A new study finds surgery appears to be linked to better survival rates for younger men with prostate cancer.

The study, published in the New England Journal of Medicine, finds surgical treatment for young men with prostate cancer improves their mortality rates.

Unlike most other forms of cancer, surgery is not always the most straightforward answer for men with prostate cancer. That is due to the fact prostate tumor can grow very slowly without many symptoms, or it could grow rapidly and spread to other parts of the body. Prostate cancer is relatively common among older men, but it is uncommon in younger men.

The study is an updated version of one that was started in Sweden, Finland, and Iceland nearly 25 years ago. In that study, almost 700 men who had been diagnosed with prostate cancer were divided into two groups. One group had half of their prostate gland completely removed. The other half were in the watchful waiting category and were treated by doctors only if their symptoms progressed.

In general, men who had the surgery immediately lived longer and the disease did not spread to other parts of their bodies. These men also had less complications from the disease. Men in their 50s and early 60s appeared to benefit the most from the treatment. Over the course of 18 years, the surgery caused the death rate to fall by over a third.

In 2013, prostate cancer researchers argued for watching and waiting rather than jumping into surgery, according to Medical News Today.

“Radical prostatectomy or radiation therapy, the usual treatments for prostate cancer, can have negative side-effects such as impotence and incontinence,” researchers noted. “Choosing active surveillance could prevent this decline in quality of life.”

“Our study shows that surgery reduces the risk of dying from prostate cancer by 44 percent. So surgery does pay off. But as we look closer at the different groups, what emerges is that this does not apply to all patients,” said Professor Jan Erik-Johannson, lead researcher for the study.