Surgery Urged For Prostate Cancer

For Men Under 65 Surgery Better Than 'Watchful Waiting'

(AP) 
About 60,000 Americans undergo prostate cancer surgery each year. A man's age, his overall health, how advanced the cancer is and how aggressive it appears under the microscope are among the factors doctors use in deciding whether to recommend surgery.

But some recent research has shown that even slow-growing tumors can become more lethal after 15 years.

The latest study began in 1989. Researchers at 14 hospitals in Sweden, Finland and Iceland studied 695 men, most of them with tumors that had not spread beyond the prostate and were considered moderately aggressive. Their age averaged just under 65. Half got prostate surgery; the other half were assigned to watchful waiting.

Preliminary results released in 2002 showed only that the surgery cut deaths from prostate cancer. Three more years of follow-up showed a reduction in overall mortality.

Among all men in the study, after 10 years, those getting surgery had a 44 percent lower rate of death from prostate cancer, a 26 percent lower rate of death from all causes, and sharply lower rates of cancer spread.

Brooks said longer-term research is needed to determine how the results apply in this country, where prostate cancer usually is diagnosed at an earlier stage by the PSA blood test; the Scandinavian men mostly were diagnosed when the tumor was large enough to be felt on a rectal exam.