Prostate cancer has been the “poster boy,” so to speak, of the cancer overdiagnosis and overtreatment epidemic. Especially when you consider that the science shows watchful waiting (or essentially doing nothing) is the right approach for most men who get diagnosed with it.
Plus, a new study just found that delaying and waiting to perform surgery on men with prostate cancer makes no difference whatsoever in mortality rates. And that’s really important. Because as I always say, morality rate is the one statistic to which we should pay attention. It’s the ultimate litmus test for whether a treatment works…or doesn’t.
I’ll tell you all about that eye-opening study in a moment. But first, let’s back up to put the problem in context…
Prostate cancer suffers from overdiagnosis and overtreatment
As I started reporting last spring, panic about the coronavirus caused many patients to put off seeking much-needed medical care. It also caused an almost-complete shutdown of routine cancer screenings for several months.
As a result, we’re now witnessing a surge in the discovery of real, aggressive cancers of all kinds. However, on the upside, there was also a short-lived lull in the problem of cancer overdiagnosis and overtreatment.
This shutdown also allowed medical science the unprecedented opportunity to examine which kinds of cancer care are actually needed and useful…and which do not really make a difference.
For example, in a study published last December in JAMA, researchers basically found no difference whatsoever in mortality rates between men with prostate cancer who had waited to get radiation treatments and those who had received treatments right away. And now, researchers are finding the same outcome when it comes to prostate surgery…
Delays in prostate surgery made no difference
In a new study from the University of Pennsylvania (my alma mater), researchers analyzed data on more than 32,000 men diagnosed with “high-risk” prostate cancer.
On average, the men were 64 years of age. And they all had their prostates removed within six months of their original diagnoses. However, there were differences in how long the men waited to undergo the procedure.
To look at the effect of delaying surgery on mortality rates, the researchers categorized the men into five groups, according to when they underwent surgery:
- Group 1: 31 to 60 days after diagnosis
- Group 2: 61 to 90 days after diagnosis
- Group 3: 91 to120 days after diagnosis
- Group 4: 121 to 150 days after diagnosis
- Group 5: 151 to 180 days after diagnosis
It turns out, there was no difference whatsoever amongst the men who had their procedures in the shortest amounts of time and those who had the longest delays. In fact, even among the men identified as having the highest-risk tumors, delaying treatment for up to six months did not alter mortality rates.
Of course, as I mentioned a moment ago, none of the men in the study waited longer than six months to get the procedure. So, how do we know whether or not waiting indefinitely (that is, not doing surgery at all) would matter?
It’s not an idle question.
For one, prostate removal surgery is considered a “radical” procedure (and the opposite of a conservative approach). Plus, it suffers from a very high rate of complications—ranging from incontinence to impotence to erectile dysfunction. And these complications, in turn, can cause low mood problems, depression, and suicide. So, you really don’t want to undergo it…unless you absolutely must.
Since delaying treatment for six months did not affect mortality rates…how do we know whether surgery was really necessary at all? In fact, how do we know it was even cancer in the first place?! Maybe it wasn’t. Which brings me to my final point…
Always get a second—or third—opinion
The researchers said this study should reassure men facing delays in treatment due to coronavirus.
But I don’t find it reassuring at all. Because I think it now appears that both prostate cancer radiation…and now prostate removal surgery…may not even be necessary at all. Even for men with “high-risk” tumors.
So, as I always suggest, get a second—or third—opinion if your doctor says you need any treatment for prostate cancer…especially if they want to urgently rush you into surgery. Because more and more men, and their doctors, are deciding to follow the conservative, “watchful–waiting” approach.
You can learn more about the major problems in the field of cancer research, diagnosis, and treatment—along with my all-natural guide to support prostate health—in the June 2018 issue of my monthly Insiders’ Cures newsletter (“The big fat reason why so much prostate cancer research is flawed”). Not yet a subscriber? Click here to become one today!
P.S. This Sunday, April 11th at 3 p.m. (Eastern time), I’ll be sharing the science behind one of nature’s most powerful sleep solutions in my exclusive Pill-Free Sleep Summit. To learn more—and to reserve your FREE spot now—click here!
“Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer.” JAMA Netw Open. 2020;3(12):e2028320. doi.org/10.1001/jamanetworkopen.2020.28320