Prostate cancer surgery ‘often waste of time’

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iol scitech april 30 prostate cancer AP File photo

London - Thousands of men are undergoing debilitating surgery for prostate cancer which may be needless, claim scientists.

They say that in many cases the tumours are growing so slowly they do not need to be treated.

A major study has shown that survival rates of men who had surgery were hardly any higher than patients whose doctors essentially did nothing.

At present men diagnosed with the illness are offered surgery to remove the prostate gland, known as a “radical prostatectomy”. The operation often has distressing side effects and more than half of men are left impotent and one in ten incontinent.

Now early results from the Prostate Intervention Versus Observation Trial (PIVOT) suggest that in many cases surgery is pointless.

The study began in 1994 involving 731 men with prostate cancer whose average age was 68.They were monitored over the next 12 years and some had surgery while others underwent “watchful waiting” which means their doctors did not treat them.

The results – presented at a meeting of the European Association of Urology – show that on average the men undergoing surgery were just three percent more likely to have survived than the “watchful waiting” group. However surgery was found to increase the survival chances of men with the most serious forms of prostate cancer, the European Association of Urology was told.

Study author Dr Timothy Wilt, of the University of Minnesota, concluded that surgery did not ‘significantly reduce prostate cancer mortality’.

Around 37,000 men are diagnosed with prostate cancer in Britain every year and another 10,000 die.

But in about 50 percent of all cases the tumour is so slow-growing that it does not affect life expectancy – and the men eventually die of something else.

In last 30 years the increasingly widespread use of the Prostate Specific Androgen (PSA) test has led to many more tumours being diagnosed that previously would have gone undetected. Some doctors argue that many of these cancers are harmless and could be left untreated.

Dr Kate Holmes, head of research at The Prostate Cancer Charity, said it was too early to say whether surgery was ineffective.

She added: “Early data from the PIVOT trial certainly suggests that surgery to remove the prostate does not provide any significant survival benefit for men with low to medium risk prostate cancer.

“However, these findings are from a large, ongoing trial, and we look forward to seeing the full published results which could help men in future to make more informed decisions about treatment.” - Daily Mail

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