Radical prostatectomy versus watchful waiting

Kongo said:

Thanks
Beau,

Thanks for sharing this report which is quite detailed. I found many aspects quite interesting but I think it is worth noting the editorial comments that state that it is unclear whether these results could be duplicated today in the era of PSA testing. It's also worth noting that quality of life aspects were not addressed in the study and longevity appeard to be the overarching aim of the data.

Given that all of these men in the study were diagnosed before the advent of routine PSA testing, the cohort consisted of men where cancer was suspected from a DRE or some other symptom. My feeling is that despite the general T1 staging level these men were put in, it seems likely to me that many of these men had a more advanced cancer condition when they were enrolled in the study than most men who are first diagnosed today where a PSA score is is the most often used factor in triggering a biopsy.

I also find it incredible that so many men would knowingly submit to such a study where some were treated with surgery and others with watchful waiting. Reading between the lines on this aspect of the study it seems to me that some of the initial men were perhaps unknowing participants in the randomization of treatment but that after some years, the doctors seemed to realize the ethical issues surrounding this approach and went to a fully informed method for getting participants.

K

Kongo said:

Surgery
Actually this study only addresses complications from the surgical process alone and involved complications within 30 days of the prostate removal. The authors conclude that this 9.8 percent rate was "safe.". I think QOL issues generally refer to incontinence, rectal, or ED issues and were not addressed in this study.