Prostate cancer surgery 'has no significant survival benefit', study suggests
Published 30/04/2012 | 09:28
THOUSANDS of men could have undergone painful surgery to treat prostate cancer for little or no benefit, a study has suggested.
Research, which has not yet been published, has indicated the standard surgical treatment did not extend the life of cancer sufferers significantly any more than “watchful waiting”.
The results, reported by the Independent newspaper, are said to have left experts “shaken” after showing the common treatment did not necessarily improve lives.
One specialist, who did not want to be named, told them: “The only rational response to these results is, when presented with a patient with prostate cancer, to do nothing.”
The Prostate Intervention Versus Observation Trust (PIVOT), led by Timothy Wilt, began in 1993 with 731 subjects, following them over 12 years to monitor their health.
It compared cancer patients who had their prostate gland removed with those monitored by “watchful waiting”, to establish how their treatment affected survival rates.
It found those who underwent the operation had less than a three per cent better chance of survival than those who had no treatment; a figure which could have arisen by chance.
When the results of the study were reported at a meeting of 11,000 experts at the European Association of Urology in Paris, they were met with “stunned silence”, the newspaper claimed.
Prostate cancer, which affects 37,000 men in the UK every year, is the most common cancer suffered by men.
But despite causing 10,000 deaths per year, it is slow growing in half of all cases, with sufferers often dying of another illness before it becomes fatal.
The standard surgery, known as radical prostatectomy, carries risks including impotence and incontinence.
Ben Challacombe, consultant urologist at Guys and St Thomas’ NHS Trust, told the newspaper he did not agree the response to the results should always be to "do nothing".
He said that for older, low-risk men, they would already "offer milder treatment such as radiotherapy or watchful waiting" and added: "We are better than the US in putting men on surveillance.”
Dr Kate Holmes, head of research at The Prostate Cancer Charity, said they were aware of the findings and awaited the full published results.
She said: “Early data from the PIVOT trial certainly suggests that surgery to remove the prostate does not provide any significant survival benefit for men with low to medium risk prostate cancer.
“However, these findings are from a large ongoing trial, and we look forward to seeing the full published results which could help men in future to make more informed decisions about treatment.
““This trial also highlights how important it is that research into improved diagnosis, staging and treatment of prostate cancer is sustained if we are to take treatment for the disease to the next level.
“We have been working with existing methods for far too long and it is vital that investment continues if we are to reduce the number of men who die from this disease every year.”
The charity added around 250,000 men are currently living with prostate cancer in the UK, with one man dying from it every hour.