Long-term study shows early prostate cancer surgery extends lifespan

The survival rate of men with prostate cancer who underwent complete prostate removal immediately after detection of the tumor increased by 17 percentage points compared to those who did not receive treatment until until the tumor begins to cause symptoms. On average, they also lived more than two years longer.

These are the final results of a 30-year Scandinavian study led by Uppsala University and published in the New England Journal of Medicine.

“It’s unique to have been able to follow a randomized treatment trial for so long and to have learned how treatment of early prostate cancer affects life expectancy,” says Emeritus Professor Lars Holmberg, involved from the start in the study.

In the study, which began in 1989, researchers compared the removal of the entire prostate immediately after the discovery of a prostate tumor with the standard treatment of the time, which was not initiated until when the tumor began to cause symptoms and almost always consisted of hormonal treatment. Over a 10-year period, 695 men with prostate cancer alone were recruited into the study. The men were followed until 2022.

After age 30, most of the men who died had died of causes other than prostate cancer. The risk of dying from prostate cancer during this period was 17 percentage points lower for people in the surgery group. These men also lived an average of 2.2 years longer than those whose treatment started later.

“We have seen that treatment affects the course of the disease for the rest of the individual’s life. This also means that the timing of a prostate cancer study has a major impact on how “The short-term perspective does not give a completely adequate picture of the benefits and harms of the treatment,” says Anna Bill-Axelson, professor of urology at Uppsala University and doctor at the University. Uppsala University Hospital.

The study was done before the PSA test (a blood test that shows changes in the prostate) became common. Most of the men in the study had prostate cancer detected due to symptoms. This is different from the current situation, where the vast majority of people with early-stage prostate cancer have had their cancer detected by a PSA test. The prognosis is therefore better today than for the men who participated in the study.

“But there is every reason to believe that current treatment choices also have consequences for the rest of the man’s life, which is important to know when counseling patients,” explains Holmberg.