Use of radical prostatectomy increases dramatically for high-risk prostate cancer
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There was a dramatic increase in the number of men with high-risk localized prostate cancer who were treated for their disease by the use of radical prostatectomy (RP) when compared to the standard management option of radiation-based therapies. This finding was published in Prostate Cancer and Prostatic Disease and was from an analysis of data from 127,391 men with high-risk prostate cancer that had not spread beyond the prostate.
“These findings prove once again the advantage of using radical prostatectomy in situations where the cancer is localized or contained just in the prostate and has not spread to surrounding tissue,” said Dr. David Samadi. “The goal of radical prostatectomy is to remove all the prostate cancer at once by either removing the prostate gland or part of it. When we do this, it should remove all of the cancer cells with a much greater chance of long-term survival.”
In 2016, more than 180,000 men were diagnosed with prostate cancer in the United States. Approximately one-third have localized prostate cancer considered “high-risk” based on National Comprehensive Cancer Network criteria. Several findings from multiple non-randomized comparative studies have suggested a survival benefit for men with high-risk prostate cancer who receive RP compared to external beam radiation therapy (EBRT).
The goal of this study was to review if the use of surgery had increased in recent years and to evaluate the trends in the initial treatment of clinically localized high-risk prostate cancer and to determine demographic and clinical factors associated with RP.
“The interesting fact of this study was that radical prostatectomies increased from 26% in 2004 to 42% in 2013 while radiation therapy decreased from 55% to 43%. Also when the researchers compared men treated in 2004, those treated in 2013 were 51% more likely to have been treated with radical prostatectomy,” stated Dr. Samadi.
Also found from the study was that the 10-year overall survival was 41% for men who received no treatment, 49% for EBRT plus androgen deprivation therapy (ADT), 24% for ADT alone, and 77% for RP. Several studies including a systematic review and meta-analysis of 19 studies have suggested better cancer-specific survival rates with RP when compared with radiotherapy and that radiotherapy was associated with a 2-fold increased risk of death compared with RP in adjusted analyses. Demographic findings revealed that African American men, older men and those without private insurance were less likely to receive RP. The study was not able to explain why there was a gap in African American men who had prostate cancer and the use of RP.
“This news is certainly encouraging for any man who is diagnosed with high-risk, localized prostate cancer when it comes to making a decision on how best to treat it,” exclaimed Dr. Samadi. “I know past studies have been documenting that radical prostatectomy is showing positive result in regards to long-term survival in men. Like many surgeries, the use of radical prostatectomy is not without side effects which could include urinary incontinence or erectile dysfunction. But generally, those complications are short-lived and can resolve in time.”
Dr. Samadi went on to add, “All men diagnosed with prostate cancer need to discuss thoroughly with their physician the right option for them, depending on their age, overall health and stage of cancer. My goal is to carefully monitor any man I see by recommending the treatment best for him making sure the cancer doesn’t return. It is also my goal to see that all men of varying demographics receive quality and comparable care when it comes to their prostate health. All men deserve that.”
Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist Dr. David Samadi at 212-365-5000 for a free phone consultation. To learn more about prostate cancer, visit ProstateCancer911.com.