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According to a recent article published in the Journal of the National Cancer Institute, delaying the surgical removal of the prostate among men with small, slow-growing prostate cancers may not compromise outcomes. However, it is important for men with early prostate cancer to discuss their individual risks and benefits of all treatment options with their physician.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men.

Early prostate cancer refers to cancer that has not spread from the prostate. A common treatment option for early prostate cancer is the surgical removal of the prostate, referred to as a prostatectomy. Another treatment option includes active surveillance, in which treatment is not administered until a specified point of disease progression (for example, a rise in PSA to a specific level). Research continues to evaluate which patients are best candidates for the various treatment options in early prostate cancer.

Researchers from Johns Hopkins School of Medicine recently conducted a clinical trial to evaluate the timing of a prostatectomy in patients with small, slow-growing prostate cancers. The perceived fear of waiting to perform surgery is that the cancer will grow during the waiting period to a point where it becomes incurable. This study included 150 men who underwent a prostatectomy within 3 months of their diagnosis and 38 men who were monitored for disease progression and underwent a prostatectomy at a median of 26.5 months following diagnosis.

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Overall, a delay in surgery did not appear to compromise outcomes for these patients:

  • Cancer that was incurable at the time of surgery was diagnosed in 23% of patients who waited to have surgery, and 16% of patients who had immediate surgery.
  • After taking into consideration several variables (age, PSA, and PSA density-PSA divided by prostate volume), the time of surgery did not have an impact on the rates of incurable cancer.

The researchers concluded that delaying surgery among men with small, slow-growing prostate cancer does not appear to affect outcomes compared to immediate surgery. However, it is important for men with prostate cancer to discuss their individual risks of delaying treatment.

Reference: Warlick C, Trock B, Landis P, Epstein J, Carter H. Delayed Versus Immediate Surgical Intervention and Prostate Cancer Outcome. Journal of the National Cancer Institute. 2006; 98: 355-357.

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