recurs, patients have other options ahead of them. I always reserve low dose radiation after surgery if needed," said Dr. Samadi.

Dr. Samadi's SMART Technique for Robotic Prostate Surgery measures each patient's individual success and recovery based on his "triple play" treatment philosophy. This philosophy equally measures three aspects of the patient's quality of life after surgery: cancer cure, and retention of sexual function and continence.

"Recovery is faster and side effects are almost eliminated. Radiation can be effective for select patients, but robotic prostate surgery is much less invasive with almost no long-term urological issues," stressed Dr. Samadi.

This study is a key indicator that each treatment for prostate cancer can have various outcomes. Experts have long debated surgery versus radiation, especially when it comes to treating prostate cancer. Over the past decade the marketplace has become flooded with new technologies for prostate cancer treatment. But the truth is for qualified patients, surgery remains the only option that gives an accurate staging of the cancer and in the hands of a skilled surgeon, the prostate can be removed with greater attention resulting in improved functional outcomes, decreased blood loss, and a shorter recovery.


  • Length of Treatment
    • One-time treatment for 2-4 hours, on average
    • 1-2 night hospital stay, on average
  • Accuracy of Treatment
    • Very accurate: prostate gland is visualized and removed
  • Side Effects During Treatment
    • Anesthesia
  • Hormone Therapy Necessary?
    • No
  • Cancer Staging
    • Very accurate because entire specimen can be analyzed
  • PSA Follow-Up
    • Testing begins at 6 weeks post-operative
    • PSA remains <0.1
  • Side Effects After Treatment
    • Impotence and incontinence
  • Risk of Impotence & Incontinence   
    • Improves with time
  • Secondary Therapy Possible?
    • Yes, radiation is possible after surgery
  • Increased risk for second cancer?
    • No


  • Length of Treatment
    • EBRT is typically administered 5 days a week for 5-6 weeks (45 days of treatment)
    • CyberKnife® is typically done over the course of 5 days .
  • Accuracy of Treatment
    • Not always accurate: radiation is targeted at prostate based on imaging data, dosage and location is approximated
  • Side Effects During Treatment
    • Fatigue, skin inflammation, frequent/difficult/uncomfortable urination, rectal bleeding or irritation, hemorrhoids, diarrhea
  • Hormone Therapy Necessary
    • Lupron a prescription given along with RT, which has its own panel of side effects, similar to menopause
  • Cancer Staging
    • Not accurate: exact type of prostate cancer not known, extensity not known, seminal vesicle and lymph node involvement not known
  • PSA Follow-Up
    • Testing begins ~2-3 months post-operative
    • Will not reach lowest point for 18-24 months
    • Majority of men experience a "PSA Bounce" (a temporary rise in PSA) where the PSA rises ~15% post-treatment, then declines again
  • Side Effects After Treatment
    • Bowel dysfunction
    • Impotence and incontinence
  • Risk of Impotence and Incontinence
    • Worsens with time
  • Secondary Therapy Possible
    • No: Surgery is very difficult to do post-radiation
  • Increased Risk for Second Cancer
    • Yes: a 5% increased risk of rectal or bladder cancer

Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a consultation. Visit and call 212.365.5000 to set up your consultation.

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SOURCE Dr. David Samadi