NEW YORK, NY -- (Marketwired) -- 03/12/14 -- In a long-term prostate cancer treatment study, men with early-stage cancer who opted for a radical prostatectomy were significantly less likely to die from prostate cancer than men who declined treatment in favor of watchful waiting. The 23-year Swedish study found that the rate of mortality among surgery patients was lowest in men younger than 65 and in those with intermediate-risk prostate cancer. In older men, radical prostatectomy was associated with a reduced risk of metastasis, or the spread of cancer to other organs.
David B. Samadi, MD, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital, contends that the cancer, if not fully removed, can spread quickly and without warning. As a robotic prostate surgery expert, Dr. Samadi encourages patients to thoroughly weigh the risk of prostate cancer treatment side effects against the risk of disease spread, which is a potential consequence of non-surgical treatments.
"Each type of treatment -- from robotic prostate surgery to radiation therapy -- carries with it some side effects. Successful outcomes result from combining a proficient assessment of tumor aggression, a patient's health and physical condition, and ultimately, a physician with a high level of expertise," said Dr. Samadi.
According to the study, by the end of 2012, 200 men in the radical prostatectomy group and 247 men in the watchful waiting group had died, thus indicating that the cumulative incidence of death at the 18 year mark was 56.1 percent in the radical-prostatectomy group and 68.9 percent in the watchful waiting group. Men over age 65 experienced mortality rates comparable to those of non-surgery participants but were less likely to experience metastases.
"It is important to note that the decision to wait out prostate cancer does not mean a life free of side effects," noted Dr. Samadi. In fact, at 18 years of follow-up more watchful waiting study participants were diagnosed with distant metastases and underwent palliative treatments, such as hormone therapy than those in the radical prostatectomy group. "Watchful waiting may mean frequent medical follow-ups and repeat prostate biopsies that can result in both physical and emotional strain," he added.
Some men are concerned that prostate removal surgery may negatively impact their sexual potency or cause urinary incontinence. However, previous studies have demonstrated that a surgeon's experience, as well as having the surgery performed at a hospital with high surgical volume can significantly improve recovery in these two areas. Dr. Samadi has performed more than 5,600 successful robotic prostatectomies with superior quality of life results for his patients.
"This study's findings are not simply about prostate cancer treatment being effective," emphasized Dr. Samadi. "They specifically point to the efficacy of the prostatectomy in improving long-term survival and quality of life. Both are optimized with the right surgeon."
Study results were published in last week's New England Journal of Medicine, http://www.nejm.org/doi/full/10.1056/NEJMoa1311593
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