Surgery Best Option for Survival After Prostate Cancer
Short- and Long-term Mortality With Localized Prostate Cancer by Arnaud Merglen et al
Arch Intern Med. Oct 8, 2007;167(18):pages 1944-1950
844 Swiss patients in Geneva were diagnosed with localized prostrate cancer in 1998.
- 158 were treated with prostatectomy
- 205 with radiotherapy,
- 378 with watchful waiting
- 72 with hormone therapy alone
- 31 with other types of therapy
Choice of treatment option had only a small effect on the chances of death from prostate cancer within 5 years. Although those treated only with hormone therapy did have a higher chance of cancer death
Compared with patients who underwent prostatectomy, those treated with radiotherapy or watchful waiting had more than double the risk for death from prostate cancer at 10 years.. The patients who were mostly likely to die from prostate cancer within 10 years tended to be younger than 70 years and have Gleason scores ≥ 7
The biggest limitation of the study is the we do not know why individuals selected a particular treatment or what other medical conditions they may have had.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative
Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.