Effectiveness of Observation for Localized Prostate Cancer

by Anne Trueman on  August 9, 2012 at 3:13 PM Health Watch   - G J E 4
Prostate cancer is the commonest cause of death among men above 75 years of age. Prostate gland is present around the urethra and carries urine out of the body. It constitutes an integral part of male reproductive system.
Effectiveness of Observation for Localized Prostate Cancer
Effectiveness of Observation for Localized Prostate Cancer

Some of the high risk factors of prostate cancer are family history of prostate cancer among brothers and father, men above 6o years of age, excessive intake of alcohol, painters, farmers, people eating too much fat, etc.

Surgery is the usual treatment of choice for patients with prostate cancer. Timothy Wilt and colleagues conducted a study that was published in New England Journal of Medicine 2012, highlighting an important fact that men in early-stages of prostate cancer get no additional benefits by prostate surgery.

The study findings were based on 731 patients of prostate cancer with an average age of 67 years, who were followed up from November 1994 to January 2002.

During the 15-year long study, 354 men died but most of them died of causes other than prostate cancer.

The researchers noted no significant statistical differences in mortality rates in surgical group that reported 171 deaths as compared to the observation group that reported 183 deaths.

In total 52 men died due prostate cancer.

The researchers said that surgery for prostate cancer proved beneficial in people with high-risk early cancers having blood levels of prostate-specific antigen (PSA) above 10 nanograms per milliliter and those individuals with large sized tumors with abnormal cells.

Dr. Timothy J. Wilt. The lead author of the study and the professor of Medicine at Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research mentioned, "Many men, when they hear about a diagnosis of prostate cancer, become fearful. They think if they aren't treated they will die from it. Our results clearly demonstrate that's not true. The overwhelming majority will not die of their disease if it's left untreated."

The researcher said that the study has given people with early-stage of the cancer more confidence to opt watchful waiting as an option beside surgery.

About two-third of the patients, suffering from prostate cancer had low PSA values and 90 percent of them had received early interventions with radiotherapy or surgery.

The favorable effects of observation on bone metastases, mortality, erectile and urinary dysfunction and quality of life should be encouraged. Hence, the adverse effects of unnecessary biopsies can be averted.

The researchers concluded that surgery could be helpful in reducing mortality among patients with high PSA values and in high-risk tumor patients but not among individuals with PSA values of 10 nanograms per milliliter or less or in people with low-risk tumors.


Radical Prostatectomy versus Observation for Localized Prostate Cancer; Timothy Wilt et al; N Engl J Med 2012; 367:203-213

Source: Medindia

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Prostate cancer is certainly NOT the commonest cause of death among men over 75 years of age. According to JNCI J Natl Cancer INst 2002;94;799-804 among men over 75 prostate cancer causes a much smaller number.If you are 75 you have a 4 1/2 percent chance of dying from prostate cancer in the next ten years. You have a 36% chance of dying from a heart attack or stroke combined. You have a 49% chance of dying from anything in the next ten years. It is true than men over 75 have a 75 % chance of HAVING prostate cancer at age 75 but most of these men with be asymptomatic from  it.
Hospitalist Tuesday, August 21, 2012

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