Myth 20

One selling point for surgery that many frightened patients find comforting is the perception they are creating a safety net, a backup plan, by doing surgery “first” rather than radiation. Their surgeons tell them, “If the cancer comes back after surgery they can do radiation, but surgery can’t be done after radiation.”

This claim is no longer true.

Yes, radiation therapy can be used after surgery for prostate cancer in certain situations. This post-surgery radiation therapy is called adjuvant radiation therapy. It is typically recommended when there is a higher risk of cancer recurrence or if there are adverse pathology findings after prostatectomy (surgical removal of the prostate gland).

Salvage seed implantation in men who have recurrence in the prostate after radiation is being done more and more frequently. Also Salvage Treatments with CyberKnife are becoming very common and extremely effective.

However, there is an even more compelling reason to ignore the surgeon’s “sequence argument.” Starting with surgery made sense 15 years ago when surgery and radiation had equally bad cure rates and equally bad side effects. Today this is a specious argument. Modern radiation has far fewer side effects than surgery and noticeably better cure rates. When you want to cure cancer, why start with a less effective and more toxic treatment while holding a better treatment in reserve?