The Surgery Debate
- NBC TODAY co-host Al Roker, 66, just recently had surgery for his prostate cancer.
- There are still debates among doctors as to whether surgery is the best option compared to radiation; the procedure can cause side-effects concerning sexual function and problems controlling your bladder.
- Experts say that making a decision around prostate cancer treatment doesn’t need to happen immediately, and it’s recommended you get multiple opinions.
In an Instagram post, Roker posted a sweet photo with his wife, Deborah Roberts, and shared that he just recently had successful prostate cancer surgery and is back home recovering. The anchor announced his cancer diagnosis during a segment on TODAY, and since, his fellow TV family and loved ones sent him overwhelming support.
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Prostate cancer is the most common cancer in men, and begins in the prostate gland, which is located between the rectum and bladder. There are certain risk-factors associated with the disease, including age, race, family history, and genetics.
Prostate cancer surgery comes with it’s own side-effects, such as stress incontinence (leaking urine when you sneeze or cough) and possible sexual dysfunction
Radiation vs. Surgery
Prostate cancer surgery comes with it’s own side-effects, such as stress incontinence (leaking urine when you sneeze or cough) and possible sexual dysfunction. These side-effects happen because the prostate is in a delicate area under the bladder and alongside nerves. These nerves control erections, and so the procedure must be done very precisely in order ensure there are no long-term sexual side-effects. Understandably, taking these factors into account, when to recommend prostate cancer surgery is still a big debate among doctors. Radiation on the other hand targets cancer cells with the goal of eliminating any signs of disease. Unlike surgery, the prostate won’t be removed and instead the tumors will hopefully be eliminated.
Related: Sex Is Possible After Prostate Cancerand 5 Other Facts You Should Know
“Studies have shown that surgeons almost always recommend surgery, and then radiation oncologist will recommend radiation,” Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, told SurvivorNet in a previous interview. “So unfortunately, for the man diagnosed with prostate cancer, that may be a somewhat confusing situation…There may be a little bit of a conflict of interest if you present to a surgeon that is recommending radiation, because again, there’s some ownership of that type of facility.”
Dr. Jim Hu explains why multiple opinions matter when considering prostate cancer surgery
Oftentimes, it's up to the patient to decide which treatment option they'd like to pursue especially considering patients may see the same results whether they choose to have radiation or surgery. That's why a treatment plan needs to be a very personal decision, and your doctor will lay out side-effects linked to radiation just like any other therapy.
Take Your Time & Understand Possible Side-Effects
Unlike other types of cancers where treatment starts immediately, making a decision about prostate cancer treatment doesn’t need to be done immediately. This can be helpful advice, especially since making a decision about whether to have prostate cancer surgery can be a tough one to make.
"The first thing I tell patients is that for the vast majority of them, there is no rush to make a decision," Dr. Patrick Swift, a radiation oncologist at Stanford, tells SurvivorNet. "This is not like pancreatic cancer or lung cancer. There is time to make a decision. There's enough time to drive yourself crazy, too, but there's time to gather the information. You need to take your time to look through the different people that are delivering it and what their experiences with delivering it. But the treatment really needs to be tailored to the individual statistics of that person's disease right that time."
Dr. Patrick Swift explains why prostate cancer patients need to research their treatment options
The goal of the procedure is to completely remove any evidence of cancer, but adjusting to life afterwards is it’s own process. Possible sexual dysfunction and uncontrollable bladder function are common side-effects after cancer surgery, but in many cases they don’t last forever.
While most men will have temporary leakage or erectile dysfunction, in time the vast majority will regain almost normal function in both areas. If you're extremely concerned about sexual function after prostate cancer surgery, it's worth asking about nerve-sparing surgery. If no nerves are preserved after prostate cancer surgery, some men may lose the ability to have an erection entirely. In order to make sure this isn't a possibility, make sure to express any kinds of fears you may have to your physician or surgeon.
Related: Women are Less Likely Than Men to Get Help for Sexual Dysfunction After Cancer Treatment
"[One of the] challenges with surgery is you have two nerves that give you an erection," Dr. Stephen Freedland, Director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai, told SurvivorNet in a previous interview. "Those nerves run right along the side of the prostate. So as we remove the prostate, our goal is not to damage those nerves, but they get pulled. They get tugged. They don't work right, perfectly, right after surgery, but again, with time, that does tend to get better."
Dr. Stephen Freedland explains how long side-effects of prostate cancer surgery typically last
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