Radical Prostate Surgery Saves Lives, But is it Worth it?

Men who have their prostate removed at the first signs of prostate cancer have a significantly increased survival rate, according to a new study. However, the radical surgery may be unneeded in most men, where a large portion of men who chose to wait and watch for advancing signs of the cancer wind up never needing any serious treatment.

The study, published in The New England Journal of Medicine, set out to determine if radical prostatectomy -- the removal of the prostate at the first signs of prostate cancer -- could prove to be more prudent compared to other treatment options.

And in some small way it did. The study evenly assigned 695 men with signs of early prostate cancer to either a group that would wait for signs of the cancer's progression before taking any action (called "watchful-waiting"), or a group that would immediately undergo radical prostatectomy.

Over the course of the next ten years, 200 men in the surgery group died, with 63 of those deaths being associated with prostate cancer. Of the watchful-waiting group, 247 men died, with 99 of those deaths being associated with advanced forms of prostate cancer. According to researchers, this implied that undergoing a radical prostatectomy can significantly decrease the likelihood that a patient with early cancer prostate cancer will die of the condition.

However, 101 men in the watchful waiting group survived the decade-long observation period with little to no treatment for their cancer, which remained in early stages. This may imply that a substantial number of the men from the radical prostatectomy group may have never needed to have their prostates removed in the first place.

With the findings, the study proved not as conclusive as the researcher may have liked. The findings, which provide positive news for men who do choose to undergo a radical prostatectomy, do appear to support the surgery. However, the researchers note that more research needs to be done looking into the long-term impacts of radical prostatectomy. The surgery could possibly still have some adverse effects that may influence the overall mortality rates mentioned above.

Adverse effects unrelated to mortality have already been associated with prostatectomy, including trouble with urinary control, impotence, and even loss of fertility, according to the American Cancer Society. For these reasons, many men may still choose to watchfully-wait, taking their chances with prostate cancer despite the significant increase in survival rate surgery can provide.

The study was published in The New England Journal of Medicine on March 6.