Older men with early-stage, localized prostate cancer live longer if the disease is treated with radiation or surgery instead of simply waiting and watching it as is often recommended, a study said on Tuesday.
Researchers at the University of Pennsylvania in Philadelphia said they found that patients whose cancer was treated had a 31 percent lower risk of death during the 12 years they were tracked than those who did nothing.
Even though the disease is considered a slow-developing one, the study “suggests a reduced risk of mortality associated with active treatment for low and intermediate risk prostate cancer in the elderly ... population examined,” concluded the report published in the latest issue of the Journal of the American Medical Association.
“These results must be validated by rigorous randomized controlled trials of elderly men with localized prostate cancer before the findings can be used to inform treatment decisions,” it added.
The disease is the most common cancer afflicting men in the United States. Because it can be detected by a blood test, increasing numbers of cases are being diagnosed, the study noted.
Waiting and monitoring the growth of tumors is considered one option, especially for older men who have a higher risk of dying from something else, given the fact that the disease progresses slowly. But the new study found that even men who were 75 to 80 benefited from treatment.
The report was based on the medical records of more than 44,000 men 65 to 80 who were diagnosed with the disease between 1991 and 1999 and who had survived more than a year past diagnosis. The study ended at the end of 2002.
Tumors can be treated with radiation or by surgical removal of the gland. Once the cancer has gone beyond the gland hormone treatments are used to slow its spread. Patients who received that kind of treatment were not included in the study.
In an editorial in the same issue commenting on the study, Mark Litwin and David Miller, two physicians at the University of California, Los Angeles, noted that the findings are preliminary.
Doctors “must remain steadfast in their efforts to reduce over-treatment and under-treatment by thoughtfully defining each patient’s unique balance between the natural history of prostate cancer and that individual patient’s life expectancy,” they advised.
Until the matter is resolved, they said, “physicians should apply these provocative findings judiciously and continue their concerted efforts to help patients make informed treatment decisions based not only on survival predictions but also on health status, functional concerns, and — most importantly — personal preference.”
