Is Radical Prostate Cancer Surgery Worth The Risk? Experts Say No
Men with prostate cancer may not benefit from surgery, according to a new study, published in the New England Journal of Medicine. Researchers found that removing the prostate and surrounding tissue, a procedure known as a radical prostatectomy, does not improve a patient's chance for survival.
Aside from skin cancer, prostate cancer is the most common cancer in American men -- more than 250,000 men will be diagnosed with the condition in 2012, according to the American Cancer Society. Most men diagnosed don't die from prostate cancer and treatment side effects are so common doctors often advise men with slow-growing tumors not to undergo treatment, according to the study.
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Prostate cancer is typically treated with tumor-removing surgery or radiation, but about 90 percent of men who undergo prostate cancer treatments experience sexual dysfunction and 30 percent have urinary incontinence, according to the American Cancer Society.
Researchers looked at 731 men diagnosed with prostate cancer, half of which were assigned to have surgery. After 12 years, 47 percent of the men who underwent surgery died, compared to 49.9 of the men who did not. In addition, the men who underwent surgery suffered adverse side effects from the surgery.
In conclusion, our study showed that, as compared with observation, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality through at least 12 years among men with clinically localized prostate cancer that had been diagnosed in the era of PSA testing," the authors wrote in the study.
Experts hailed the findings, saying it will change how prostate cancer is detected and treated.
"I think this is game-changing," Dr. Leonard Marks, a professor of urology at the University of California, Los Angeles, who was not involved in the study, told the New York Times. "What this study does is call attention to the fact that there are a lot of prostate cancers that are diagnosed today that are not dangerous."
However, that doesn't mean men should not get tested, Dr. Peter Scardino, chief of surgery at Memorial Sloan-Kettering Cancer Center in New York, who was not involved in the study, told ABC News.
"The message to patients should be, get tested, have a biopsy if necessary, but be very careful before agreeing to treatment," he said. "Make sure you have a cancer that really poses a serious risk to your life and health and that the treatment is not worse than the disease."
In an accompanying editorial, Dr. Ian Thompson, director of the cancer therapy and research center at the University of Texas Health Science Center in San Antonio, wrote that men shouldn't always worry about a disease that probably won't kill them.
"The real point is that we shouldn't focus on finding every prostate cancer because, as this study and all the screening studies show, the majority that you find don't need to be found," he told the New York Times. "What we should focus our screening on and our testing on are patients who are likely to have more aggressive tumors in which treatment seems to make a difference."
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