Risks and Benefits of Radiation Therapy

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There are 2 types of radiation therapy. In one type, called external beam radiation therapy, radiation is given from a machine like an x-ray machine. In another type, radioactive pellets (called "seeds") are injected into the prostate gland. This is sometimes called seed therapy or brachytherapy (say: "break-ee-ther-uh-pee"). Both types work about the same in curing prostate cancer.

The machine therapy is usually given 5 days a week over 7 weeks, which you might find time-consuming. However, you don't need any anesthesia. The side effects are milder than the side effects that can come with seed therapy. However, seed therapy can be done with just one hospital visit. For seed therapy, you have to have anesthesia for a few minutes, but you should be able to go home right after the treatment. In seed therapy, higher doses of radiation can be put right on the cancer. You may feel more discomfort after this treatment.

About one half of patients become impotent within 2 years of having radiation therapy. Many men feel very tired at the end of the treatment period. About 15% to 30% of men who have radiation therapy have urinary burning, urinary bleeding, frequent urination, rectal bleeding, rectal discomfort or diarrhea during or shortly after the treatment. Serious complications are rare. However, a degree of uncertainty goes along with radiation treatment. Since the prostate gland and the lymph nodes are not taken out, your doctor can't tell the exact size of the tumor. The cancer could come back many years after radiation treatment.

At 10 years after treatment, cure rates are about the same for radiation therapy and radical prostatectomy. There are no surgical risks for men who have radiation therapy. There's no risk of bleeding. You don't have to stay in the hospital. You'll recover faster. Daily activities can usually go on during the treatment. Incontinence is extremely rare afterward. However, surgery may give you a better chance of cure over the long term.