Rethinking Prostate Cancer Treatment

Many men given a diagnosis of prostate cancer receive intensive treatment like surgery or radiation therapy even though the cancer is unlikely to spread or to be fatal, a new study has found.

Researchers used data from a large cancer registry to analyze the risk profiles and treatment patterns of 123,934 men whose cases were diagnosed between 2004 and 2006.

In some 14 percent of the new cases, about one in seven, the men had low blood levels of prostate-specific antigen, according to the paper, published in the July 26 issue of Archives of Internal Medicine.

These patients were less likely to experience fast-growing tumors, and more than half were classified as having low-risk disease. Yet they were just as likely to receive intensive treatment as patients with higher P.S.A. scores.

A vast majority--more than 75 percent--had either prostate surgery or radiation treatment, the study found. The treatments can have serious side effects, including incontinence and erectile dysfunction.

Some of these men might have benefited from a more conservative approach, like being closely monitored with regular P.S.A. tests, biopsies and rectal exams, said Dr. Mark N. Stein, an assistant professor at the Cancer Institute of New Jersey and one of the paper’s authors.

“We need to figure out if we can manage more men in a conservative manner,” he said.

The New York Times, Tuesday, August 3, 2010

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