men with prostate cancer may have gone through the trauma of unnecessary
surgery – leaving them at risk of impotence, a study has suggested.
have found that many men with the disease who decide not to go for
surgery or other invasive therapies such as radiotherapy fare just
as well as those who do choose the treatment.
happen because the standard PSA test used to detect prostate cancer
is so unreliable that it cannot distinguish between aggressive and
mild forms of the disease.
with the aggressive or ‘tiger’ form may require surgery or radiotherapy
to save their lives, those with mild or ‘pussycat’ cancer can live
for years without treatment.
It is hard
for doctors to know which is which.
But going for
surgery and radiotherapy – as hundreds in Britain do every year – is a risk because they can both leave men impotent and sometimes
Britain’s most common cancer among men and the second highest killer,
after lung cancer. Some 35,000 people a year are diagnosed with
it – and 12,000 die.
Dr Martin Sanda, associate professor of surgery at Harvard Medical
School, said: ‘With the advent of PSA screening nearly 20 years
ago, we started to detect prostate cancers at much earlier stages.
while PSA testing has enabled us to successfully begin aggressive
treatment of high-risk cancers at an earlier stage, it has also
result in the diagnosis of cancers that are small they pose no near-term
danger and possibly no long-term danger.’
His team studied
the health of 51,529 men who they have been following since 1986.
Every two years,
the men respond to questionnaires inquiring about diseases and health-related
topics, including whether they have been diagnosed with prostate
cancer. A total of 3,331 men reported receiving a diagnosis of prostate
cancer between 1986 and 2007.
But among this
group, 342 men – just over 10 per cent – had opted to defer treatment
for one year or longer. Ten to 15 years later, half the men who
had initially deferred treatment still had not undergone any treatment
for prostate cancer – meaning they had never needed it in the first