Although it’s also the second-leading cause of cancer-related death in men (more than 26,000 are expected to die from prostate cancer this year), the American Cancer Society says it can often be treated successfully with surgery and radiation. The new review had almost 10 times more cases to examine than the 2014 study, which looked into 800 prostate cancer deaths.
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Jacobs and his colleagues reviewed data on nearly 364,000 men aged 40 and older who participated in the Cancer Prevention Study II, a vast research project organized by the American Cancer Society. Study’s lead researcher Eric Jacobs said that the new study would give a certain level of assurance that vasectomy would not increase prostate cancer risk.
In the latest finding, researchers found no connection between vasectomies and overall risk of prostate cancer, or of dying from the disease. Of the total, little more than 42,000 men were found to be having a vasectomy, a surgical procedure in which tubes that carry sperm from testicles are either blocked or cut.
“We need something to allow us to identify men with aggressive disease earlier”, said Dr. Malcolm Mason, a prostate cancer expert at the charity Cancer Research U.K. He said the study confirmed that for men in the early stages of the disease, there is no wrong treatment decision. “Minimally invasive therapies such as HIFU may have a lower morbidity than prostatectomy and radiotherapy for prostate cancer, but questions still remain about the long-term efficacy of these procedures for tumor control”. For African-American men, one in 6 will be diagnosed and one in 23 will die from prostate cancer.
“This cohort [group in the cancer prevention study] was particularly informative because of the large number of fatal prostate cancers, over 7,400, that occurred during 30 years of follow-up”, said Jacobs. In other words, doing “nothing” (surveillance) resulted in a slightly higher risk of cancer spreading – 6 per cent vs. 3 per cent – but not a statistically significant increase in mortality, at least after 10 years.
“About one in seven men will be diagnosed with prostate cancer at some point in his lifetime, and early detection is essential”, said Dr. Gary Larson, medical director at ProCure Proton Therapy Center.
Men in the radiation group tended to experience more bowel problems after treatment than the other groups.
Have definitive patient selection criteria been established for HIFU treatment for localized prostate cancer?
Some symptoms of prostate cancer are: difficulty starting urination; weak or interrupted flow of urine; frequent urination, especially at night; difficulty emptying the bladder completely; pain or burning during urination; blood in the urine or semen; pain in the back, hips, or pelvis that doesn’t go away; and painful ejaculation. Prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland.
However, there’s much debate in medical circles over the value of PSA screening. An elevated PSA level may indicate many things, including the possible presence of cancer.
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A previous study on the association between vasectomy and prostate cancer found that vasectomy was associated with about 10% higher overall risk of prostate cancer and about 20% higher risk of fatal prostate cancer. The analysis showed no increase in the prostate cancer hazard ratio for men who underwent vasectomy among all men who developed prostate cancer (HR 1.02, 95% CI 0.96-1.08) or in a subgroup of 1,070 men who had high-grade disease, defined as a Gleason score ≥8 (HR 0.91, 95% CI 0.78-1.07).
