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Outcomes Vary for Prostate Cancer Patients Choosing Surgery; Overall, No Treatment Proven Superior
Date:2/4/2008

an those treated by external radiation.

-- One study showed that men who choose surgery over watchful waiting are less likely to die or have their cancer spread. The benefit appears to be limited to men under 65. However, because few patients in this study had cancer detected through PSA tests, it is unknown if this finding would apply to those whose cancers were detected through PSA screening. Another smaller study showed no difference in survival between surgery and watchful waiting.

-- Among patients who choose surgery, urinary complications and incontinence are less likely if their surgeons performed more than 40 prostate removals per year.

-- Surgery-related deaths, urinary complications and readmissions were lower and hospital stays were shorter in hospitals that performed more prostate removals.

-- A lack of research makes it impossible to compare several treatments: rapid freezing and thawing (cryotherapy); minimally invasive surgery (laparoscopic or robotic assisted radical prostatectomy); testicle removal or hormone therapy (androgen deprivation therapy); and high-intensity ultrasound or radiation therapy.

-- Adding hormone therapy prior to prostate removal does not improve survival or decrease recurrence rates, but it does increase the chance of adverse events.

-- Combining radiation with hormone therapy may decrease mortality. But compared with radiation treatment alone, the combination increases the chances of impotence and abnormal breast development.

The report released today, Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer, is the newest analysis from AHRQ's Effective Health Care program. This AHRQ program represents an important federal effort to compare treatments for significant health conditions and make the findings public. The Effective Health Care program also translates reports into plain-language guides for clinicians, patients and policymakers. In
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SOURCE Agency for Healthcare Research & Quality
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