Prostate Surgery Spin

The radical prostatectomy as a treatment for prostate cancer, has failed to extend life in two randomized controlled studies, and over 500 studies indexed on Medline document the harmful side effects of the radical prostatectomy. Yet, surgery is still being spun as being a successful treatment for prostate cancer. Despite all the scientific evidence against surgery, surgery has many fans, most notably the surgeons who benefit financially from performing the radical prostatectomy.

1. Iversen P, Madsen PO, and Corle DK: Radical prostatectomy versus expectant treatment for early carcinoma of the prostate. Twenty-three year follow-up of a prospective randomized trial. Scandinavian Journal of Urology and Nephrology, supplement 1995, Jan 1;172:65-72.

In the Iverson study of 111 men, the radical prostatectomy failed to extend life for those who underwent surgery, even after 23 years of follow up.

2. Holmberg L, Bill-Axelson A, Helgesen F, Salo JO, Folmerz P, Haggman M, Andersson SO, Spangberg A, Busch C, Nordling S, Palmgren J, Adami HO, Johansson JE, Norlen BJ; Scandinavian Prostatic Cancer Group Study Number 4. A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. New England Journal of Medicine. 2002:Sep 12;347(11):781-789.

In the Holmberg study, 695 men were diagnosed with prostate cancer between 1989 and 1999. The men had stage T1b, T1c, or T2 and were randomly assigned to watchful waiting or the radical prostatectomy. After an average follow-up period of 6.2 years, the authors concluded that “. . . there was no significant difference between surgery and watchful waiting in terms of overall survival.”

Randomized controlled trials are the most definitive studies that can be done. Randomized controlled trials separate modern medicine from quackery, and the radical prostatectomy has failed to extend life in two randomized controlled studies.

I’m sure that the FDA would ban any drug with this track record of failure and harm. Surgery; however, is not controlled by a body that requires success in randomized controlled studies.

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© Bradley Hennenfent, MD November 22, 2004