Prostate Cancer Study: Hold The Surgery

The eternal debate about treatment (or not) of early stage prostate cancer continues to fuel studies of the pros and cons of surgery. The latest, a 12-year-long look by researchers at the Massachusetts General Hospital, finds that men in their 60s who had surgery didn’t live significantly longer than those whose cancers were merely monitored. Deborah Kotz, writing in the Boston Globe’s Daily Dose, reports that the trial, published in the New England Journal of Medicine, involved 731 men (average age of 67) who were diagnosed with early-stage prostate cancer. About half were randomly selected to have their prostate removed and the rest were monitored. Kotz reports that after 12 years, nearly 6 percent of men who had immediate surgery died of the cancer compared with slightly more than 8 percent of those patients who were observed, numbers that fall short of a statistical significance. There were, however, some subsets that might benefit. One is men with PSA levels of greater than 10 nanograms per millimeter. That group had a 33 percent lower risk of dying from prostate cancer if they were immediately treated with surgery rather than observed. The MGH docs also looked at quality-of-life costs of surgery: About 17 percent had urinary incontinence compared with 6 percent of those who skipped the treatment, and 81 percent in the surgery group had erectile dysfunction compared with 44 percent of those whose cancers were monitored. Read more in the Boston Globe.