Undergoing surgery for prostate cancer has been a source of controversy among urology specialists as to whether it is advisable or not. As Dr. Diaz Bermudez, an expert in laparoscopic surgery and prostate cancer, explains, until very recently it was directly ruled out, but recent statistics rethink the model.
The Journal Clinic Oncology in 2013 published some statistical studies concerning prostate cancer patients that are currently a reference for specialists around the world.
Until recently, the possibility of surgery in cases of prostate cancer patients was not widely considered, since it is an aggressive treatment and offered little chance of curing the patient.
What changes is that in certain cases, the evolution of the cancer is so slow, that even if the surgery does not completely remove the tumor, it could extend the patient’s life longer than what is probably left due to other natural causes.
Always based on statistical projections, these patients are considered the most at risk because of the extent of the tumor (called T3) and are the ones who benefit the most from surgery.
The study over the years of the biopsies of hundreds of patients makes it possible to determine different profiles of the disease according to its aggressiveness and development. This, in a way, will make it possible to evaluate which are the cases in which surgery has a greater possibility of positive results, also taking into account that these are aggressive actions with the organism.
Surgery yes or surgery no?
Until recently, when there was a high possibility of metastasis, surgery was often ruled out. Now the statistics rethink the model. There is still a high degree of uncertainty due to infrasteriaje, but it is a matter of performing certain statistical equations with biopsy results, and according to the parameters shown, a scale of aggressiveness of the different types of tumors begins to be determined in order to make more accurate decisions.
This scale, numbered from 2 to 10, indicates the danger of the cancer. From 6 downwards the aggressiveness is lower and from 7 onwards the aggressiveness of the tumor is considered to be high.
From these parameters, if one encounters patients of advanced age and a tumor of low aggressiveness, what is proposed is an active follow-up. This means that without undergoing surgery, longevity can be achieved with an adequate quality of life, avoiding surgery that would do a little more damage than is necessary.
Then there are the patients who will benefit from surgery. Removing the focus of the cancer prolongs the life of the sick patient, and this has always been the case. What changes is that those patients with a significant tumor burden, and who have already gone beyond the edge of the prostate, who until recently were considered very unviable for surgery, it has been proven that they are possibly those who benefit most from a surgical operation.
They are tougher surgeries, with more complications and risk, but removing the main focus of the problem could either cure or at least get the patient to survive for more years.