Surveillance of Low-Risk Cases Leading the Way in Improving Prostate Cancer Treatment Strategies

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Marji_130715_6A new study in the journal JAMA is reporting that there has been an improvement in the treatment strategies for prostate cancer in recent years. According to researchers, the management of localized low-risk prostate cancer has risen as overtreatment has declined, suggesting the improvement in managing the disease.

Led by Dr. Matthew Cooperberg and Dr. Peter Carroll, the study analyzed 10,472 men from 1990 to 2013. Researchers noted that surveillance for low-risk diseases rose between 2010 and 2013, being used in 40% of the cases studied, compared to just 7%–14% of all cases between 1990 and 2009.

The report also found the rates of treatment with androgen deprivation for intermediate-risk and high-risk tumors fell, declining from 10% and 30% in 1990 to just four percent and 24%, respectively, in 2010.

As for using surveillance, or “watchful waiting,” as a management treatment, this was an option chosen more frequently among men 75 years old or younger and rose in prevalence from 54% between 1990 and 1994, to 22% from 2000 to 2004, and up to 76% from 2010 to 2013.

The use of surgery in low-risk cases also increased among men 75 years of age or older to 9.5%; for intermediate-risk cases, this treatment option rose to 15%. There was no increase in surgery as a management treatment for high-risk prostate cancer treatments, for which androgen deprivation was still the primary treatment choice at 67%.

Based on these numbers, the researchers believe these trends may lead to changes in the way prostate cancer is approached for older men: “Given that overtreatment of low-risk disease is a major driver of arguments against prostate cancer screening efforts, these observations may help inform a renewed discussion regarding early detection policy in the United States.”

In 2015, prostate cancer is expected to account for 13.3% of all new cancer cases in the U.S., with an estimated 220,800 new cases of prostate cancer this year alone. Furthermore, 27,540 American men are expected to die from the disease this year.

The researchers of this latest study conclude, “the magnitude and speed of the changes suggest a genuine change in the management of patients with prostate cancer in the United States, which could accelerate as more clinicians begin to participate in registry efforts.”

Sources for Today’s Article:
MacGill, M., “Localized prostate cancer: ‘treatment strategies have improved’,” Medical News Today web site, July 13, 2015; http://www.medicalnewstoday.com/articles/296655.php.
“SEER Stat Fact Sheets: Prostate Cancer,” Surveillance, Epidemiology, and End Results Program: National Cancer Institute web site; http://seer.cancer.gov/statfacts/html/prost.html, last accessed July 13, 2015.




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