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Cancer surgery questioned.

Researchers have found that for older men with prostate cancer in its early stages, doing nothing but watching and waiting may be better than surgery, the increasingly popular approach among doctors.

In a study in the Journal of the American Medical Association, researchers found that men over 65 who received aggressive treatment lived less than a year longer on average than those whose cancer was simply monitored.

A second study found that the rate of radical prostatectomy--removal of the prostate gland--increased nearly sixfold from 1984 to 1990 among Medicare patients. All of the patients in that study were over 65.

"We have, in essence, an epidemic of treatment and no scientific proof that it's valid," said Dr. John Wasson, who worked on both studies.

Cancer of the prostate, a chestnut-shaped male gland beneath the bladder, is the most common cancer in American men. It will cause an estimated 35,000 deaths this year. Many prostate cancers grow slowly and may not invade other tissues for years. For such men, the immediate risk of complications from treatment may not be worth trying to buy extra years of life, the study said. Such men are likely to die of other causes before their malignancies spread and cause problems.

The first study found that men ages 65 to 70 with localized prostate cancers lived, on average, 14.1 years after diagnosis if their cancers were just watched, compared with 14.2 years for men who underwent radical prostatectomy and 14.3 years for men who received radiation.

Treatment costs run from $15,000 to $25,000, Wasson said.
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Title Annotation:for prostate cancer
Publication:Special Delivery
Date:Jun 22, 1993
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