Prostate Cancer (Part 3): Surgery, Radiation, and the Reality of Side Effects

In the third and final installment of our prostate-cancer trilogy with UCLA urologic oncologist Dr. Wayne Brisbane, Dr. Mills walks a 55-year-old patient through the modern treatment menu—active surveillance, focal therapy, surgery, and radiation—and why “having prostate cancer” doesn’t always mean “operate immediately.” Dr. Brisbane breaks down how doctors risk-stratify tumors (including what Gleason scores really mean), why PSA “ups and downs” can trigger anxiety, and how newer tools (from genomic tests to MRI-guided radiation) help personalize decisions. They also get real about side effects and recovery, from muscle-sparing prostatectomy techniques that can speed urinary control to the “sunburn in the bladder” sensations some men feel after radiation. The takeaway: treat the cancer the way it’s asking to be treated—and don’t be afraid to slow down, get second opinions, and choose the option that best matches your life.

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