There have been ongoing news reports, and now a new book, regarding the over treatment of prostate cancer. It seems many urologists and other surgeons are recommending for men to have their prostate removed on the first detection of prostate cancer. And on top of that, the “C” word is enough to scare the bejesus out of just about anyone, so who could blame men for wanting to take aggressive steps.
As most older men know, either through personal experience or by reading up on the increasingly controversial subject of prostate cancer, problems with urination and increased prostate-specific antigen (PSA) levels (determined through a blood test) are typically the first indication that something could be awry with the prostate.
High PSA levels trigger an alarm that typically results in a doctor recommending that a patient be tested for prostate cancer, which means a biopsy. A recent study released in the Journal of Urology set out to warn men that biopsies are also not without major side effects in many cases.
A total of 198 German men were followed after committing to a prostate biopsy. Three types of biopsies were studied from standard (10 samples) to standard with nerve-block for pain, to saturation (20 samples).
Unsurprisingly, the men undergoing the saturation biopsy experience greater risk for long-term urination challenges. Before the study, 10 percent of men reported severe urination problems, and that number jumped to 29 percent 12 weeks after the biopsy. For the standard biopsy, the number escalated from 32 to 39 percent of men reporting moderate urinary problems.
In terms of erectile dysfunction, a major symptom of prostate cancer treatment itself, men reported that their problems had for the most part subsided after 12 weeks. One week after the biopsy, however, ED issues were rather severe. Men who reported severe ED jumped from 25 to 51 percent among both the standard and saturation biopsy groups, and from 11 to 39 percent in the nerve-block group.
Doctors say that damage to the “neurovascular bundle” is what causes problems with urination, ED and incontinence among men who undergo treatment to their prostate, a small gland that is tough to access in men.
The authors of the study conclude that screening may result in treatment in men that would never have experienced problems from their prostate cancer. Then again, 40 percent of the participants in the nearly 200-man study were diagnosed with cancer after screening.
It seems to be a two-way road on which it is easy to err on the side of caution – but not without a high percentage of men receiving unnecessary treatment, and major repercussions.
The new book “Invasion of the Prostate Snatchers,” was released this week by two authors. One man has lived with prostate cancer for 20 years and another is an oncologist who has treated the disease exclusively since 1995.
They state that only 1 in 7 men who are diagnosed with prostate cancer are at risk for a serious form of the disease. More than 40,000 of the 50,000 radical prostatectomies performed every year are not necessary, they conclude. A recent study in the New England Journal of Medicine stated that radical prostatectomies extended the lives of just 1 patient in 48.
About 200,000 cases of prostate cancer are diagnosed every year in the U.S.
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