Younger Men Do Well with Prostate Cancer Surgery

By Anthony J. Brown, MD

NEW YORK Aug 22 2005 (Reuters Health) - As a treatment for prostate
cancer in men younger than 50 years of age, surgery to remove the
prostate can provide good results with low complication rates,
according to a recent report.

Moreover, the findings, which appear in the journal Urology, may have a
broader message as well: that men should be screened earlier for
prostate cancer, perhaps.

The study involved 790 men who underwent surgical prostate removal --
prostatectomy -- performed by a single surgeon over a four-year period.
The patients included 66 who were younger than 50 years of age and 724
who were 50 years of age or older.

The rate of complications during the operation and after was very low,
just 1.3 percent overall, and no significant differences were seen
between the groups, report Dr. Herbert Lepor and colleagues from New
York University School of Medicine.

The rates of urinary continence for younger and older men were 93
percent and 97 percent, respectively, the report indicates.

Among men who did not have erectile difficulties before the operation,
the percentage who afterwards had erections that were adequate for
intercourse (with or without the use of medical therapy) was 100
percent in the younger group compared with 81 percent in the older
group.

"Current guidelines suggest that screening should begin at 50 years of
age, unless you have a family history of the disease or are African
American, in which case it should begin at a younger age," Lepor told
Reuters Health.

"However, when I reviewed the patients who were referred to me for
surgery, I found that the percentage with a family history of prostate
cancer or African American ethnicity was comparable in patients over
and under 50 years of age," Lepor noted.  "This suggests that many
younger men were being screened who didn't have indications for early
screening" and yet they had disease that was comparable to that seen in
older patients."

Taken together, these observations led Lepor to conclude that prostate
cancer screening should begin at 40 years of age in all men.  "You
can't prove that PSA screening in general (saves lives), so certainly I
can't prove that screening all men starting at 40 will be beneficial.
Still, I believe that finding cancers earlier will lead to better
outcomes."

SOURCE:

Urology, July 2005.
Steve U