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American Morning

Study Shows Immediate Surgery More Helpful for Prostate Cancer

Aired September 16, 2002 - 08:41   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

BILL HEMMER, CNN ANCHOR: Confusion typically reigns over how best to treat prostate cancer. Now, that may change, though. There are findings in a new study offering important guidance for the nearly 200,000 men in the U.S. who are diagnosed with the disease every year. Our "House Call" today, Dr. Sanjay Gupta back with us, live in Atlanta -- good morning, doctor. How are you, and what are we learning now?
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning. Well, it is a very confusing topic, no question. When we talk about prostate surgery, we talk about actually separating people into either early operations or watchful waiting. In this particular study, they found that people who had prostate surgery operations after going to their doctor with problems, with complaints of symptoms, they actually had prostate surgery, they actually lived longer in terms of their overall survival from prostate cancer than people who did not have the operation.

That is a mouthful, and sort of confusing, but basically what it means is if you go to your doctor with complaints that end up being prostate cancer and you get an operation, you are going to not die from prostate cancer as much so as the people who did not have the operation. Sort of confusing.

Seven hundred Scandinavian men who had prostate cancer were separated into two groups: those who had surgery, and those in the watchful waiting group. That is people who were observed, but did not actually have any surgery. And they found over time that the people who had the surgery actually did not die from prostate cancer as likely.

Now as surgeons, we are trained to sort of -- when we see a tumor, when we see cancer, go in and cut it out, basically take it out, but that may not always be the right answer. It depends on the overall health of the patient. Overall survival, overall quality of life. And these are issues that are just as important when deciding who gets an operation versus who does not.

A mentor of mine, Bill, once used to tell me that just because you want to cure something doesn't mean that it is always possible, and just because it's always possible doesn't mean you should always cure something. I thought that was a very important lesson -- just because someone has cancer doesn't mean that an operation is always the right answer. Watchful waiting might be just as good an option.

HEMMER: What did you find out regarding side effects for either group? Much there? GUPTA: Well, there are some side effects. Certainly, when you think about doing operations on people, you have to think about the side effects. The side effects for the people in the surgery group, impotence was an increase in the people who had operations. There were side effects that were very similar in the two groups, if you looked at people who had surgery versus those who did not. Bowel function, anxiety, depression, side effects like that were actually similar between the two groups.

HEMMER: What about screening doctors? Are we learning more about perhaps the guidelines, the qualifications, things to look for, et cetera?

GUPTA: Well, one thing we hear a lot about, Bill, is PSA, the screening test that has become so popular and also controversial. This is a test, Bill, that actually determines whether or not you have any abnormalities with your prostate whatever. For example, someone who has inflammation of the prostate might actually have an elevated PSA and may not always be cancer. But the bottom line is that early diagnosis leads to early treatment, which can lead to early survival from the cancer -- Bill.

HEMMER: Best advice all day. Thank you, Sanjay. Dr. Sanjay Gupta in our "House Call."

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