Welcome to Johns Hopkins Health Alerts!

"Johns Hopkins Health Alerts is an excellent site and I have recommended it to several of my friends. Thanks again, and keep up the good work!"
  • - D. Ambrosio

This free public service from Johns Hopkins Medicine helps keep you up to date on the latest breakthroughs for the most common medical conditions which prevent healthy aging.

Get the latest news sent straight to your inbox for FREE. Check all the boxes below for the topics that interest you.
We value your privacy and will never rent your email address

Johns Hopkins Health Alert

The Pros and Cons of Prostate Cancer Treatment Options

Comments (0)

The standard treatment options for prostate cancer are active surveillance, radical prostatectomy, external beam radiation therapy, and brachytherapy. Here’s a look at the advantages and disadvantages of each, in brief. 

Active surveillance for prostate cancer 


• Avoids side effects from radiation therapy or radical prostatectomy

• No hospitalization or surgical risks 


• Requires close monitoring (regular digital rectal exams, PSA tests, and prostate biopsy) to monitor for signs of progression

• May be psychologically stressful knowing that the prostate cancer will not be actively treated until it progresses 

Radical prostatectomy for prostate cancer 


• Proven to reduce prostate cancer death rates

• Removed tissue allows accurate staging

• PSA levels reliably predict recurrence

• Fewer bowel/rectal problems than with EBRT

• Less urinary urgency and frequency than with EBRT or brachytherapy 


• General risks of surgery

• Hospitalization required

• Catheter in place for 1-2 weeks

• Recovery period: at least 1 month

• Incontinence: 5-20% (mostly stress incontinence)

• Erectile dysfunction: 30-50% at 5 years (with nerve preservation) 

External beam radiation therapy (EBRT) for prostate cancer 


• No hospitalization or surgical risks

• Activities unrestricted

• Low risk of urinary incontinence (1-2%)

• Less urinary retention than with brachytherapy 


• No post-treatment staging information

• Daily treatments for 6-8 weeks

• Fatigue may occur when treatment ends

• Erectile dysfunction: 30-50% at 5 years

• Bowel/rectal problems: 5-10% (urgency, pain, diarrhea, or bleeding) but typically improve after treatment

• Bladder irritation: 5% (urinary frequency, urgency, discomfort) 

Brachytherapy for prostate cancer 


• No hospitalization or surgical risks

• Less radiation damage to healthy tissue

• One treatment

• Low risk of urinary incontinence (1-2%) 


No post-treatment staging information

• Less favorable option for men with intermediate- or high-risk prostate cancer

• Urinary retention, urgency, and frequency more common than with other treatments, especially in men with lower urinary tract symptoms before treatment 

Posted in Prostate Disorders on March 24, 2011

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer

Notify Me

Would you like us to inform you when we post new Prostate Disorders Health Alerts?

Post a Comment


Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.

Post a Comment

Already a subscriber?


Forgot your password?

New to Johns Hopkins Health Alerts?

Register to submit your comments.

(example: yourname@domain.com)

Customer Service

Registered Users Log-in:

Forgot Password?

Become a Registered User!
It's fast and FREE!
The Benefits of Being a Registered User

Health Topic Pages

  • Health Alert
  • Special Report

What is this?