A higher percentage of prostate cancer patients who undergo surgery survive for at least ten years than patients who opt for other forms of treatment, this is especially the case for younger patients, and those with specific tumor characteristics. You can read about this in Archives of Internal Medicine (JAMA/Archives), October 8th edition.

As prostate cancer treatments have not yet been compared in a randomized trial, the topic still hotly debated, “Therefore, treatment choice is strongly influenced by patient and physician personal preferences and experiences,” explain the authors.

Arnaud Merglen, M.D., of Geneva University, Switzerland, and team collected information from the Geneva Cancer Registry and assessed 844 patients who had localized prostate cancer in Geneva during the period 1989-1998. Localized prostate cancer means it has not spread yet. 158 of these men had undergone surgery to remove part or all of the prostate, 205 had received radiotherapy, 375 opted for watchful waiting (active follow-up treatment if the disease advances), 72 received hormone therapy, while 31 were treated with another type of therapy.

The follow up period ranged from 0 to 15.8 years and averaged 6.7 years. 47 of the men had left Geneva before the end of the study.

“At 10 years, patients treated with radiotherapy or watchful waiting had a significantly increased risk of death from prostate cancer compared with patients who underwent prostatectomy,” the researchers wrote.

The patients’ ten year survival rates were as follows:

  • Prostatectomy (surgery) 83%
  • Radiotherapy 75%
  • Watchful waiting 72%
  • Hormone therapy 41%
  • Other treatment 71%

“The increased mortality associated with radiotherapy and watchful waiting was primarily observed in patients younger than 70 years and in patients with poorly differentiated tumors,” explained the authors. Also, tumors that have specific cellular characteristics that make them spread more aggressively also increase mortality.

The researchers concluded “Until clinical trials provide conclusive evidence, physicians and patients should be informed of these results and their limitations.”

Written by: Christian Nordqvist