Does my choice of initial prostate cancer treatment preclude other treatments later on?
Answer From Erik P. Castle, M.D.
For most initial prostate cancer treatments, the answer is no. For instance, if your initial treatment is surgery to remove the prostate (prostatectomy), other treatments, such as radiation therapy and hormone therapy, may be options for you later, if necessary.
However, if you choose radiation therapy or cold therapy (cryosurgery) as an initial treatment, surgery may not be an option later because of the risk of complications.
Radiation therapy and cryosurgery cause changes to the prostate and surrounding tissues that make later surgery to remove the prostate (salvage prostatectomy) very difficult. Salvage prostatectomy carries a significantly increased risk of urinary incontinence and erectile dysfunction, as well as a risk of injury to nearby structures, such as your rectum.
Salvage prostatectomy can be performed with careful planning at specialized medical centers, but it isn't an option for everyone. Your doctor may recommend other treatments, such as hormone therapy, before considering salvage prostatectomy.
Nov. 02, 2018
See more Expert Answers
- AskMayoExpert. Radical prostatectomy (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Prostate cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 21, 2018.
- Wein AJ, et al., eds. Management of biochemical recurrence after definitive therapy for prostate cancer. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed June 21, 2018.