Surgery has always been a first line of defense against prostate cancer. Radical prostatectomy is a tried, tested and effective means of treating cancer of the prostate.
But, there has been debate about who will truly benefit from the surgery because prostate cancer can develop slowly in some men. Also, some believe that patients, particularly older ones, might benefit more from doctors monitoring the development of the cancer over time — a sort of "watchful waiting."
The study in the New England Journal of Medicine finds that men who had the surgery reduce the risk of death by seven percent and reduce the risk of the cancer's spread to other parts of the body by 14 percent, compared to men who did not have the surgery.
"There is still a patient population who will still be better served by watchful waiting," said Dr. Senay. "Surgery is not recommended for those men who are too old or too ill to survive longer than 10 years. But for a young man whose cancer hasn't spread, it seems surgery is the best option."
Impotency is a risk of surgery since the prostate is close to the bladder and the nerves that control sexual function. But, the surgical techniques have been refined a lot over the years to reduce those risks.
Dr. Senay says that in addition to surgery, external beam radiation can target the prostate to kill off emaining cancer cells after the prostate is removed. Branchy therapy is another technique that uses radiation by implanting radioactive seeds in the prostate to kill cancer cells.
Hormone therapy is commonly used and cryosurgery, which kills cancer cells by freezing them, also holds a lot of promise.
Current guidelines say men should get their prostates checked at the age of 50, or at age 40 for those with a family history of the disease or for African-Americans," said Dr. Senay.
There are a number of ways to detect prostate cancer. The digital rectal exam and a blood test called the PSA, prostate specific antigen, are the most common. The PSA test is quick and easy. Refinements, like the complex PSA test, may mean fewer biopsies are needed after initial screening.