A study of men diagnosed with early-stage prostate cancer has confirmed that patients who wait for the cancer to reach a later stage have the same odds of living as those who have their tumors removed at the early stage itself. The results show that while each path comes with its own benefits and risks, neither would lead to death due to prostate cancer.
The study began in November 1994, when Dr. Timothy Wilt, of the Minneapolis VA Center for Chronic Disease Outcomes Research, and his team, enrolled 731 men in a clinical trial, all diagnosed with localized prostate cancer. 364 of these men were randomly assigned to have their prostates removed surgically and the remaining 367 men were assigned to the observation group. The average age of all the patients was around 67 when they joined the study. They were tracked until they died or August 2014, whichever came first.
7.4% of the men in the surgery group died of prostate cancer as did 11.4% of the men in the observation group. The difference was too small to be of any statistical significance. 61% of the men in the surgery group died of other reasons as did 67% of the men in the observation group. This difference was also too small to be regarded as statistically significant.
In the past few years, doctors have been recommending observations for men who were diagnosed with early-stage prostate cancer instead of surgical removal or radiotherapy. Prostate cancer is a slow-moving disease and often the pain and side effects of the surgery are more likely to cause problems than the cancer itself. Patients who undergo surgery are more likely to suffer from erectile and sexual dysfunction and for up to 10 years after the surgery, they are reported to have more urinary incontinence than their counterparts who avoided the surgery. The patients in the observation method are also more likely to need additional treatments like prostatectomy, radiation, or cryotherapy.
However, the study was conducted based on the surgical methods of November 1994 and the methods have advanced to a much higher level today. Dr. Christopher Saigal of the David Geffen School of Medicine said that patients contemplating surgery today might face a lower risk of the side effects.
Men who contract the disease at an early stage in their life are usually recommended observation since the disease is not fatal. But those who are at the higher-risk stage, they are usually recommended treatment beyond surgery.