Observation only may be the best medicine for men with early-stage prostate cancer, suggests a 20-year study.
The study is published in The New England Journal of Medicine.
Early-stage prostate cancer means the cancer is small, confined to the prostate gland, and can only be detected with a biopsy.
Researchers randomly assigned 731 men, average age 67, with localized prostate cancer to receive either surgery or observation only.
At the 20-year follow-up, 62% of the men who had prostate cancer surgery had died of other causes, while only 7% died from prostate cancer.
In comparison, 67% of the men assigned to observation died from other causes and 11% from prostate cancer. The absolute differences in mortality were not significant.
Most striking was how often erectile dysfunction and urinary incontinence occurred following surgery.
For instance, 80% of the surgery group reported having erectile dysfunction throughout the study, compared with 40% of the men who were not treated.
And more than 40% of the men who’d had surgery needed to use a daily pad to manage the urinary incontinence, compared with less than 10% of the observation group.
The researchers concluded that for most men ages 65 and older with localized, early-stage prostate cancer, observation might be the preferred treatment.