Surgery may not always be the answer for men with early-stage prostate cancer, a new study from Washington University in St Louis suggests.

For the study, which was recently published in The New England Journal of Medicine, researchers randomly assigned 731 men with localised prostate cancer to radical prostatectomy or observation from November 1994 to January 2002.

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That means half the guys underwent an operation to remove their prostate gland, while others closely monitored their symptoms under their doctor’s care, or opted for more frequent PSA testing.

Men in the observation group were only treated if their symptoms became more severe, like if they had bone pain or trouble urinating, both of which suggest the cancer might be becoming more aggressive.

During the nearly 20-year follow up, there was no significant difference in the number of deaths of men in the surgery group and those in the observation group. That means there was no significant survival benefit to going under the knife.

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But the guys who did have the surgery had some other issues to contend with: Side effects from the operation.

The researchers found that 15% of the 364 men treated with surgery suffered from erectile dysfunction and 17% reported having urinary incontinence, or difficulty holding in their pee. An additional 45% developed other complications from surgery.

“About 70% of patients newly diagnosed with prostate cancer cases are in the early stages, meaning the cancer is confined to the prostate gland, and they have nonaggressive tumors,” explained study author Dr Gerald L Andriole, director of Washington University’s Division of Urologic Surgery in a press release.

 “As such, these patients have an excellent prognosis without surgery. This study confirms that aggressive treatment usually is not necessary.”

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That’s not to say surgery has no benefits. For healthy guys with intermediate- to high-risk prostate cancer, surgery can be lifesaving, the study authors say.

“It would be a disservice to dismiss surgery as a viable option for patients with intermediate-risk prostate cancer,” added Dr Andriole. “For these patients, and for some men with high-risk prostate cancer, surgery is often beneficial, as are other treatments, such as radiation.”

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Prostate cancer is the third leading cause of cancer death in American men, according to the American Cancer Society. If you experience any of the telltale symptoms of prostate cancer, like problems urinating, blood in your pee or semen, or trouble getting an erection, talk to your doctor immediately.

Even if you don’t experience any symptoms, make sure you read up on the eight steps you can take to prevent prostate cancer and everything you need to know about the PSA blood test to figure out if you should actually need one.

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