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You’ll find many studies showing success rates comparing surgery with radiation being statistically equivalent no matter which treatment is chosen (https://www.nejm.org/doi/full/10.1056/NEJMoa2214122).
And that paper studied outcomes even before today’s availability of precision radiation, PSMA PET scans, and other modern technologies.
It mostly comes down to side-effects and quality-of-life (or as that paper concludes, “… the choice of therapy involves weighing trade-offs between benefits and harms associated with treatments for localized prostate cancer.”).
Replies to "You’ll find many studies showing success rates comparing surgery with radiation being statistically equivalent no matter..."
@brianjarvis Thanks! I clicked the link to NEJMoa2214122 and read through the webpage. After which I saw the posting by @jeffmarc suggesting to watch a PCRI video. In the video, the speaker also referenced the NEJM article. Yours and Jeff's postings are both helpful.
(https://www.nejm.org/doi/full/10.1056/NEJMoa2214122)
I read the paper you linked. I found it deceptive. It did not fully describe the radiotherapy type and dose. There are vast differences in cure rates that depend on this.
I pulled many many research papers during my time trying to navigate out of this prostate cancer zone. I found NONE that supported the often reported mantra that two vastly different treatment techniques coincidentally yielded identical curative outcomes.
I challenge you to produce more papers. And if you do not come up with the same papers i found, if you do not produce the very easily found papers that i found within maybe an hour of internet search… i will know
The gist of the many papers i found was this… if you have an agressive grade, chances are you may have cells collecting on the prostate periphery. Going surgery may leave these behind. Going radiation (with brachy boost) can mop up these outer cells sometimes.
Look it up. Do your research
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So I have just joined the group, having received an updated biopsy with Gleason 3+4 and malignant cells in 20% of the cores. The literature seems to show equal success rates between radiation and surgery, but I'm very interested in gathering information about which treatment option has the best quality of life outcome. I'm 73 and still very active.