A radical prostatectomy can make all the difference when it comes to the likelihood of survival from prostate cancer.
We recently spoke with a leading urologist, Mr Neil Haldar, to find out about survival rates of those who have had a radical prostatectomy.
Radical prostatectomy survival rates
Men who undergo radical prostatectomy have a high survival rate and low rates of cancer recurrence, cancer spread and death, according to a study of 10,332 men who had surgery between 1987 and 2004. The research showed that between 5 and 20 years after having the surgery, only 3% of the patients died of prostate cancer, 5% saw their cancer spread to other organs, and 6% had a localised recurrence.
Another large Scandinavian study compared men who chose active surveillance with those treated by radical prostatectomy. The results suggest that in the long term, younger men with higher-risk tumours who have a radical prostatectomy, have a definite survival advantage.
Results from another study at Johns Hopkins Hospital in Baltimore (USA) confirmed that 82% of men undergoing radical prostatectomy were free of recurrence at 15 years. The data from the research also indicated that in those men whose PSA level starts to rise again after surgery, the recurrent prostate cancer spreads in only around one-third of the men. In addition, unless a man had an aggressive grade of prostate cancer, the spreading of the disease would not become life-threatening for several years and would be amenable to treatment.
Further treatment after radical prostatectomy
Two other therapies are occasionally recommended after surgery, based on the pathology report after the surgery as well as the subsequent PSA response.
Radiation therapy may be offered to some men with high-risk prostate cancer who have cancer that has penetrated through the prostate capsule or have positive margins after surgery. Studies have shown that recurrence rates drop by approximately 50% in these men if they receive radiotherapy after surgery. However, some of these men may not develop recurrent tumours even without further treatment and may also suffer the additional side-effects of the radiotherapy. The most standard strategy, therefore, is to use radiation therapy only if PSA levels rise above 0.2 ng/mL.
Hormone therapy may be recommended for men who have cancer found in their lymph nodes at the time of surgery. Studies have shown that for some of these men, hormone therapy helps patients live longer.
BAUS radical prostatectomy audit
The British Association of Urological Surgeons (BAUS) now publishes the results of radical prostatectomy for surgery performed in the UK. Details of the operations performed by each surgeon and centre are given, with information about the technique used, transfusion rates, postoperative complications and length of stay for individual surgeons and units. The responsibility of entering the data, however, lies with the individual surgeons and is not always complete.