Surgery or Waiting: The Debate on Early-Detected Prostate Cancer

Surgery or Waiting: The Debate on Early-Detected Prostate Cancer


One of the biggest debates in the men’s health world is whether younger men should have surgery to rid their bodies of the cancerous cells or play what is affectionately called the waiting game. For years, doctors have been telling their young patients diagnosed with prostate cancer might not require surgery, but there is new research that says that it would be in their best interest to have surgery instead of watching and waiting.

The New England Journal of Medicine was published recently and isn’t guaranteed to end the debate as to what is best for young men with prostate cancer, but it does show some interesting information.

The Study

This 23-year study is still ongoing and is comparing prostatectomy against watchful waiting. The study features 695 men that have already been diagnosed with a localized prostate cancer.

Between the years of 1989 and 1999, those with the study randomly assigned certain patients to either get a prostatectomy or to simply wait. Those patients below the age of 65 that had surgery to remove the cancer from their body faced a 15.8 percent lower chance of dying from prostate cancer opposed to those who didn’t. These patients also had a 25.5 percent lower chance of dying from any illness and a 15.8 percent lower chance of having their disease spread to other organs.

The author of the study, Jennifer Rider, is an assistant professor of epidemiology at the Harvard University School of Public Health. She said that the study results “suggest that surgery may be more beneficial to younger men.”

One of the advantages of this trial going on for more than 20 years is the simple fact that in that time, treatment methods have been changed to a more refined process that has been proven to work better than it ever had previously. The basic procedures involved in the surgery have been changed for the better and the side effects, while still there, have become less.

The trial was funded by the U.S. National Institutes of Health and the Swedish Cancer Society.

The Argument Against the Results

The biggest reason why many scientists and researchers might not take these results completely serious is because the study has been going on for so long. The men in the study were diagnosed with prostate cancer long before the prostate specific antigen, or PSA, test was used across the board to detect prostate cancer in its earlier stages.

The chief medical officer of the American Cancer Society says that the results from this study need to be taken essentially with a grain of salt. This is because those diagnosed with prostate cancer for this study came before the PSA test was implemented. The PSA test has become one of the most reliable methods of early detection for men and with this test, prostate cancer can be found a lot earlier.   

Some may wonder why waiting to see what happens with the prostate cancer before having surgery. The most basic response to this is this. When prostate cancer is in its earliest stages, it isn’t a given to turn into a life-threatening disease. The surgery that would be required to remove the prostate is a serious and dangerous procedure that might otherwise not be needed.

Before any universal decision on this matter is given, more research will be needed on both methods. Should research be conducted on this matter again like the one being done in this study, we may be able to get a better and closer look at whether it would be better for patients with prostate cancer to have surgery to remove the cells instead of waiting.

Prostate Cancer Facts

For American men, prostate cancer is the most common cancer. In 2014, the American Cancer Society estimates that more than 230,000 new cases will be diagnosed and additionally, 29,000 men will lose their battle this year.

With the advanced PSA testing, nine out of 10 men that are diagnosed with prostate cancer have their tumors detected at an early point when they are still solely in the prostate gland. The treatment methods after this diagnosis are where the problems arise. As we’ve covered already, some doctors feel that it is important for surgery to happen sooner, while others would claim that instead of having a drastic and dangerous procedure when it might otherwise not be needed, the waiting game is more important.

When it comes down to it, the most important thing you should do if you are diagnosed with prostate cancer is to do your research and ask your doctor anything that would be relevant to your case. They will be able to give you the pros and cons of both decisions with early detection.

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