Researchers recent released a study indicating that men with early prostate cancer who have their prostate glands surgically removed are less likely to die from the disease than those who take a more passive, wait-and-see approach.
There is a frequent debate and controversy over which approach is the best in dealing with prostate cancer. Typically prostate cancer is a slow-growing tumor that in some cases poses little threat to the man and yet an estimated 254,000 men dye from prostate cancer annually. It is listed as the sixth leading cause of cancer death in men worldwide the American Cancer Society.
Some surgeons and experts believe that radical prostatectomy - the surgical removal of the prostate gland and neartissues - is always recommended soon after a man is diagnosed with prostate cancer. Yet other's have argued that the majority of men will die from other unrelated issues before prostate surgery becomes an issue.
Surgery and other types of treatment such as radiation or hormone therapy pose risks and side effects, including urinary, erectile dysfunction and other problems.
The Scandinavian Prostate Cancer Group Study was launched in 1989 with hopes of clarifying whether the best way to deal with prostate cancer is patience or aggressive treatment. The researchers previously published findings after tracking the men for an average of eight years, also seeing a survival benefit for the men who got surgery.
The study involved about 700 men from Sweden, Finland and Iceland diagnosed early prostate cancer while in their 60s on average. Half were assigned a radical prostatectomy and half were given a passive "watchful waiting" approach in which they were not immediately given surgery. Later treatment depended on changes in their condition.
After tracking them for an average of about 11 years, 13.5 percent of men in the surgery group died from prostate cancer, compared to 19.5 percent of men in the watchful waiting group.
Dr. Lars Holmberg of the Kings College Medical School in London, who helped lead the research, said that in this study in order to avert one man's death from prostate cancer, about 20 men must undergo radical prostatectomy.
"The gain in terms of prostate cancer mortality from radical prostatectomy still holds out 10 to 15 years after the operation," Holmberg, whose findings appear in the Journal of the National Cancer Institute, said in a telephone interview.
Studies looking into whether PSA screening saves lives are still ongoing. Some experts note that such screening often can detect tumors that may never threaten the life of the man, and lead to surgery and other treatment that is not necessary.
A U.S. panel of experts last week said PSA screening for prostate cancer is not likely to benefit men over age 75 and is not recommended for them. The panel said more evidence is needed to determine whether younger men benefit from early detection of this usually slow-developing form of cancer.
But researchers at Brigham and Women's Hospital in Boston this week said men who had been screened for a longer period of time using PSA tests were less likely to have more serious features of prostate cancer at the time of diagnosis.
Holmberg said the watchful waiting approach assessed in the study may be outdated, with "active surveillance" now favored some as an alternative to aggressive surgical treatment. With active surveillance, doctors more closely monitor a patient's condition in deciding if treatment is merited.
With PSA screening finding tumors so early on, Holmberg said it is possible "up to 50 or even 100" men would need to have surgery in order to avert one prostate cancer death.
Source: Reuters News |
