When Prostate Surgery Makes Sense

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A large study recently published in the New England Journal of Medicine adds a new twist to the debate raging over prostate cancer screening, giving evidence that surgery might be a better option than previously thought. The study showed a 16 percent improved survival advantage for younger men (under 65) with prostate cancer when they are treated with surgical removal of the gland.  

Recent trends – following statements from the American Urological Society and the U.S. Preventive Services Task Force – have pushed for less cancer screening and, when someone develops the disease, more observation over surgical intervention. This may all now be called into question based on the analysis of nearly 700 Swedish men with prostate cancer who were followed for greater than 20 years.

The men in the study who chose surgery rather than "watchful waiting" for their prostate cancer had a significantly reduced risk of death and the difference was most pronounced in men younger than age 65 at the time of their diagnosis. The surgical group underwent radical prostatectomy which involves removing the entire prostate gland containing the cancer. This is the main type of surgery available for prostate cancer and, over the last few years, has more often been performed using laparoscopic robotic technology. The risks of surgical removal of the prostate include potential decreases in urinary control and sexual function.  

In light of this new study, however, determining a best course of action between observation versus surgery requires collaboration between the patient and his urologist with consideration of multiple factors including patient age, overall health, and aggressiveness of their cancer.