Surgery vs. Radiotherapy (SBRT) for Early Stage Disease

Hi Sandberg , is there a reason why you can’t link to this publication or provide an extract?  I have thought for a long time that our site would benefit by having a good scientific reference for the fundamental question facing many couples.  Yes our individual experiences are very useful, but if I were at the early stage wanting to decide which treatment to go for (I never was), I would welcome some science based research.  I don’t want to get you put on the naughty step so perhaps Brian (Millibob ) or the team can tell us if it would be allowed under the guidelines.  

Hello David (David2017) 

Most links from an outside source now needs to be looked at by the moderation team as we are now under the new Online Safety Act.

In the past we have looked at a "pinned post" outlining all the different treatments available but because everyone of us is different and joins us at a different stage we considered the individual reply to be the better option and more personal.

Another problem is we can't give medical advice, we can only speak from personal experience so again it depends on the link and if it's deemed to be medical advice.

I hope the above helps.

Best wishes - Brian

This is an interesting problem.

I am not entirely on board with the position adopted my the online safety team, presumably advising the moderation team.

However, it is certainly correct that we are all amateurs at this, and our own experience should form the foundation of what we say. I try to remember this at all times.

Nonetheless, our disease and its treatment has changed and is changing almost weekly.  It also true that we all need that word of hope or comfort from time to subdue that little voice shouting "you've got cancer you idiot, be miserable", apparently into your left ear.

I used the words above to search the internet and found 3 papers that fit the bill.

To follow our friend's decision, I will not name or link to them.

They were all linked to both the Hospital and Institute mentioned. You had to reach them to be able to see the link.

They were all from organisations I trust.

There was nothing unusual or unknown about them, merely confirming what can be viewed on the National Institute of Clinical Excellence website.

I haven't provided a direct link or reproduced content as this normally results in the post being deleted. If you paste the text I have provided into an AI or search tool you will easily find further information. Rob

Hi Sandbergand other members of the prostate cancer forum.

My name is Dylan and I work in the Online Community team. I thought it might be helpful to reply to this post and explain a little about our Community guidelines when it comes to linking to clinical information. 

We want members to be able to share information they have found helpful, while making sure that any information shared is safe and comes from reputable sources.

In this situation, we would allow links to sites such as The Royal Marsden and The Institute of Cancer Research, as these are NHS or registered UK charity sites working in partnership with the Royal Marsden.

We do have to remove links to international websites or sites not run by UK-regulated health bodies. This is because we cannot verify whether the information on those sites meets UK health regulations.

If you have any questions please feel free to email our team on community@macmillan.org.uk.

Thank you for helping us keep the Online Community safe and reliable. 

Can we get a link added for the research mentioned earlier within the thread please. 

That study—known as the PACE-A trial—is a landmark piece of research in prostate cancer care. It’s the first randomized trial to directly compare long-term side effects of stereotactic body radiotherapy (SBRT) with surgery for early-stage prostate cancer2. Here's what they found after two years:

Key Findings from the PACE-A Trial

• Urinary Incontinence:

  • Only 4.5% of men treated with SBRT needed urinary pads.

  • A striking 47% of surgical patients required them.

• Sexual Function:

  • SBRT patients reported better sexual function than those who underwent surgery.

• Bowel Issues:

  • 16% of SBRT patients experienced minor bowel problems.

  • 0% of surgical patients reported such issues.

️ What Makes SBRT Different?

• SBRT uses sub-millimetre precision to target tumors.

• Treatment is completed in five high-dose sessions over one to two weeks.

• It’s delivered via advanced machines like the CyberKnife, which is available at centres like The Royal Marsden3.

Clinical Implications

Professor Nicholas van As, who led the study, emphasized that SBRT is often a “kinder” treatment option. It may help men avoid some of the most feared side effects—like incontinence and sexual dysfunction—while still effectively treating the cancer.

If you're weighing treatment options or supporting someone who is, this research could be a game-changer.

Hi Sandberg , many thanks for that post.  Is there anything around to compare outcomes on the actual PCa (life expectancy).

Cancer Teaser Research has a summary here: 

www.cancerresearchuk.org/.../a-trial-comparing-surgery-conventional-radiotherapy-and-stereotactic-radiotherapy-for-localised-prostate-cancer-pace