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Aggressive Treatment May Be Beneficial for Early Prostate Cancer
Date:5/5/2011

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, May 4 (HealthDay News) -- Among men under 65 with early stage prostate cancer, those who have the prostate gland removed are less likely to die than those who adopt a "watchful waiting" approach, according to a new long-term study out of Europe.

But the findings are not likely to be practice-changing, said Dr. Richard E. Greenberg, chief of urologic oncology at Fox Chase Cancer Center in Philadelphia, who was not involved with the study.

"This is relatively early stage disease, and it shows what we would expect it to show: that those who have more years [to live] have better survival if treated aggressively," he said.

Men with prostate cancer face a confusing maze of options today, including not only surgery but hormone therapy, different kinds of radiation therapy and even simply foregoing medical treatment while monitoring the cancer closely ("watchful waiting," also known as "active surveillance").

"Watchful waiting" is often recommended when a man is not expected to die of the cancer and would like to avoid the risk of the debilitating side effects associated with prostate cancer treatment. These may include: incontinence and erectile dysfunction (surgery); erectile dysfunction and secondary cancers (radiation therapy); nausea, breast growth, liver problems (hormonal therapy); and weakness, hair loss, fluid retention (chemotherapy).

The data presented in the May 5 issue of the New England Journal of Medicine is a 15-year follow-up of a study for which three-years of follow-up had previously been reported.

The earlier study also found that undergoing a radical prostatectomy lowered the risk of the cancer spreading, as well as the death rate from prostate cancer or any other cause.

The researchers, Drs. Anna Bill-Axelson and Lars Holmberg of University Hospital, Uppsala, and colleagues, enrolled nearly 700 men with early prost
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