Rapid surgery not needed for prostate cancer

After a positive biopsy result for prostate cancer, surgical removal of the prostate (radical prostatectomy) does not need to be performed immediately, at least as far as the risk of recurrence is concerned, according to a report in the urology journal BJU International.

“Most surgeons prefer to wait a minimum of 2 months after the biopsy before surgery to allow the post-biopsy inflammation to resolve,” Dr. James A. Eastham from Memorial Sloan-Kettering Cancer Center, New York told Reuters Health. “Such a wait does not influence outcomes and is not concerning.”

Eastham and associates examined data on nearly 4000 consecutive patients who underwent radical prostatectomy within a year of the diagnosis of prostate cancer

After taking into account other patient factors that could influence prognosis, the researchers found that the time from biopsy to radical prostatectomy did not predict recurrence.

Similarly, in a separate analysis of patients considered at a high risk of recurrence, the time to radical prostatectomy did not predict recurrence after surgery.

“Most patients will not delay longer than 6 months if they are considering immediate treatment,” Eastham pointed out. “However, some men opt for watchful waiting (active surveillance) but will eventually undergo treatment months to years after their original diagnosis.”

Eastham said that studies will continue to follow these men to determine whether waiting influences outcomes, including recurrence after eventual surgery.

“Take time to gather the information needed to make an informed decision about what is best for the patient based on their individual cancer, age and health, and preferences,” Eastham advised. “Taking the time to gather this information will not have a negative impact on outcomes.”

SOURCE: BJU International, October 2005.

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