Long-Term Effects of Prostate Cancer Surgery and Radiation Examined

A comprehensive national study has shed light on the long-term effects of treatment choices for prostate cancer, specifically comparing surgical removal of the prostate and radiation therapy. This investigation included over 20,000 men, monitored for up to 20 years, with results revealing significant differences in urinary, sexual, and survival outcomes.

According to the study, men who underwent surgical prostate removal experienced higher incidences of urinary incontinence and erectile dysfunction. Specifically, urinary incontinence was observed in 28.5% of surgical patients compared to 6.1% of those receiving radiation. Erectile dysfunction was reported in 35% of men undergoing surgery, contrasting with 13.9% in the radiation group. Additionally, surgery was associated with a higher prevalence of urinary tract infections and obstructive urinary complications.

Conversely, radiation therapy was linked to a higher all-cause mortality over the follow-up period, with a 45% increased risk of death from any cause compared to surgery. The study also found elevated rates of urinary retention, bladder inflammation, and hematuria among men treated with radiation therapy.

The researchers used data from the TriNetX Research Network, ensuring that the patient groups were well matched in terms of demographic and health characteristics, thereby enhancing the study's rigor. Despite these controls, the study's observational nature means causation cannot be definitively established.

Jeffrey P. Weiss, MD, PhD, FACS, of SUNY Downstate Health Sciences University, emphasized the importance of patients understanding the distinct risks and benefits associated with each treatment option. "Both treatments impact urinary and sexual function, yet they offer potential for a cure," Weiss stated.

Given the complexities involved in choosing between these treatment modalities, the study underscores the necessity for a thorough discussion between clinicians and their patients about the potential long-term implications. Future research is expected to delve further into cancer-specific survival, recurrence rates, and other critical outcomes associated with these treatment strategies.

These findings will be presented at the upcoming American College of Surgeons Clinical Congress 2026 in Washington, where the medical community will continue to discuss advances in surgical practices and related patient care strategies.