Radical prostatectomy worthwhile

22 Aug 2008

A major study from Sweden and Denmark has established that removal of the prostate is better than simply waiting and watching.

The SPCG* trial, conducted at many institutes across scandinavia, followed 695 men with clinically localised prostate cancer; 347 allocated ‘watchful waiting’ and 348 radical prostatectomy. The trial, began in 1989 and previously reported results in 2005, well ahead of the UK equivalent Prostate Testing for Cancer and Treatment (ProtecT) study.

After an average follow-up of 10.8 years, 13.5% of the men in the radical prostatectomy groupand 19.5% of the watchful waiting group died from prostate cancer.

At 12 years, 12.5% of the surgery group and 17.9% of the watchful waiting group had died of prostate cancer. Also, 19.3% of the men in the surgery group and 26% of the watchful waiting group had been diagnosed with distant metastases.

Researchers from Uppsala University Hospital, Sweden, concluded: “Radical prostatectomy reduces prostate cancer mortality and risk of metastases.”

Prostate cancer generally affects men over the age of 50, and is rarely found in younger men. Around 32,000 men in the UK are diagnosed with prostate cancer each year. It differs from most other cancers in the body, in that small areas of cancer within the prostate are very common and may not grow or cause any problems for many years.

About one in three men over the age of 50 have some cancer cells within their prostate and nearly all men over the age of 80 have a small area of prostate cancer. Most of these cancers grow extremely slowly and so, particularly in elderly men, will never cause any problems.

* Scandanavian Prostate Cancer Group