Men Beware! 80% of Prostate Cancer Surgeries are Unnecessary.

Prostate cancer is a significant concern for men, being one of the most commonly diagnosed cancers in the United States. In 2023, approximately 299,010 men received this diagnosis.
Understandably, such a diagnosis can be frightening, leading many to consider aggressive treatment options like radical prostatectomy. However, it's crucial to understand the implications and necessity of this surgical procedure fully before making a decision.
While prostatectomy can be life-saving for some, it's essential to recognize that it is not always necessary. Alarmingly, estimates suggest that up to 80% of prostatectomies might be avoidable.
This statistic implies that around 72,000 men undergo this invasive surgery without a clear medical necessity each year.
About the Author
Scott Oliver is not a doctor and does not give medical advice. However, he has prostate cancer and, while he trusts doctors, he always verifies their recommendations.
For more detailed information, please refer to the following sources:
2024: Comparing side effects after prostate cancer treatment. www.nih.gov/ne...
2024. Cancer Stat Facts: Prostate Cancer. seer.cancer.go...
2024. Common Cancer Types. Estimated new cars of prostate cancer in 2024 www.cancer.gov...
2024. Key Statistics for Prostate Cancer. www.cancer.org...
2023. Urinary tract infection after radiation therapy or radical prostatectomy on the prognosis of patients with prostate cancer: a population-based study. bmccancer.biom...
2022. Surgery vs. Radiation for Prostate Cancer: Uses, Benefits, Side Effects www.verywellhe...
2021. Treating Urinary Incontinence After Prostate Surgery healthcare.uta...
2019. Financial toxicity associated with treatment of localized prostate cancer. www.ncbi.nlm.n...
2018. Surgery Unnecessary for Many Prostate Cancer Patients. medicalxpress....
2017. National Trends in Prostate Biopsy and Radical Prostatectomy Volumes Following the US Preventive Services Task Force Guidelines Against Prostate-Specific Antigen Screening. jamanetwork.co...
2014. Robot-Assisted Prostate Cancer Surgery on the Rise www.cancernetw...
2014: The cost for the procedure ranged from a high of $135,000 to a low of about $10,000. Physician fees varied from $4000 up to about $19,000. The average cost for a physician or for a surgeon was about $8000. www.medscape.c...
2012. Annual volume of radical prostatectomies in US doubled between 2003 and 2009 prostatecancer...
2011. Robotic-Assisted Laparoscopic Radical Prostatectomy Has Steep Learning Curve. www.onclive.co...
2010. Doctor: 80% of Prostate Surgeries Are Unnecessary www.newsmax.co...
2005. 30-Day Mortality and Major Complications after Radical Prostatectomy: Influence of Age and Comorbidity. academic.oup.c...
Erectile Dysfunction After Prostate Surgery: What You Should Know: www.pcf.org/ab...
Survival Rates for Prostate Cancer. www.cancer.org...
Prostatectomy - Robotic Costs: www.mdsave.com...
Urinary Dysfunction After Prostate Cancer Treatment. www.hopkinsmed...
Incontinence After Prostate Surgery. my.clevelandcl...
Erectile Dysfunction After Prostate Cancer: www.hopkinsmed...

[@livinginguatemala]

If any of you guys have questions you think we should be creating videos for in relation to prostate cancer, PLEASE let me know in the comments.

[@MyFrank71]

good video,iam gleason 6 and on AS ,does being overweight effect your psa /

[@omarssonkristjan5049]

Good advice i cot prostate cancer i was put in beam therapy for 39 days and hormone injection to whom six month and my last one is in November the state in Iceland pay almost 90% off my Treatment and i can have sex live.

[@QZ46000]

Excellent video. Thanks. Factors responsible for qui ck aggressive surgery is cancer scare, unethical money minuting attitude of some doctors and most of private hospitals, people in social circle suggesting to quickly get rid of cancer.uncertainity about side affects of radiation is another factor that patients choose surgery. Would request to do a video on radiation.

[@livinginguatemala]

Thank you for your feedback, it's much appreciated. A video about radiation is on the list....

[@21dewsbury]

Good video. I do not live in the USA. But we have good free health care where I live. I am currently low risk but surgery or brachytherapy is being suggested. My preference is active surveillance. THEORY: From the providers perspective - surgery is usually the end of the matter... over and done with in a few short days. On the other hand active surveillance means that there will be lots of tests/biopsy's that will go on for years and years. Hence surgery is preferred solution for the state to provide (??)

[@livinginguatemala]

Thank you for your comments. But I must disagree with you because "surgery is RARELY the end of the matter." 20-30% of men who have had the prostatectomy will relapse and the difference in the long-term survival rate between men who have had surgery and men who have not is minimal. (I'm working on that video next week). As I've mentioned in this video, this surgery is fraught with serious potential side effects that leave tens of thousands of men each year, leaking bleeding and limp. And lastly, as the video also explains, 50,000+ of these surgeries each year are medically unnecessary. PS. Active surveillance - which I also prefer - is easy and cheap....

[@21dewsbury]

@@livinginguatemala I take your points. I guess my point is that the expertise of the surgeon is only required once usually. The side effects don't impact the surgeon so much. The side effects are a problem for the patient but the surgeon has done his job. Personally, I am very focussed on A.S. but I am also aware that a non-blood relative died from prostate cancer 25 years ago.

[@livinginguatemala]

@@21dewsbury Well yeah! Once the surgeon cuts out your prostate once, he can't do it again. 🤣 The good news is that prostate cancer awareness and the treatment options are vastly different from what they were 25 years ago... Good luck with your AS. I'll be posting a new video each week so don't forget to subscribe.

[@21dewsbury]

@@livinginguatemala Thank you!

[@daxmac3691]

Excellent video ! Starting step for high PSA level is 3T MRI with rectal coil.....that level of imaging is found at a University medical center. Been there...done that..YouRwelcome

[@livinginguatemala]

@@daxmac3691 Thank you for your tip, much appreciated.

[@andrewgynn4502]

All of what you say is true i had an rp four years ago and have all the problems and two years in psa was back had to go on adt and rad .As of today psa is on the way up again life is not much fun at 57.

[@livinginguatemala]

@@andrewgynn4502 Very sorry to hear that Andrew and wish you the best.

[@michaelcasey6546]

I'm approaching 52 years old, diagnosed with 4 cores out of 12 prostate cancer, 3 cores were gleason 3 and 1 core gleason 4. I'm a young man and feel I'm being shoved towards radical prostatectomy and I would really appreciate your advice. I had one negative biopsy 2 years ago before this diagnosis and my psa has held steady at 3.2 for a full year with my prostate size at 32cc. I would really appreciate any advice I can get, thanks.

[@livinginguatemala]

Good afternoon Michael, I am not a doctor so do not give medical advice but if you want a supportive chat with someone else who has PC (me) and who has avoided surgery so far, I'm happy to do so: calendly.com/prostate-cancer-warriors/45min

[@MyFrank71]

the best of luck going forward,iam 53 and on active survalence for the past 2 years

[@MM-sf3rl]

While a PSA at 3.2 is not high, it is for a 52 year old man. 3 cores of Gleason 3 and 1 core of Gleason 4 has the possibility of active surveillance. It would depend of the type of pc cancer, the volume of pattern 4, your PSA density is 0.10 (good), PIRADS score, and genomics. All answerable. You have time, keep investing.

[@michaelcasey6546]

@@MM-sf3rl Thanks for the advice. I maybe should have clarified 3 cores of Gleason 3 plus 3 and one core of Gleason 3 plus 4. I also had a 16 core biopsy taken 2 years ago which was negative so I'm grateful for any advice and opinions.

[@MM-sf3rl]

@@michaelcasey6546 Glad to try and help. Other really good KZbin channels are Grand Rounds in Urology, Focal Therapy Society and Prostate Cancer Research Institute. Best of luck!!!

[@randallsample1005]

Is there any sort of clear line between necessary and unnecessary prostatectomies? I was diagnosed with a fairly aggressive cancer three years ago (4+3, which my urologist said was on the border of 4+4, high volume - 90% of the biopsy cores were cancer, high grade). With research, I decided I was well beyond any treatment gray area, and I opted for a radical prostatectomy because I was relatively young (62) and in otherwise very good health. Further, I chose the surgery route because I did not want to suffer the radiation side effects not related to incontinence and ED, which could hit me 5 years down the road.

[@MM-sf3rl]

This video has a lot of drama to it. I’ve had pc for 2.5 years (probably 6-7 years if one considers the .08+ rise of PSA every year). I have 3+4 favorable intermediate GG2, non-aggressive pc. If I had 4+3 or 4+4 like you, I would probably make the same choice.

[@randallsample1005]

@@MM-sf3rl My best wishes to you, and hopes that your PC remains indolent.

[@MsElaine122]

Protectectamy is marketed on bill boards here. Says something!

[@OliverW-n1e]

Unreal, until recently I hadn't realized that Mario updated his favorite way to tackle ED and it's a relief! Although what he previously suggested was pretty good, it was a real pain to follow... I just go'ogled the latest by Mario Volpstein, it's so much simpler and potent now!

[@maxthemagition]

There be the advantage of the British NHS because the treatment offered is consistent throughout the whole of the UK determined by decades of experiemce and records. Here the patient with low risk prostate cancer would never be offered invasive treatment. Those with localised intermediate prostate cancer would be offered Radiation Therapy or active surveilance. I suspect that it is only those with high risk prostate cancer that has spread would be offered surgery along with radiation therapy. We are so lucky here in the UK to have our beloved NHS.... However we still have the private sector and it is possible to get an operation for prostate cancer....It would be down to the individual making that decision when given the choice....

[@livinginguatemala]

Thank you for your feedback. In the USA there are unethical surgeons who will happily suggest a prostatectomy for your dog if it sneezes too much so yes! It's unfortunately aggressively recommended. I haven't used the NHS for over 45 years so would not know what they do now. Having said that, over the past 4 years, the NHS killed off plenty of our old age pensioners with Midazolam and are still aggressively recommending a vaccine that has proven to be anything but 'safe and effective,' I'm afraid I do not have the respect for the NHS that you have.

[@MM-sf3rl]

Not 100% true. I have no health insurance so I contact the NHS for treatment with 3+4 favorable intermediate pc. They said I was not a candidate for focal therapy and offered me ADT and radiation. In the USA, some doctors and institutions would have said the same thing as the NHS while others have offered HIFU, Cryotherapy, irreversible electroporation, TULSA-PRO, etc. It all depends on the “standard of care” that doctor or institution prescribes to. Buyer be ware.

[@mikekelly6479]

I have to disagree the default position is to offer surgery I know this from my own experience and others who I have met on urology wards. I refused surgery and was considered to be reckless I am now on active surveillance whilst waiting for a decision on focal therapies which were not offered and in some cases derided as not effective. I was also offered ADT which I also refused as the side effects were too great in my opinion. My risk of dying from PC was 2% in 10 years but if I had a radical prostatectomy that was reduced to 1% but the risk of incontinence and ED were too great for me to consider this option. I did my research prior to consultation and was very clear about what I did and did not want, quality of life is such an important consideration. Guys do your own research before agreeing to surgery

[@livinginguatemala]

@@mikekelly6479 Delighted you made YOUR own decision. Me too... I met with 5 different urologists all of whom - 100% - recommended the prostatectomy within the first 30 minutes saying it was the 'standard protocol'.

[@antoniodelrey164]

Probably many are not necessary but no way 80%. This is one article and who did it and why? Fellas, don’t disregard having all the right exams and tests before not doing anything. Active surveillance may be the thing to do but don’t just not do anything. Who is this guy and what makes him an expert?

[@livinginguatemala]

"Who is this guy?" I am someone who can read... You obviously did not read the description below the video and see the link of the article written by an experienced prostate cancer doctor who estimated that 80% of prostatcetomies were not medically necessary? That's "who"!

[@antoniodelrey164]

@@livinginguatemala I can read too but I don’t take everything I read or see on KZbin as the gospel and make a KZbin video as if I am an expert giving advice on a potentially life threatening disease.

[@livinginguatemala]

@@antoniodelrey164 There's nothing in my video that says I am claiming to be an expert but as you can see, I am using information taken from numerous medical experts. After the last 4 years of 'medical experts' forcing people to take supposedly 'safe and effective' products that have killed about 20,000,000 people so far, I share your distrust for the vast majority of 'medical experts.'

[@antoniodelrey164]

@@livinginguatemala OK my friend. I think we agree and sometimes I’m just too skeptical and took it out on you. Peace. I’m sure now that you posted your video with good intentions. I’m going through test etc and need to make a decision so I read a lot and was doing active surveillance but now it’s time to decide what to do and hopefully I’m a candidate for what seems to me to be a good option, TULSA-PRO. Surgeons do like to push surgery. It’s too bad that a lot of it is profit driven. We need another system of health care that’s for sure.

[@livinginguatemala]

@@antoniodelrey164 Best of luck to you...