Comparing the effectiveness of surgery versus radiation in the management of prostate cancer has been hotly debated for many years. It is the goal of research to be able to offer the most up-to-date and accurate information for men with a diagnosis of prostate cancer in order to help them make an informed decision right for them.

In the past year, several studies have credited surgery as a superior to radiation for treatment of clinically localized high-risk prostate cancer.

“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 from surgery only improve as time goes on,” explained Dr. David Samadi, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital in New York City.

A study presented at the American Urologic Association Annual meeting this year based on best-available data in 2018, described at least 11 studies supporting the assertion that surgery is superior to radiation for high-risk prostate cancer. Notably, the greatest beneficial effect of surgery over radiotherapy was largest among patients with high-risk disease.

Another study from the Washington University School of Medicine, found that higher doses of radiation do not improve survival for many patients with prostate cancer. Past studies have shown that gradually escalating the radiation dose resulted in improved cancer control, such as slower tumor growth and lower levels of prostate-specific antigen (PSA), an indicator of cancer growth. The main concern of using higher doses of radiation was that of patients experiencing more side effects, such as urinary irritation or rectal bleeding, sometimes years after treatment.

“Surgery simply makes more sense for most men with prostate cancer,” stated Dr. Samadi. “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. In addition, the prostate gland and surrounding lymph nodes are completely removed and the patient’s PSA will drop to undetectable levels.”

Dr Samadi also added, “Radiation involves frequent treatments which take up time. Radiation can also have numerous side effects such as increased fatigue, rectal bleeding caused by the radiation in addition to a higher probability of developing erectile dysfunction along with bladder or urinary problems such as incontinence.

Dr. Samadi’s SMART Technique for Robotic Prostate Surgery is an innovative robotic-assisted laparoscopic prostatectomy (RALP) technique, developed by Dr. Samadi that reduces surgical time to less than two hours and hospital recovery stay to less than 24 hours. This minimally invasive procedure employs the latest advancements in robotics and computer technology to remove cancerous prostate tissue.

“Recovery from surgery is faster and side effects are almost eliminated,” explained Dr. Samadi. “Radiation can be effective for select patients and I always reserve low dose radiation after surgery if needed but robotic prostate surgery is much less invasive with almost no long-term urological issue.”

Dr. Samadi went on to add, “Simply put, surgical removal of the prostate can be done with greater attention resulting in improved functional outcomes, decreased blood loss, and a shorter recovery. My goal, my philosophy for each man I treat for prostate cancer is that they will have a cancer cure after surgery, attain continence and preserve full sexual functioning.”

Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.

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