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Health See other Health Articles Title: Prostate cancer overkill I have been saying for the last ten years now that men with Prostate cancer get no benefit in the long term from invasive treatment, but do get a significant reduction in their quality of life. Now there is some new evidence about men men with early prostate cancer that supports my view. A new study shows that surgery to remove the prostate gland appears to offer no survival advantage over watching and waiting. The study, which is published in the New England Journal of Medicine, suggests that many men who undergo the surgery, which is called a radical prostatectomy, are being needlessly exposed to the risk of debilitating side effects, including erectile dysfunction and incontinence. Radical prostatectomy, where a doctor removes the prostate and some of the tissue around it, can damage the nerves and blood vessels that control the bladder and penis, leading to impotence and urine leakage. Indeed, 81% of men in the study who had surgery to remove their prostate had erectile dysfunction within two years of their procedures, nearly double the ED experienced by men assigned to observation. Roughly 17% of men in the surgery group experienced urinary incontinence, about three times the percentage in the observation group. The men in this study had their cancer diagnosed by a prostate specific antigen test (PSA). There has been a lot of debate over the effectiveness of this test at showing appropriate risk. In this case, the research shows that two-thirds of the men with a PSA below 10 who had surgery did not appear to have a real benefit from that surgery. On the other hand, some doctors would say a PSA of 10, even if the cancer has not spread beyond the prostate, is too risky. Prostate cancer is the second most frequently diagnosed cancer in men, behind skin cancer. But most prostate cancers are slow growing, and many men with prostate cancer live relatively untroubled by their tumors and will die of other causes. Despite the good odds of survival associated with most cases, studies show that radical prostatectomy procedures are becoming more common. A study published in June in the Journal of Urology, for example, found the number of radical prostatectomies roughly doubled in the U.S. between 2004 and 2010. "The idea that we are overtreating prostate cancer has been well known for a long time. Many men with low-risk prostate cancer will probably die of other causes rather than die of prostate cancer," says Manish Vira, MD, director of the Fellowship Program in Urologic Oncology at the North Shore-LIJ Health System's Smith Institute for Urology in New Hyde Park, N.Y. Based on a combination of factors that included a man's PSA, the way the cancer looked under a microscope, and the size of the tumor, doctors assessed how risky the cancer appeared to be. Forty percent of men in the study had tumors that were considered low-risk; 34% were intermediate-risk; and 21% were considered high-risk. After an average of 12 years, there was no significant difference in the number of overall deaths or deaths related to prostate cancer between the two groups -- 47% of men who had surgery died compared to 49.9% of men who didn't have surgery. Among men assigned to radical prostatectomy, 21 (5.8%) died from prostate cancer or treatment, compared with 31 men (8.4%) assigned to observation -- a difference so small that it might have been caused by chance alone. Only men who had PSA levels higher than 10 and perhaps those with intermediate- or high-risk tumors appeared to gain any benefit from surgery. "What was remarkable was that even with observation, the chance of dying of prostate cancer was quite low -- about seven chances in 100 over 12 years," Barry says. "People have always said that for these PSA-discovered cancers that you're much more likely to die with prostate cancer than of it, and I think we proved that's way more likely." Having been thanked so many times in the past ten years for persuading men with suspected prostate cancer not to have a prostate biopsy, please talk to me before committing to that step. Similarly, having been thanked by so many men who had diagnosed prostate cancer to avoid invasive treatments, talk to me before you commit to that. You might also like to consider my prostate cancer trial. You can read about that at www.bensprostatecancer.com Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest
#1. To: Tatarewicz (#0)
My dad let the bastards roto rooter his prostate and died of bone cancer close to the area. We figured the two were connected.
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