Early Prostate Cancer Surgery May Not Prolong Life: Treatment May Even Cause Lifelong Complications
Findings of a study spanning 20 years have suggested that prostate cancer surgery may not be beneficial for many men who are in the early stages of the disease.
Surgery Did Not Prolong Life Of Men With Newly-Diagnosed Prostate Cancer
Researchers found that in newly diagnosed prostate cancer patients, surgery did not prolong life and even caused serious complications such as urinary incontinence, erectile dysfunction, and infection.
For the research published in The New England Journal of Medicine on July 13, Gerald Andriole, of Washington University's Division of Urologic Surgery, and colleagues randomly assigned 731 men with localized prostate cancer to either receive surgery or no treatment.
The researchers found that in those who underwent prostate cancer surgery, 61 percent died of other causes during the follow up period that spanned up to 20 years. The percentage of death during this same period in those who did not have surgery was 66 percent, a difference that researchers do not consider as statistically significant.
Of the men who underwent surgery, 7 percent died of prostate cancer while the rate was 11 percent in the control group, which again is not statistically significant.
Side Effects From Treatment
About one in three men who underwent surgery also suffered from lifelong side effects from the treatment. Of the 364 patients who underwent surgery, 15 percent suffered from erectile dysfunction, 17 percent reported incontinence, and others developed other complications.
"Many men, when they hear the word cancer, you want to do something about it," Andriole, said. "The reality is, if you have a low-risk cancer, like the study shows, you don't need treatment, certainly not urgently."
The findings of the study were about men with low grade and nonaggressive cancer, which make up about 70 percent of men who develop prostate cancer.
"About 70 percent of patients newly diagnosed with prostate cancer cases are in the early stages, meaning the cancer is confined to the prostate gland, and they have nonaggressive tumors. As such, these patients have an excellent prognosis without surgery," Andriole said.
Treatment May Be Beneficial To Some Prostate Cancer Patients
The researchers nonetheless noted that surgery may still have mortality benefit in some patients particularly those with more aggressive or high-grade tumors. Patients with aggressive tumor do better with active treatment such as radiation or surgery.
Researchers said that the idea is that aggressive treatment may not always be necessary and that doctors should steer away from making treatment recommendations of radiation or surgery to men with nonaggressive early-stage prostate cancer.