Some Prostate Cancer Patients May be Over-Treated
According to a new study from the University of Michigan Comprehensive Cancer Center, more than half of men with lower-risk prostate cancer received surgery or radiation treatment – an over-treatment, when a wait-and-see approach of no therapy and active surveillance would have been a reasonable option.
The balance between the risks and benefits of immediate surgery or radiation treatment is difficult to define in men with less aggressive prostate cancers.
While older men with lower-risk prostate cancer who choose so-called watchful waiting are likely to die from another cause during the first 20 years after their cancer diagnosis, treatment with surgery or radiation can lead to complications like erectile dysfunction (ED), urinary incontinence and bowel difficulties.
“Just as a failure to treat a potentially lethal prostate cancer is generally considered inappropriate from a quality-of-care perspective, overtreatment of lower-risk cancers is also not in the patient’s best interest.
For some men with early stage prostate cancer, surgery or radiation therapy may result in substantial negative effects without a survival benefit,” says study author John T. Wei, M.D., M.S., associate professor of urology at the U-M Medical School.
So where do oncologists find the balance?
It should be noted that prostate cancer treatment is not a one-size-fits-all thing.
According to lead study author David C Miller, M.D., MPH, adjunct lecturer at U-M and now a health services research and urological oncology fellow at the David Geffen School of Medicine at UCLA:
“Based on data from this study, it is clear that the number of lower-risk patients who receive initial aggressive therapy is not trivial and we have to ask the question whether this is too much treatment for some of these men.
“We should continue to explore our patients’ preferences regarding the different treatments for early-stage prostate cancer and better educate them about the entire spectrum of options, including the appropriateness of initial active surveillance in many lower-risk cases.”
For many men with lower-risk cancers, this research recommends a potentially appealing treatment option called active surveillance.
From the traditional concept of watchful waiting, active surveillance involves frequent monitoring of the tumor without immediate active treatment, which can then help distinguish between more-aggressive and less-aggressive cancers thereby improving the doctors’ judgment in identifying patients who are most likely to benefit from surgery or radiation.
Read more at UMCC News.
Tags: prostate-cancer, prostate-cancer-treatmentRelated Stories
POSTED IN: Prostate & testicular cancer
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Cancer Commentary » Treatment of Prostate Cancer, Preferable Over “Watchful Waiting” Confirms JAMA Study
Dec 23, 2006 at 6:45 pm
[…] While watchful waiting is being recommended by advocates of personalized cancer treatment, a large study published in the Journal of the American Medical Association (JAMA) this month (December 13, 2006) confirms that men with early prostate cancer should seriously consider all prostate cancer treatment options before choosing “watchful waiting” as a disease management approach. […]
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