Didn't mean to be misleading. The facts have their limitations and I wanted to point that out. I wasn't criticizing radiation therapy as a treatment, my criticism is for the evidence for deciding whether radiation or surgery is better. It's full of holes. Swiss cheese.
I looked a little more and found a 6 year study on later effects of radiation. This shows some deterioration in sexual and urinary function after brachytherapy, but that overall quality of life wasn't affected:
Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1054-60. Epub 2010 Jan 25.
Health-related quality of life up to six years after (125)I brachytherapy for early-stage prostate cancer.
Roeloffzen EM, Lips IM, van Gellekom MP, van Roermund J, Frank SJ, Battermann JJ, van Vulpen M.
There is evidence for existence of urinary and erectile problems years after radiation; what I couldn't find are long term studies comparing surgery and radiation urinary and erectile problems years after treatment. There is a real good study doing this comparison for the first 24 months after surgery (you can get the whole article free on line):
N Engl J Med. 2008 Mar 20;358(12):1250-61.
Quality of life and satisfaction with outcome among prostate-cancer survivors.
Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Mahadevan A, Klein E, Kibel A, Pisters LL, Kuban D, Kaplan I, Wood D, Ciezki J, Shah N, Wei JT.
There is no question that radiation has fewer side effects that surgery, short term. I couldn't find good long term studies. If you can find a study that shows a lower LONG TERM incidence of urinary and ED side effects with radiation, well, bring it on...
As for effectiveness for cancer control, there was a thread about this some time ago. There are some studies that show better outcomes for surgery:
Short- and Long-term Mortality With Localized Prostate Cancer
Arnaud Merglen, MD; Franz Schmidlin, MD; Gerald Fioretta, BSc; Helena M. Verkooijen, MD, PhD; Elisabetta Rapiti, MD, MPH; Roberto Zanetti, MD; Raymond Miralbell, MD; Christine Bouchardy, MD, MPH
Arch Intern Med. 2007;167(18):1944-1950.
This one is a Swiss study. These studies have limitations, but this one is a large population based study. You can get the whole article for free at that website. If you know of similar studies showing that radiation has a better outcome that surgery, well, er, bring it on...
It's human nature to think that we absolutely made the best decision about treatment. I chose surgery, but I'm actually not sure that I made the best choice. I think the evidence guiding treatment choices is really c****y. Prostate cancer and the effects of treatment roll out slowly over the years, and it's incredibly difficult and time consuming to do definitive clinical trials to get level 1 evidence (another thread from several weeks ago).
The reality is that no one really knows whether radiation or surgery is better. That's not backhanded.