For tumors that are confined to the prostate—stages T1 and T2 (A1, A2, B1 and B2)—there are two main choices: Surgery, the radical prostatectomy; and radiation therapy. Radiation also is used when the cancer has spread just outside the gland, to kill cancer cells and to shrink the prostate. High-energy X-ray beams are aimed at the prostate and sometimes at nearby lymph nodes.
Table 4.1 Treatment Pros and Cons
Radical Prostatectomy
Radiation Therapy
Ideal candidate
Age
Younger than 70
Any age
Stage
T1b, T1c, T2 (and some men
TI, T2, T3, T4
with Tia disease)
Chief advantages
If cancer is confined to the
Less invasive
prostate, this is the best way
to cure
Chief disadvantages
Side effects:
May not cure localized cancer;
impotence 25-75%
Side effects:
incontinence 2-5%
rectal injury 1-2%
death 0.2%
impotence 40%
death 0.2%
.
*93\201\8*
