Wednesday, September 16, 2009

The Best Treatment for Prostate Cancer is .............NO TREATMENT!!

In the largest analysis of its kind, new research pinpoints how long older men who are diagnosed with early-stage prostate cancer can expect to live if they opt for a conservative, "watchful waiting" approach to their cancer treatment — as opposed to seeking immediate, aggressive therapies such as surgery and radiation.

Epidemiologists at the Cancer Institute of New Jersey examined national cancer-registry data involving 14,516 men over age 65 who were diagnosed with localized prostate cancer (that which has not spread beyond the prostate) from 1992 to 2002 and delayed surgery or radiation for at least six months after the diagnosis — the wait-and-see strategy commonly referred to as watchful waiting.

In the majority of these patients — those who were diagnosed with early-stage disease at a median age of 78 — the 10-year risk of cancer-related death was less than 10%.

Researchers also calculated the risk of death in a smaller group of watchful waiters who were diagnosed between ages 66 and 74, an age group for whom comparable data existed in past research. These patients' 10-year risk of death from prostate cancer was just 6% — a significant improvement over the risk in a similar group of men who were diagnosed from 1949 to 1992.

The new findings confirm what oncologists have long known, (and I HAVE BEEN TELLING MY PATIENTS FOR YEARS!!!) — that, in general, aggressive treatment for older prostate-cancer patients does not significantly improve survival. Indeed, according to the American Cancer Society (ACS), the 10-year survival rate for prostate-cancer patients over age 65 who pursue aggressive treatment (surgery, radiation or chemotherapy) is 97%, slightly higher than the survival rate of the 66-to-74-year-old patients in the current study who chose no treatment.

"Cancer is the scariest word in medicine for many patients. The first thought is, Oh, my God, I'm going to die. The next thought is, What can we do to get rid of this? But we've known for quite some time that many men — especially those in their advanced age — don't need aggressive therapies," says Dr. Durado Brooks, director of prostate and colorectal cancers at the ACS.

My analysis: Another case of the treatment being more likely to cause harm than the disease itself. Too many men rush into radiation and, even worse, radical surgey and find they are either incontinent or impotent or both! Now the scientists have finally caught up with me!