Navigation Links
Men Who Have Prostate Cancer Surgery Do Well

But study didn't determine value of any treatment vs. watchful waiting

MONDAY, July 27 (HealthDay News) -- A major study has good news for men who have prostate cancer surgery but leaves unanswered the complicated question of whether a man should have that operation, another treatment or just watchful waiting.

The study of almost 13,000 American men who had a radical prostatectomy -- surgical removal of a cancerous prostate gland -- between 1987 and 2005 found that only 12 percent of them died of the cancer, according to the report in the July 27 issue of the Journal of Clinical Oncology.

"Patients with what we thought of as high-risk prostate cancer had a much lower risk of dying of their cancers than we ever thought," said Dr. Peter T. Scardino, chairman of the department of surgery at Memorial Sloan-Kettering Cancer Center, and a member of the research team. "Patients with more favorable prostate cancers did remarkably well, so well that you have to begin to question whether they should have been treated."

The choice of surgery, radiation therapy or watchful waiting must be made each year for more than 190,000 American men, most middle-aged or older, who are diagnosed with prostate cancer. Most choose some kind of treatment, said Dr. Andrew Stephenson, head of urological oncology at the Cleveland Clinic's Glickman Urological and Kidney Institute, and another member of the research team. From 40 percent to 50 percent choose surgery, about 10 percent choose watchful waiting, and the rest choose some form of radiation therapy, Stephenson said.

For men who have surgery, the new research has produced a tool that can allow them to predict their chance of survival for at least 15 years, Scardino said. Survival is measured by essentially three elements: the clinical stage of the cancer when it is detected, determined in great part by how large it is; the Gleason score, a measure of how much of its normal structure the prostate gland has lost; and blood levels of prostate-specific antigen, a protein produced by the gland.

The study found that the score had an accuracy of 82 percent in predicting 15-year survival, Scardino said. "If you could predict what would happen in the stock market in the next 15 years with 82 percent accuracy, you would be a genius," he said.

Overall, there was a greater chance that a man in the study would die of a cause other than prostate cancer. The rate of death from other causes was 38 percent, compared to 12 percent attributed to prostate cancer.

The new predictive method will be made public soon, after medical review, so that physicians and men can learn about their anticipated survival after surgery, Scardino said.

"Any person can look at it and put in the numbers," he said.

The new predictive tool is an improvement over the existing method, which relies essentially on readings of prostate-specific antigen levels, Stephenson said.

But no such predictive method exists for newly diagnosed men who must chose between treatment and watchful waiting, and so the study presents a predicament for those men and their physicians, he said.

"It questions the lethality of prostate cancer," Stephenson said. "Perhaps a similarly low risk might have been seen if the men did not have prostatectomy. We can't say whether a cancer poses enough of a threat to the patient so that therapy is needed."

Prostate cancer surgery is not free of problems, Stephenson said. Its major side effects are incontinence and loss of sexual function.

Many prostate cancers grow slowly -- so slowly that an old medical byword is that "more men die with their prostate cancer than of it." No existing method can single out the cancers that will be fatal if left untreated.

"We really need better tools for really identifying prostate cancers that pose a threat to longevity," Stephenson said. "Many have been proposed. All are being investigated, and hopefully in the future we will have better tools that accurately predict the risk of dying from prostate cancer."

Until those tools are available, the question is often "a balance between quantity and quality of life," he added. "That is a very complicated decision that must take many factors into consideration."

More information

Basic facts about prostate cancer are provided by the U.S. National Cancer Institute.

SOURCES: Peter T. Scardino, M.D., chairman, department of surgery, Memorial Sloan-Kettering Cancer Center, New York City; Andrew Stephenson, M.D., head, urological oncology, Cleveland Clinic Glickman Urological and Kidney Institute, Ohio; July 27, 2009, Journal of Clinical Oncology, online

Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Conventional prognostic factors fail to explain better prostate cancer survival in most Asian men
2. First biomarker discovered that predicts prostate cancer outcome
3. Frequent Prostate Screens Fail to Improve Aggressive Cancer Diagnoses
4. New male sling procedure helps prostate cancer survivors who suffer from urinary incontinence
5. Us TOO Launches National SEA Blue Campaign for Prostate Cancer Awareness Month
6. Red wine compound shown to prevent prostate cancer
7. Barbershop Talks Cut Black Mens Prostate Cancer Risk
8. Generic prostate drug helps find high-risk cancers early
9. Finasteride unlikely to induce high grade prostate cancers
10. Shrinkage of prostate led to overestimation of cancer risk in trial
11. Prostate Cancer Awareness Week to Screen Thousands
Post Your Comments:
Related Image:
Men Who Have Prostate Cancer Surgery Do Well
(Date:11/27/2015)... , ... November 27, 2015 , ... ... center software Q-Suite, announces the incorporation of Asterisk 11 LTS (Long Term Support) ... supported Asterisk 11 LTS brings Q-Suite 5.10 up-to-date with a version of Asterisk ...
(Date:11/26/2015)... ... November 26, 2015 , ... Inevitably when people think Thanksgiving, they also ... buy during the Black Friday and Cyber Monday massage chair sales to ... Internet high and low to find the best massage chair deals, they can see ...
(Date:11/26/2015)... , ... November 26, 2015 , ... ... Express Travel Representative. As a franchise owner, Somu now offers travelers, value and ... destination wedding packages, private cruise sales, as well as, cabin upgrades and special ...
(Date:11/26/2015)... NE (PRWEB) , ... November 26, 2015 , ... Jobs ... searched by healthcare professionals and offered by healthcare staffing agency Aureus Medical Group ... during the month of October 2015 among those searching for healthcare jobs through the ...
(Date:11/26/2015)... (PRWEB) , ... November 26, 2015 , ... ... second medical opinion process, participated in the 61st annual Employee Benefits Conference. The ... and took place Sunday, November 8th through Wednesday, November 11th, 2015. The conference ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... november 2015 AAIPharma Services Corp./Cambridge ... investering aan van ten minste $15,8 miljoen ... het mondiale hoofdkantoor in Wilmington, ... in extra kantoorruimte en extra capaciteit voor ... behoeften van de farmaceutische en biotechnologische markten. ...
(Date:11/26/2015)... --> --> Juntendo University ... contrast weighting of MRI for patients with Multiple Sclerosis ... agreement with SyntheticMR in order to use SyMRI in clinical ... to generate multiple contrast images from a single scan and ... making it possible to both fine tune images and recreate ...
(Date:11/26/2015)... 26, 2015 Research and Markets ( ... "2016 Future Horizons and Growth Strategies in ... Shares, Country Segment Forecasts, Competitive Intelligence, Emerging Opportunities" ... --> --> This new ... Japanese therapeutic drug monitoring market, including emerging tests, ...
Breaking Medicine Technology: