Surgery Can be Avoided for Men with Early Stages of Prostate Cancer
After a ten yearlong study, researchers have concluded that surgery for prostate cancer was no better in saving lives than observation.
The research was sponsored by the U.S. Department of Veterans Affairs, the National Cancer Institute, and the Agency for Healthcare Research and Quality.
Researchers had 731 men across the country with early prostate cancer have the gland surgically removed or be observed without any attempt at curative treatment.
Researchers initially wanted to study 2,000 patients, but found difficulty in getting men to enroll.
After a median of 10 years, 171 of 364 men assigned surgery had died, while 183 of 367 assigned to observation died. In the surgery group, 5.8 percent of the men died from prostate cancer compared with 8.4 percent of the men in the observation group. Neither difference was statistically significant.
According to the results, 47 percent of men who had surgery died, mostly from other diseases, compared to 49.9 percent of those who were observed.
According to researchers, one-in-five patients who underwent surgery had complications within 30 days of the operation. Urinary incontinence and erectile dysfunction were much more common in men who got the surgery, while men who got observation had a higher rate of developing bone metastases.
The study's lead author Timothy Wilt said the results are consistent with other studies that observation can be a wise and preferred treatment choice.
The results were published in the New England Journal of Medicine.
Chief Medical Officer for the American Cancer Society Otis Brawley said performing surgery might have been the wrong thing to do all this time.
"There is no question in my mind that what we have been doing in the United States for the last 20 years has hurt a lot of men needlessly," Brawley said. "We need to be telling men that there is tremendous evidence that a large number of men with prostate cancer could be watched and don't need to be treated."
Each year, more than 241,000 American men are diagnosed with prostate cancer. The cancer kills more than 28,000 die from it and it is the second-leading cause of cancer death in men, according to data from the American Cancer Society.
Currently, only 10 percent of American men with prostate cancer who are eligible for observation choose observation, while the vast majority chooses surgery or various forms of radiation in an attempt to cure the cancer.