There has always been a concern about the optimal treatment for patients with locally advanced prostate cancer. When we talk about locally advanced prostate cancer, specifically radiation therapy vs prostatectomy, the modalities of treatment that are generally recommended are surgical extirpation (to remove or destroy totally) via open radical prostatectomy or robotic radical prostatectomy vs radiation therapy along with Hormone Therapy.
In a recent article where they studied over 14,000 men with locally advanced prostate cancer, the results are now irrefutable that surgery for locally advanced prostate cancer has far better outcomes in terms of being disease free and overall survival then primarily treating these patients with localized radiation therapy.
Also in terms on incontinence and erections, men who had radiotherapy or (radiation treatment) after prostatectomy experienced higher rates of erectile dysfunction and urinary incontinence. This article clearly states that robotic radical prostatectomy is the gold standard in terms of eliminating prostate cancer with the least side effects.