Is Prostate Cancer Surgery Recommended For Everyone?

Surgery for early prostate cancer may not be more beneficial than observation

(RxWiki News) For some men with prostate cancer, surgery may not be more beneficial than observation, according to a new study.

The surgery could even cause side effects like erectile dysfunction and urinary incontinence, said the researchers behind this study. In addition, there is a risk for infection at the surgery site. 

"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," said study author Dr. Gerald L. Andriole, of Washington University in St. Louis, in a press release. "As such, these patients have an excellent prognosis without surgery. This study confirms that aggressive treatment usually is not necessary."

This study compared the outcomes of surgery and observation for 731 men over a 20-year follow-up period.

Observation means a man’s prostate cancer is monitored over time to make sure it is not getting worse. Surgery or other active treatments are considered if the cancer is getting worse. 

In the group who had surgery, 7.4 percent died of prostate cancer. In the observation group, that number was 11.4 percent. The study authors noted that the difference was not considered statistically significant.

Urinary incontinence and erectile dysfunction were both greater with surgery when compared to those who were in the observation group through 10 years. 

Despite these findings, these researchers said surgery is still an important and effective treatment option for many men with prostate cancer.

"It would be a disservice to dismiss surgery as a viable option for patients with intermediate-risk prostate cancer," Dr. Andriole said. "For these patients, and for some men with high-risk prostate cancer, surgery is often beneficial, as are other other treatments such as radiation."

Every cancer case is different. Always follow your health care provider's treatment recommendations and ask any questions you may have.

This study was published in the New England Journal of Medicine.

The Department of Veterans Affairs and others funded this research. Information on potential conflicts of interest was not available at the time of publication.

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Review Date: 
July 19, 2017