Prostate cancer: observing instead of operating?
Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.
More posts by Christiane Fux All content is checked by medical journalists.Prostate cancer may be operated on much more often than necessary. Often checking and waiting could be the better option.
Prostate tumors may be operated on much more often than necessary. In the early stages and with less aggressive tumor forms, men whose cancer is "only" closely monitored are just as likely to survive as those who undergo surgery.
Having a potentially fatal tumor in your body - the idea is terrifying. In fact, for most cancers, removing the tumor early is the safest and most sensible option. In many prostate cancer operations, however, the cut in the crotch could be excessive. Because in many patients the tumor grows only slowly and does not spread. In that case, if left untreated, the men will die with the ulcer - but not from it.
Early stage, good chance of survival
Researchers led by Tim Wilt from the Minneapolis VA Center for Chronic Disease Outcomes Research have now examined which strategy leads to which survival rate in a study with 731 prostate cancer patients. In the selected study participants, the cancer was discovered at a very early stage on the basis of a suspicious PSA test.
The result: Of the patients who had undergone an operation, some with subsequent radiation, 38 percent survived a period of 20 years. Of those whose tumor was only checked regularly, the proportion was hardly lower at 33 percent.
However, the proportion of those who actually died as a result of the cancer itself was greater. Among those who had surgery, only 7 percent of the patients died from cancer - the remainder from other health problems. Of the deceased who decided against the operation, however, it was 11 percent who succumbed to their tumor disease.
Stressful interventions
There are various explanations for this apparent paradox. For example, the consequences of prostate cancer surgery are often serious. In addition to the stress caused by the operation or the subsequent chemotherapy or radiation therapy itself, the intervention in the sensitive region often results in incontinence and impotence.
That in turn could reduce the quality of life of some men so drastically that they sink into depression. And these in turn increase the risk of a wide variety of diseases, for example those of the cardiovascular system.
Watch and wait
“Whatchful waiting”, as the close-knit control of prostate cancer is also called, could therefore be the better alternative in many cases. The patients save themselves the painful procedure and its long-term consequences and gain a better quality of life. And that without running a higher risk of premature death. A careful consideration of the options together with the doctor is a prerequisite for this.
Not an advanced option?
However, this option is particularly available if the tumor is discovered at an early stage, as in the context of this study. If the disease is already advanced, surgery is often the only way to get the cancer under control.
