Surgery and radiation shouldn’t be the first choice for early prostate cancer

The most critical thing a man with prostate cancer needs to know

This may be the most important option out there for treating prostate cancer. One your doctor may never tell you about.

A powerful new study just published in The New England Journal of Medicine confirms what researchers have been saying for decades: For men with early prostate cancer, surgery and radiation should not be the first course of action.

I know, that flies in the face of everything we hear about dealing with cancer. How early treatment saves lives. How surgically removing that tumor and blasting it with radiation will help you live longer.

But time and time again, that’s been proven to be just plain wrong.

Starting at square one

It’s called “active surveillance.” And now we have the clearest evidence ever that it’s the best way to go for most guys with early prostate cancer.

Researchers have been talking about — and studying — active surveillance for decades, but only in recent years has solid research backed up the theory.

In previous prostate cancer studies, the research was called observational. I told you about one earlier this year. It was a good study, but the data researchers used depended on their observation of cases where men and their doctors made their own decisions about treatment.

In this new study from the University of Oxford, the researchers were in control of treatment, making the results more reliable.

Over 1,600 men with early prostate cancer were randomly assigned to one of three groups: active surveillance, radiation treatment, or surgical removal of the prostate. The men were part of a trial called ProtecT, which started in 2001.

And at the ten-year follow up the results were undeniable. “Virtually no one had died from prostate cancer,” said Dr. Mark Litwin, urology chair at the David Geffen School of Medicine, who reviewed the study.

Dr. Litwin also commented that the research “should give all men pause” before they’re rushed into “radical treatment for low- or intermediate-risk tumors.”

Of course, when discussing your options, doctors try to make radiation and surgery seem so routine that there’s no need to even think about it.

But nothing could be farther from the truth.

The Oxford researchers reported that almost 50 percent of the men who had their prostates surgically removed were wearing adult diapers a few months later. As for radiation, the lion’s share of that group became impotent.

And as I told you earlier this year, new Canadian research confirms that prostate cancer radiation treatment spikes your risk of developing deadly bladder, colon, and rectal cancers.

Despite this clear, well-done and respected study, there are still plenty of doctors out there who will try to scare men into having surgery and radiation any way they can.

For example, in an editorial that appeared in the same NEJM issue, a radiation oncologist warns that without radiation treatments, malignant cells can travel to your brain and bones. Then, he says, you’ll need hormone treatments, which he compared to “chemical castration.”

But there’s a good reason why so many men are never even informed about the safety of active surveillance. It’s just not the cash cow that surgery and radiation are.

Last year I told you about research that showed how most prostate cancer treatment recommendations aren’t based on a patient’s age or even his level of cancer. Most doctors just recommend treatment in the field they specialize in.

It’s sad but true. If you’re a surgeon, you schedule surgery. If you’re a radiation oncologist, you radiate.

That’s why if your doctor recommends — or even is willing to discuss — active surveillance, you should consider yourself lucky.

But if he dismisses the idea as if it’s some kind of crazy talk, it may be time to find yourself another doctor.

Sources:
“Men with early prostate cancer can safely opt out of treatment, finds landmark study” Sharon Begley, September 14, 2016, Stat, statnews.com