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New Research Questions Early Prostate Cancer Treatment Options

Update Date: Jul 15, 2014 11:32 AM EDT
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According to two new studies, many men who are diagnosed with low-risk prostate cancer are not receiving the best advice from their urologists. These studies suggest that physicians need to better inform their patients about the best available options for their cancer.

In the first study, the researchers headed by Dr. Karen Hoffman, an assistant professor at the University of Texas MD Anderson Cancer Center in Houston, TX analyzed data on more than 2,000 men who were aged 66 and older. They were diagnosed with low-risk prostate cancer between 2006 and 2009. 80 percent of them had received treatment while 20 percent of them were observed.

The team found that older urologists were more likely to advise their patients to undergo surgery or radiation instead of taking the wait-and-see approach. A patient's likelihood of receiving treatment also increased if his urologist performed these treatments.

"The variation of treatment of low-risk prostate cancer by physicians was striking," said Dr. Hoffman reported by WebMD. "The diagnosing urologist influences a man's treatment fate. The urologist not only influences up-front treatment versus observation, but also the type of treatment."

In the second study headed by Dr. Grace Lu-Yao, a professor of medicine at the Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School in New Brunswick, N.J, the team followed more than 66,000 prostate cancer patients over 17 years. The researchers found that even though a hormone therapy called androgen-deprivation therapy (ADT) is typically not recommended for low-risk prostate cancer, it was still used for many patients whose cancer did not spread.

"It really is not a benign treatment Androgen-deprivation therapy is palliative, not curative," said Alan J. Wein, professor and chief of urology at the University of Pennsylvania reported by Philly. "ADT also has been associated with thinning of the bones, weight gain, decreased muscle tone, the appearance of diabetes, and perhaps deep venous thrombosis."

The researchers concluded that ADT could be an effective treatment for advanced cancer. However, for older patients with localized cancer, hormone therapy should not be the first choice. The team added that during the follow-up portion of the study, they found that ADT did not improve survival rates.

Both studies, "Physician Variation in Management of Low-Risk Prostate Cancer," and "Fifteen-Year Survival Outcomes Following Primary Androgen-Deprivation Therapy for Localized Prostate Cancer," were published in JAMA Internal Medicine.

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