Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Font Size

Prostate Surgery May Be a Better Option

Cuts Cancer Death More Than Watchful Waiting, but Not Everyone's a Candidate


Or is it? The study began in 1989 -- before PSA blood tests became routine. PSA tests offer much earlier detection of small prostate cancers. As many as one in five men with very small prostate tumors may do better with watchful waiting, Walsh's editorial suggests.

Holmberg notes that there are men for whom watchful waiting is the better option.

"Let's say you are an older man and you have a very small and less aggressive prostate cancer, and you feel that the side effects of incontinence and impotence would bother you very much in your life," Holmberg says. "In that kind of situation you would opt for watchful waiting."

Or say you had other medical conditions that would make surgery a high-risk proposition. Again, you might want to choose waiting. On the other hand, if it seems to you that the side effects of surgery are acceptable, and you have the kind of prostate cancer where your risk is maybe not very high but substantial -- and you wouldn't like to risk that -- perhaps surgery is the better choice."

A second part of the Swedish study compared quality of life for men who underwent prostate surgery and those assigned to watchful waiting. After about four years, the two groups reported about the same quality of life. However, surgery -- performed in most cases without use of Walsh's nerve-sparing technique -- resulted in more impotence and urinary leakage. Watchful waiting, however, also resulted in significant impotence -- and in greater inability to empty the bladder.

"The point this makes is the one I have been trying to make to waken the skeptics: Waiting can cause side effects," Walsh says. "Men who have prostate cancer and do nothing don't just wait five years and wake up dead. You go through five years of life-changing events."

Still, not all side effects are equal. Which are worse? That depends on the individual.

"Different people have different degrees of bother from side effects," Holmberg says. "Incontinence is not the same kind of problem for every person. It will be kind of guesswork to counsel people on which treatment they should choose, because when we see how much people are bothered, well, that is after the fact. To decide what kind of treatment -- whether watchful waiting or [prostate surgery or radiation] -- it is still a very difficult decision. At least now we have these data to give you. It makes the guesswork more informed."

1 | 2

Today on WebMD

man with doctor
Symptoms, risks, treatments
man coughing
Men shouldn’t ignore
prostate cancer cells
What does this diagnosis mean?
doctor and male patient
Is it worth it?
cancer fighting foods
15 Cancer Symptoms Men Ignore
Prostate Enlarged
Picture Of The Prostate
Prostate Cancer Quiz
screening tests for men
Prostate Cancer Symptoms
Vitamin D