For men with prostate cancer, deciding whether to opt for radiation or surgical removal of the gland can be overwhelming. How does one decide with the risks such as the unpleasant side-effect of erectile dysfunction and incontinence? With prostate cancer the 2nd most common malignancy, second only to skin cancer. Unfortunately over 240,000 men are diagnosed with the disease every year, translating into 1 in every 6 men being affected by prostate cancer.

Published Thursday in the Journal Lancet Oncology,” found men treated with radiotherapy had fewer minimally invasive urological procedures, compared to those who chose surgery. But over time, radiation group had a higher proportion of hospital admissions, rectal or anal procedures, related surgeries and secondary cancers.”

Men need to take the time to do their research on how “radiation” really works and what side effects they will have to live with. There are two kinds of radiation, external beam and brachytherapy involving radioactive material inside the prostate. We as men have all the control in the world to decide what form of treatment is best for us. Do you just want a quick fix that will sometimes shows you upfront results from radiation, but will suffer from side effects in the long run or having robotic prostatectomy with minimal bleeding, 95 – 97% continence rate and an overall better quality of life. Put aside the temporary leakage and erectile dysfunction that you may receive from robotic prostatectomy, because a year from your surgery those minimal side effects will dissipate. The questions you should be asking yourself is:

• Do you want to be admitted to the hospital all the time?
• Do you want to bleed from your bladder or rectum?
• Do you want a second cancer?

This is the reality of radiation and how it can decrease your confidence, self-esteem, and overall quality of life. Radiotherapy complication rates were 2 to 10 times higher than those men who were treated with Robotic prostatectomy. “When choosing surgery after radiation makes the surgery that much harder. Radiation makes the anatomy very hard and difficult to get through. The PSA is what we are concerned about once the prostate is removed to ensure that the cancer doesn’t come back, but the PSA will fluctuate due to radiotherapy and pieces of the prostate that are left behind, this is all due to choosing to have radiotherapy first, says Dr. Samadi, Chairman for the Department of Urology and Chief of Robotics at Lenox Hill Hospital.

So, following your diagnosis, you are going to be flooded with tons of information and trying to make sense of the different treatment options can make even the most educated patient uncertain. Do your homework and really look at the outcomes 1 month, 1 year to a lifetime from now and ask yourself, “Will I be happy with these results?” As the numbers point to robotic prostatectomy the decision lies in your hands.

“Behind every successful robot there is a successful surgeon.” David B Samadi, MD