A new study cautiously suggests that elderly men with low and medium risk, localized prostate cancer may be better off having treatment than waiting to see how the cancer develops.
The study was published today in The Journal of the American Medical Association.
The study looked at 44,630 men aged from 65-80 years who had been diagnosed between 1991 and 1999 and lived more than 12 months afterwards. All the men had localized prostate cancer, that is it had not spread to other parts of the body. The researchers compared men who received treatment, such as surgery or radiation therapy (32,022 patients), with those who were under observation only (“wait and see”, 608 patients).
The scientists found that over a 12-year period, a higher percentage of men in the observation group had died than in the treatment group. And the treatment group had a higher 5- and 10-year survival. The survival advantage of being in the treatment group was statistically significant, including in subgroups such as men with low-risk disease, black men, and men aged 75-80 years at diagnosis.
The study excluded patients who received hormonal therapy only and the researchers suggest more research is needed to confirm the results.
Treatment of low and medium risk prostate cancer in elderly men is a controversial issue. There are two options: to treat or to “wait and see”.
In older men with prostate cancer, the likelihood that death will occur from other causes is greater (compared to younger men), making decisions about treatment very difficult. The most common treatments are surgical removal of the prostate (prostatectomy), radiation or hormone therapy, and less commonly, chemotherapy. Prostate-specific antigen (PSA) screening, where a blood test shows if cancer traces are present, has led to more men being diagnosed at an early stage, before the cancer has spread to other organs.
The prostate is a gland that sits in a man’s pelvic area, just below the bladder and above the testicles. Prostate cancer usually develops in men over 50 and often causes pain, difficulty urinating, and erectile dysfunction. It is the most common form of cancer for men in the US, and takes second place to lung cancer as the biggest killer of US males.
“Survival Associated With Treatment vs Observation of Localized Prostate Cancer in Elderly Men”
Yu-Ning Wong, MD; Nandita Mitra, PhD; Gary Hudes, MD; Russell Localio, PhD; J. Sanford Schwartz, MD; Fei Wan, MS; Chantal Montagnet, MA, MPhil; Katrina Armstrong, MD, MSCE
JAMA. 2006;296:2683-2693
Written by: Catharine Paddock
Writer: Medical News Today