Per the NCCN guidelines, the treatment options for High-Risk prostate cancer are surgery, beam radiation, or a combination of beam radiation plus radioactive seeds. Hormonal therapy (with Lupron for example) is usually given along with the radiation for two to three years. But patients certainly wonder if one of these three treatment options is better than the other two. A study published recently in the October 2016 issue New England Journal of Medicine compared surgery and beam radiation prospectively in men with mostly Low-Risk prostate cancer. It showed equivalent survival rates. A prospective study for High-Risk prostate cancer, however, is unavailable. Only retrospective studies are available.
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Why Screen for Prostate Cancer?
Screening finds earlier stage cancers, allows for simpler treatments with fewer side effects, and saves lives. For example, in 1985, prior to PSA screening, the prostate cancer five-year survival rate was 69% compared to 99% in 2006. It’s unclear whether this dramatic survival increase is entirely due to PSA screening. Other factors, such as improved therapy have also contributed.
The majority of radical treatment decisions are made on the basis and results of PSA testing. PSA or Prostate-Specific Antigen, is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in the blood. Due to the dangers of overtreatment some experts have proposed forgoing PSAtesting altogether. However, this attitude is like throwing the baby out with the bathwater, since early diagnosis and treatment of high-grade prostate cancer unquestionably improves survival and quality of life.