More than 75 percent of men diagnosed with prostate cancer are treated aggressively, even though most prostate cancers are slow-growing and will never pose a risk to a man’s life, according to a study conducted by researchers from The Cancer Institute of New Jersey and UMDNJ-Robert Wood Johnson Medical School, and published in the Archives of Internal Medicine.
“There’s no question there is a problem of overtreatment of prostate cancer,” said Matthew Cooperberg of the University of San Francisco, who was not involved in the study.
Researchers examined data from 16 tumor registries covering roughly 26 percent of the U.S. population and found records from 124,000 men diagnosed with prostate cancer between 2004 and 2006. They found that even in men with low levels of prostate specific antigen (PSA), indicating a low-risk cancer, aggressive treatments were pursued more than 75 percent of the time.
Part of the problem, experts say, is the lack of a reliable way to predict the progression of prostate cancer.
“This article is saying that PSA when used alone as a screening tool will tend to uncover many cancers that are harmless and do not need to be treated,” said Stuart Holden of Cedars-Sinai Medical Center, who was not involved in the study. “However, it will also discover some that do need to be treated.”
In an accompanying commentary, two other scientists suggest a strategy of “active surveillance” rather than aggressive treatment, consisting of close monitoring of prostate tumors and only initiating treatment if the cancer worsens.
All three major prostate cancer treatments — drugs, radiation and surgery — carry a serious risk of major side effects, including impotence and incontinence. For instance, in the book Bottom Line’s Health Breakthroughs 2007 Bottom Line Health addresses the risks and benefits of surgery: “The most common treatment for prostate cancer is removal of the prostate gland, but clinical studies show that the operation is of little benefit to men who have a life expectancy of 10 years or less because the cancer grows very slowly. This means that most men older than 75 have nothing to gain.”
Sources for this story include: http://www.webmd.com/prostate-cance….