Men diagnosed with prostate cancer are often faced with a difficult question: should I have surgery to remove it, or wait and see whether it will progress? This question can have serious implications about lifestyle and sex life. A new study in the New England Journal of Medicine found that men who opted for radical prostatectomy lived up to three years longer than those who chose to wait and monitor their condition.

The study followed nearly 700 men, all younger than 75 years old, whose cancer had not yet spread. Herbert Lepor, MD, the Martin Spatz Chair of the Department of Urology at NYU Langone, and other experts in prostate cancer tell SurvivorNet the study is significant. The improved survival of the men who had surgery is an important factor to consider, as the side effects of surgery cause many men to choose active surveillance, also known as watchful waiting.

“For men with a 10-year life expectancy where sexual dysfunction is a low or non-existent priority, the present study suggests that the risk/benefit of surgery is quite favorable,” says Dr. Lepor, who treats men at Smilow Comprehensive Prostate Cancer Center, part of Perlmutter Cancer Center. However, he also notes that “over half the men who chose watchful waiting did not develop metastasis, which highlights the high rate of unnecessary curative treatment.”

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