This is what happens when men forgo prostate surgery

Men who are managed by observation only after diagnosis of low-risk prostate cancer live as long as those managed with radical prostatectomy, 20-year data from a US study show.

There was a 0.7% difference in overall survival rates between immediate surgery and observation for low-risk prostate cancers, according to the latest follow-up of the PIVOT study.

The randomised trial of 731 men with localised prostate cancer showed that surgery was not associated with any significant all-cause or prostate cancer mortality benefit compared with observation.

During 19.5 years of follow-up, deaths due to prostate cancer occurred in 7.4% of men who had surgery and 11.4% of men who had observation.

But for men with low-risk disease, who accounted for most cases, the absolute difference in mortality was less than 1%.

Men who opted for prostatectomy had high rates of adverse effects such as incontinence