Do men with prostate cancer really need surgery?

Do men with prostate cancer really need surgery
Credit: NIH.

Prostate cancer is the second most common cancer in men and the third-leading cause of cancer deaths among men, after lung and colorectal cancer.

Many prostate cancer patients wonder if surgery can help them treat the disease.

However, recent research shows that in many cases, surgery is a good or necessary option for patients.

For example, a 20-year study from Washington University in St. Louis shows that prostate cancer surgery offers few benefits to many men with early-stage disease.

Researchers randomly assigned 731 men in the U.S. with localized prostate cancer to receive either surgery or observation

The researchers found that in the patients, surgery could not prolong life and often caused serious complications such as infection, urinary incontinence, and erectile dysfunction.

Early-stage prostate cancer often grows slowly and rarely causes symptoms.

About 70% of patients newly diagnosed with prostate cancer are in the early stages. This means the cancer is confined to the prostate gland, and they have nonaggressive tumors.

These patients have an excellent prognosis without surgery. The study confirms that aggressive treatment usually is not necessary.

In another study, researchers from UCLA find for people with aggressive prostate cancer, radiation treatments are as effective as surgery.

The study also suggests that a particular form of radiation therapy, consisting of external radiation followed by brachytherapy, provides the best chance of preventing metastatic disease.

The researchers analyzed 487 prostate cancer patients treated for Gleason scores of 9 or 10 prostate cancer.

Gleason score is a grading system of how aggressive the disease appears under the microscope.

Both surgery and radiation-based treatments have vocal supporters and detractors within the medical community.

The relative efficacy of these treatments is particularly important for the most aggressive forms of prostate cancer, which will most likely lead to metastatic disease and eventually death.

In the third study from Imperial College London, UK, researchers found that high energy ultrasound beams can destroy prostate cancer tumors as effectively as surgery or radiotherapy, but with fewer side effects.

The study tracked 625 men with prostate cancer who received a type of treatment called high-intensity focused ultrasound (HIFU).

The treatment is similar to a ‘lumpectomy’ for other cancers – where doctors remove only tumor cells, leaving as much healthy tissue as possible.

HIFU delivers beams of high energy ultrasound directly into the prostate gland, via a probe inserted up the back passage.

Because there are no needles or cuts to skin, it allows a surgeon to precisely target tumor cells within the gland to millimeter accuracy, with less risk of damage to surrounding tissues.

The study also showed the risk of side effects of HIFU, such as urinary incontinence and erectile dysfunction, were lower than other treatment options, at 2% and 15% respectively.

The researchers suggest that the side effects of surgery or radiotherapy can be life-changing for prostate cancer patients.

The ultrasound treatment could tackle cancer with fewer side effects.

The team believes their finding is very encouraging and can provide a new option for prostate cancer patients.

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