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who refuse prostate cancer surgery have
worse long-term survival
DETROIT, June 2010 – Men who refuse surgery for
prostate cancer and instead opt for
"watchful waiting" – monitoring cancer
progression without undergoing treatment –
have a significantly worse long-term
survival rate than those patients that
choose radiotherapy, according to
researchers at Henry Ford Hospital in
The study found that patients who refused
any treatment for their prostate cancer had
a 10-year overall survival rate of 51
percent, compared to 68 percent for those
who chose radiation treatment.
"Surgery has been shown to offer a survival
advantage to patients with prostate cancer
when compared with other treatment options.
a significant number of patients refuse
surgery and instead opt for other treatments
such as radiotherapy" says study lead author
Naveen Pokala, M.D., an urologist at Henry
The study was presented at the 2010 American
Urology Association's annual meeting in San
These findings follow a study published by
Dr. Pokala in 2009 that showed surgery
improves 5-, 10- and 15-year survival rates
for men younger than 50 with moderately and
especially in poorly differentiated prostate
cancers, when compared with other standard
treatments such as radiation therapy or
The new research, a population-based
analysis of 9,704 patients chosen from the
National SEER database, looked at survival
rates among men with a mean age of 64.4
years, of whom 77 percent were white and
16.4 percent black.
Of that group, nearly 30 percent refused any
treatment for their prostate cancers, and
about 70 percent chose radiation therapy.
Within the group, 6 percent had
well-differentiated cancers, 75 percent
moderately differentiated cancers, and 18
percent had poorly differentiated cancer.
More than 70 percent of the patients were
unmarried. In all, African American men
older than 65 had the worst prognosis.
Prostate cancer is second only to skin
cancer as the most common cancer in American
men, affecting one in six during his
lifetime. The majority of the cases are in
men older than 65, but it is becoming more
prevalent in men under 40.
It affects black men twice as often as
whites, and their mortality rate is also
twice as high.
While curable in its early stages, symptoms
often don't appear until the cancer has
spread beyond the prostate gland itself, so
annual exams for the disease are
In addition to Dr. Pokala, study co-authors
at Henry Ford Hospital included James
Peabody, M.D., and Mani Menon, M.D.