Prostate Cancer ... Surgery now ... or Wait and See?

An article on Prostate Cancer Surgery published in the prestigious New England Journal of Medicine this month has compiled data from men treated with prostate cancer with follow up going up to 23 years.

The study showed that men under 65 years in particular, benefitted in terms of increased survival after surgery for prostate cancer, but also that older men had a reduced risk of cancer spreading through the body if they have an operation.

The men who took a “wait and see” approach did not do as well. One weakness of the study is that some of the men were treated in the days before PSA, so their cancers were usually more advanced than most patients that we see today. Does this mean that all men with a diagnosis of prostate cancer need an operation? The answer is still No.

The men who benefitted the most were men with a diagnosis of Intermediate Risk prostate cancer, which is calculated on a man’s Gleason score, PSA level and examination findings.

For the High Risk men in some cases the “horse had bolted”, and unfortunately treatment may not be curative. For the Low Risk men, surgery is still an option, but in many cases, delayed treatment or Active Surveillance is the best way to go. In summary, the new study supports what we are doing; shows that our surgery is effective; and men are benefitting from it.

Jim Duthie; Urologist; Grace Hospital