Surgery for Prostate Cancer Cuts Death Risk

The study was published in the September 12, 2002 issue of The New England Journal of Medicine (NEJM).

In all, 695 men with prostate cancer, aged 60-70, took part in the study. Most men in the study had not had screening for prostate-specific antigen (PSA). About half (348) of the men had no treatment unless their cancer spread. The rest (347) had surgery that removed their cancer. After an average follow-up of 6.2 years, 31 (8.9%) of the men who did not have surgery had died, while in the second group only 16 (4.6%) had died, about half as many as in the first group. The study was considered important because for some time now, doctors have been unsure whether surgery helps more than the "watchful waiting” that many have advised their patients to do for lack of proof that surgery would be better.

There were quality-of-life differences also in the two groups. Of the men who had surgery, 80% experienced impotence, compared to only 45% of those in the watchful waiting group. Distress from compromised sexuality was experienced by 56% of the men who had surgery, compared to 40% of those who did not. Similarly, 49% of those who had surgery experienced urinary leakage, compared to only 21% in the control group; and 27% reported distress from urinary symptoms, compared to 18% in the control group.

The study was conducted by researchers at the University Hospital (Uppsala, Sweden), with Dr. Lars Holmberg as principal investigator.




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