According to a new study, some men with lower-risk prostate cancer may not need to undergo surgery or radiation treatment for their illness. Instead, a wait-and-see approach combined with active surveillance could be just as beneficial.
Â Since, according to the American Cancer Society, 234,000 men will be diagnosed with prostate cancer this year alone, and a staggering 27, 350 will die from the illness, the findings in this study are important to note if you or a loved one are facing this type of cancer.
Â Researchers from the University of Michigan’s Comprehensive Cancer Center looked at men with less- aggressive forms of prostate cancers and found that half of the participants in the study who received surgery or radiation treatment would have been better off if they were to forego the treatment and instead received no treatment, only surveillance.
Â The researchers pointed out that the balance between the benefits and the risks of immediately treating lower-risk prostate cancer with either radiation therapy or surgery is not always defined well.
Â The large-scale study was recently published in an August issue of the Journal of the National Cancer Institute. Looking at 64,112 men who were diagnosed with early stage prostate cancer, the researchers divided them into high-risk or low-risk categories. (They did this by looking at the different characteristics of their tumors.)
Â Of the 24,835 participants who fell into the lower-risk category, 55% of them were initially treated with either surgery or radiation. This finding suggested that aggressive treatment is actually pretty common among patients who could have possibly taken the wait-and-see approach.
Â What’s more, the researchers found that when looking at the men who had the lower-risk cases of prostate cancer, those who were under the age of 55 were actually more likely to be treated with surgery rather than taking the active waiting approach. Compared to this, the researchers also found that men who fell into the 70 to 74 age bracket were more likely to get radiation treatment rather than engage in active watching.
Â Looking at the years 2000 through to 2002, the researchers also found that more than 13,00 patients who had lower- risk prostate cancer received either radiation or surgery within the first several months after they were diagnosed with the illness. Among these men, it turned out that those who were over the age of 70 and had mid-grade tumors received potentially unnecessary treatment for the cancer within the initial year after diagnosis.
Â To make things clear, for many patients, undertreatment was also as big a problem as overtreatment was for other individuals with lower-risk prostate cancer. The researchers found that older men suffering from lower-risk prostate cancer who went with “watchful waiting” were likely to die because of another cause other than the cancer within 20 years of diagnosis.
Â However, those individuals who choose to go with active therapy also face risks — surgery and radiation therapy can result in problems such as urinary incontinence, bowel difficulties, and even impotence.
Â The author of the study, John T. Wei, MD, MS, an associate professor of urology at U of M, said, “Just as a failure to treat a potentially lethal prostate cancer is generally considered inappropriate from a quality-of-care perspective, overtreatment of lower-risk cancers is also not in the patient’s best interest. For some men with early stage prostate cancer, surgery or radiation therapy may result in substantial negative effects without a survival benefit.”
Â So what is the balance? For some men, depending on the severity and stage of their prostate cancer, active surveillance can help reduce their need for therapy. However, for other men, there may be no other recourse.
Â The key is to actively participate in the process and communicate with your doctor to find out what the best options are for you. Weighing the pros and cons of each choice will help you and your doctor choose the right treatment option for your individual case.