Delayed prostate cancer surgery probably okay

The time elapsed between a diagnosis of localized prostate cancer and surgery does not appear to have a large effect on the risk of cancer recurrence, according to a study. However, doctors say it’s best to avoid undue delays.

Men diagnosed with localized prostate cancer must educate themselves about the disease and the available treatment options. This can take time, often leading to delays in treatment. Waiting lists for surgery may also delay treatment.

Whether a delay in therapy for localized prostate cancer has an adverse impact on outcome is the subject of debate, Dr. Andrew J. Vickers and colleagues from Memorial Sloan-Kettering Cancer Center in New York City note in the journal Cancer.

Using data from 3149 patients who had undergone prostate surgery, they developed a mathematical model to evaluate whether the time from biopsy to removal of the diseased prostate can predict recurrence of the disease.

“We found no clear evidence that an increased time between biopsy and surgery was associated with a significantly poorer outcome,” the authors report. “This suggests that any effect of a treatment delay is moderate, at least for a time period up to 6 to 12 months.”

The reason for the findings may lie in the fact that prostate cancer is a relatively slow growing tumor.

“We were unable to prove that there was an effect of a delay in diagnosis on recurrence, but the lack of proof of an effect doesn’t mean that there is no effect,” Vickers emphasized in comments to Reuters Health.

In the absence of clear data, doctors “need to have some clinical judgment,” Vickers said. “If someone has an aggressive cancer, waiting around is not a sensible thing to do, but if the cancer is not aggressive, then you might take some time to make a decision,” he concluded.

SOURCE: Cancer, February 1, 2006

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