Prostate cancer: best left alone

Men with prostate cancer may not need to undergo radical prostatectomy (removal of prostate gland).

A 10 year follow up study of men with early prostate cancer left untreated showed that 10 years later only 8.5 per cent of the 223 patients had died from prostate cancer. The survival rate of 86.8 per cent in the untreated group was nearly identical to a subgroup who met all the conditions for radical prostatectomy.

In two thirds of some 76 patients, after a decade the tumour had only undergone local growth, and had not spread to other organs. In these patients, hormonal treatment was usually successful. Only six of the entire study group of 223 had substantial local problems arising from the tumour.

The study also found that after an initial surge of deaths among the 8 per cent who died, disease progression and death from prostate cancer decreased during the last years of the decade long follow up.

Other studies of survival rates after irradiation or radical prostatectomy have been reported as 65 to 83 per cent demonstrating that the more radical treatment offers no benefit (and possibly a disadvantage) to patients over leaving well alone particularly for patients of an advanced age.