VA Study Urging Watchful Waiting for Early Prostate Cancer Sparks Controversy

By Brenda L. Mooney

MINNEAPOLIS — New research out of the Minneapolis VAMC finds that radical prostatectomy does not significantly reduce the risk of death in prostate cancer patients, when compared to observation over more than a decade. While that study confirms other major research on the topic, the controversy about how to treat early-stage prostate cancer continues.


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The results came from the Prostate Cancer Intervention Versus Observation Trial (PIVOT), partially funded by VA and led by Timothy J. Wilt, MD of the Minneapolis VAMC. PIVOT, which began enrolling patients in 2004, looked at men with early-stage prostate tumors detected by PSA screening and compared the relative benefits of prostate cancer surgery soon after diagnosis to observation.

Study results, published recently in the New England Journal of Medicine, found that most men did not benefit from the surgery by reductions in mortality from prostate cancer or other causes.

“Our data show that observation provides equivalent length of life, with no difference in death from prostate cancer, and avoids the harms of early surgical treatment,” Wilt said in a VA press release.

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