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Dr. Kearns on the Role of Surgery in High-Risk Prostate Cancer

James Kearns, MD
Published: Friday, Oct 19, 2018



James Kearns, MD, assistant professor of urology, Levine Cancer Institute, discusses the role of surgery in patients with high-risk prostate cancer.

Physicians have to decide whether surgery is the right option for patients on an individualized basis, Kearns says. It is an important conversation to have with patients, though some patients are inclined to opt for surgery, explains Kearns. An important factor is the patient’s risk tolerance. Because this is a high-risk population, it is expected that these patients will need further therapy down the line, whether it be radiation or hormone therapy. Physicians want to make sure that if patients undergo surgery, there is a good chance it will delay or eliminate the need for that future treatment. If later treatment is unavoidable, Kearns notes it is probably better to avoid the morbidity of surgery.

On the other hand, if a patient is skeptical about the procedure, it is important for the physician to outline the risks and benefits of surgery. However, Kearns adds that most patients seem to be willing to undergo the procedure.


James Kearns, MD, assistant professor of urology, Levine Cancer Institute, discusses the role of surgery in patients with high-risk prostate cancer.

Physicians have to decide whether surgery is the right option for patients on an individualized basis, Kearns says. It is an important conversation to have with patients, though some patients are inclined to opt for surgery, explains Kearns. An important factor is the patient’s risk tolerance. Because this is a high-risk population, it is expected that these patients will need further therapy down the line, whether it be radiation or hormone therapy. Physicians want to make sure that if patients undergo surgery, there is a good chance it will delay or eliminate the need for that future treatment. If later treatment is unavoidable, Kearns notes it is probably better to avoid the morbidity of surgery.

On the other hand, if a patient is skeptical about the procedure, it is important for the physician to outline the risks and benefits of surgery. However, Kearns adds that most patients seem to be willing to undergo the procedure.

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