Prostate cancer researchers publishing in the Cancer Research journal argue for more watchful waiting to manage the disease, rather than moving straight to aggressive treatment or surgery.
Kathryn Penney ScD, instructor in medicine at the Harvard Medical School, added:
“Choosing active surveillance could prevent this decline in quality of life.”
The research paper analyzes data from two sets of research – one study with 420 physicians recruited to it, and the other involving 787 health professionals. All had been treated with surgery following diagnosis made between the years 1982 and 2004.
The findings from these studies were divided up according to when the men received their disease diagnosis and treatment.
Correlations between the participants’ grade of cancer disease (Gleason score) were drawn against the increasing use of PSA screening by doctors to help identify prostate cancer, which has risen “from 42% in 1994 to 81% in 2000.”
The American Cancer Society (ACS) says most healthy men have levels of PSA (prostate-specific antigen) in their blood of under 4 nanograms per milliliter (ng/mL) and that the diagnostic test indicates a higher chance of prostate cancer the more the result rises above this level.
The PSA level is not completely reliable though – it does not always suggest cancer and does not necessarily show level of malignancy. The oncology experts for ACS list numerous other factors that can influence levels of prostate-specific antigen, including, among other possibilities:
- An enlarged prostate (benign prostatic hyperplasia, BPH, for example)
- Prostatitis (infection or inflammation of the gland)
- And simply age – levels are likely to rise slowly in older men.
Dr. Kathryn Penney, also associate epidemiologist at Brigham and Women’s Hospital in Boston, MA, said:
“Over time, because of PSA screening, men have been more likely to be diagnosed with prostate cancer at an earlier stage, before the disease has had an opportunity to grow and spread.”
The analysis by the researchers was designed to find out if the prostate screening test had succeeded in bringing about a reduction in severity of cancers.
But Dr. Kathryn Penney, said of the results:
“We were surprised by just how constant the incidence of high-grade disease has been over time.”
“If Gleason grade also progressed over time, we would expect a similar decrease in high Gleason grade disease over time,” Dr. Penney continued, adding:
“Men with low-grade disease at diagnosis should seriously consider talking with their doctors about active surveillance.”