Coleman says he chose RP because he was unsure of the track record of other treatments. Besides being a serious operation that requires weeks of recuperation, RP can have lingering side effects, including impotence and incontinence. Until the early 1990s, virtually all RP patients were saddled with these effects. The CaverMap, a device cleared by FDA earlier this year, aids surgeons in locating nerve bundles to help avoid severing nerves related to continence and erections when removing the prostate. Radiation is a treatment option that may be less traumatic than RP and appears to have similar results when used in early-stage patients.
Radiation also produces side effects, including impotence, in about half of patients.
It can be applied through an external beam that directs the dose to the prostate from outside the body. Studies done at the Georgia Center for Prostate Cancer Research and Treatment show that 68 percent of men treated with both radiation methods applied simultaneously are cancer free 10 years after treatment. Cryotherapy, in which prostate tumors are killed by freezing, shows encouraging early results. But some medical professionals consider it experimental with not enough long-term data yet to determine its effectiveness. Hormonal therapy is often used in all phases of prostate cancer treatment to help block production or action of the male hormones that have been shown to fuel prostate cancer.