If both are spared and if the patient is young and potent and has a small prostate cancer, there is a 50 percent chance that he will remain sexually potent after surgery. However, the rate of potency declines if one or both of the neurovascular bundles are resected as part of the operation. Most patients with stage C disease who do not have lymph node involvement are given external-beam radiotherapy. Over the past five years, there has been increased popularity of brachytherapy. Although this modality, in which seeds containing radioactive iodine or palladium are implanted, has been used since the discovery of radium, technological advances have allowed more precise dosimetry and exact placement of the seeds within the prostate.
Patient selection is important in maximizing success.
Cryosurgery Cryosurgery involves the insertion of probes containing liquid nitrogen into the prostate. The gland is then frozen and thawed, up to two times, causing cellular necrosis and sloughing of the prostate cancer and gland. As with brachytherapy, long-term results are not available. Many investigators have reported high complication rates. The proponents of both brachytherapy and cryosurgery emphasize that these procedures are less morbid and require substantially shorter hospitalizations than more traditional local treatments.