Waiting Could Be Better Than Radiation in Treating Early Prostate Cancer
Prostate cancer forms in the tissues of the prostate, which is a gland located under the bladder and in front of the rectum. According to the National Cancer Institute, the estimated number of new cases and death in 2013 is 238,590 and 29.720 respectively. When people are diagnosed with prostate cancer, they are usually sent to surgery or radiation treatment right away. Even though these options are effective in treating the cancer, a new study found that routinely examining and checking men with early and slow-growing prostate cancer could be more effective and significantly cheaper than other treatment options.
"Most of the men who are diagnosed in this country these days have low-risk prostate cancer," Dr. Julia Hayes said according to Reuters. Hayes led the study at the Dana-Farber Cancer Institute Boston. "There's a huge group of men out there who are probably treated unnecessarily."
The research team analyzed and compared the effectiveness of immediate treatment and two wait-and-see methods for the low-risk version of prostate cancer. One method involved active surveillance in which the patients had a prostate specific antigen (PSA) test every three months. On top of this test, these men also underwent regular prostate biopsies and digital rectal exams. The other approach, which was considered the less intensive route, involved a PSA test every half a year and a bone scan every five years.
The researchers concluded that for hypothetical 65-year-old men, around 78 percent of them who had active surveillance would end up undergoing prostate cancer treatment. For the group of men who had the less rigorous approach, 34 percent of them would undergo prostate cancer treatment. Due to these percentages, the researchers stated that watchful waiting could be the better approach because it was cheaper and it did not pose any extra harm to the cancer patients.
Based on their statistics and models, the researchers found that the risk of dying from prostate cancer in the group of men with active surveillance was 4.8 percent. The risk of dying for the group who took the watchful approached was 6 percent. For the group of men who were sent straight to treatment, the risk of dying was 8.9 percent. Although the researchers found that waiting and watching either under an active or a less active approach appeared to be as effective as immediate treatment, the team stressed that the models they used computed averages and that ultimately the fight against cancer should be determined based on individual symptoms and health.
"This is an important study that adds to mounting evidence about the value of observation [watchful waiting] as a treatment option for many men, in particular for men with localized, low-risk prostate cancer," Dr. Timothy Witt of the Minneapolis VA Health Care System stated. Witt contributed data to the model that the researchers used to conclude their findings. "Observation can help men live a similar length of live, prevent death from prostate cancer and avoid the harms associated with early treatment."
The results were published in the Annals of Internal Medicine.