Can't understand why anyone would choose surgery over Brachytherapy? I must be missing something?

I think that a wide range of factors influence men’s choices on this.

1. Historically, prostatectomy achieved better cure rates than radiotherapy, although I believe that there is not much in it nowadays.
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3. Radiotherapy was also associated with some nasty side effects especially because of the potential for damage through burns to nearby organs. Again, radiotherapy options have become more sophisticated and accurate so this is apparently less of a problem now. In fact, for many men, the side effects of radiotherapy may now generally be less severe than those associated with prostatectomy. ( This is a major factor underlying Dr Scholz’s clear preference for radiotherapy).
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5. Radiotherapy has also been associated with a potential for long term damage, e.g. a small increased risk of other cancers.. The extra risk is probably small, but this can be an issue for some younger men.
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7. Radiotherapy is also often accompanied by hormone therapy which is dreaded by many. I remember reading that this was a crucial factor in steering Stephen Fry towards prostatectomy.
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9. There can also be a tendency for us to think along the lines that this is cancer and, as with any cancer,” I want it out as soon as possible.”
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11. In some cases men may be put off by the thought of having to travel to hospital on a daily basis over a prolonged period – this was definitely a factor for me in the middle of the covid era.
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13. Partly because of the above, the field has tended to be dominated by surgeons and they are naturally inclined to favour their own field, even at the expense of maybe sometimes being over-optimistic. More generally, there is a danger that we can be swayed by the persuasiveness of the experts that we talk to and so we may be subject to their biases.
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15. There are probably various other factors which come into play and each of us ultimately have to make our own judgement of the various trade-offs involved. That is if we have a choice which is not always the case. For example, prostatectomy has not always been offered to older men or those who have other health issues, or sometimes to those with locally advanced cancer.

Edited by member 19 Aug 2024 at 10:38  | Reason: Not specified