A new study in the New England Journal of Medicine finds men who opt to surgically remove their prostate gland - a procedure called a radical prostatectomy - are no less likely to die than men who choose wait and monitor their symptoms to see if the cancer progresses. The study adds to the ongoing debate surrounding prostate-specific antigen (PSA) testing and whether the tests pick up cancers that may be too slow-growing to ever cause a problem. In May, the U.S. Preventive Services Task Force ... reported in its final recommendation that healthy men of all ages should not take a PSA test because the potential harms from a positive test outweigh the benefits from catching the cancer early. The researchers found that out of 364 men who had their prostate removed, 171 died (47 percent), and 21 of those men (6 percent) died from prostate cancer or treatment. In comparison, 183 of 367 people who were assigned for watchful waiting died (50 percent), and 31 of the men died from prostate cancer (8 percent). The differences between groups were not statistically significant, meaning prostate cancer surgery did not significantly reduce the men's risk of dying from the cancer or any cause, as compared with the observation approach. Within two years of surgery, the researchers found that 81 percent of the men who underwent the procedure experienced erectile dysfunction, 17 percent had urinary incontinence with symptoms such as dribbling" or having "no control over urine," and 12 percent reported bowel dysfunction.
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