The Benefits of Surgery for Organ Confined Prostate Cancer

According to a major recent study, appearing in the July 27 issue of the Journal of Clinical
Oncology, there is a definite downstaging trend for prostate cancer. The study, which surveyed
almost 13,000 American men who had a radical prostatectomy (surgical removal of a cancerous
prostate gland) between 1987 and 2005, found that only 12% of them died of the cancer. This is
great news.

The take-away message of this study shows that radical prostatectomy works well. As mentioned
previously, the results determined that 15 years later, 12 percent had died from cancer, and yet the
chances of death by natural causes were 38%, greater than for those with prostate cancer.

This down staging of prostate cancer is due to the increased expertise of surgeons, along with
improved patient education and public awareness of the disease. Doctors are detecting cases in
earlier stages, when it’s more organ confined. Patients are getting screened regularly and working
closely with their doctors to monitor their PSA levels and Gleason scores. Gleason scores are a
system of grading prostate cancer, which assigns a grade to the areas of cancer in the tissue
samples. This is particularly important when dealing with a disease known as the “silent killer,”
which often exhibits no symptoms.

The technological evolution of surgery has made robotic prostatectomy the number one treatment
option because it is less invasive than the older modalities, such as radiation therapy. Robotic
prostatectomy involves the surgical removal of the prostate, which spares the delicate nerves
responsible for continence and sexual function. Radiation therapy, which uses high doses of
radiation to destroy cancer cells, is usually best recommended after surgery to destroy any
remaining cancer cells.

For early-stage prostate cancer, however, this study lends credibility to the theory that
prostatectomy is the best treatment available for long-term survival. In the hands of an
experienced robotic surgeon, the cancer cure rate is over 95%, there is less incidence of rectal
bleeding, the future risk of secondary carcinoma is avoided and the dreaded side effects of
incontinence and impotence are eliminated. Previously, surgeons did not have such a level of
magnification, a bloodless field to work in and often had a higher risk of leaving cancer behind.

The study, which took place over the course of 1987-2005, paints a radically different picture
than that of today’s patients. With technological advances, earlier screening and better patient
education, the morbidity rate could be closer to 5% percent. If a newer study were to incorporate
a contemporary series of robotic surgery patients, it is likely that the down-staging trend and the
prognosis outlook for prostate cancer 20 years from now will be even more positive.