More men with prostate cancer can afford to put off harsh treatments without compromising their health, a study suggests.
The decades-long research found that active monitoring by health care professionals is an equally good option for men who don’t have late-stage cancer.
The study found that men who were monitored after diagnosis were just as likely to survive at least 15 years as those who underwent more severe radiation or surgical treatments.
Both treatments have serious long-term consequences. In fact, the researchers say ‘our findings indicate that, depending on the magnitude of the side effects associated with early radical treatments, more aggressive therapy may do more harm than good’.
Researchers found that the death rate was the same in people who initially received treatment (red, blue lines) and those who were instead monitored by a doctor until they needed it (dotted line)
Doctors hope to save patients a lot of pain and hassle by postponing treatment without disadvantages (photo file)
While prostate cancer kills about two percent of all men, it has a relatively high survival rate 95 percent over the first 15 years. This has led doctors to theorize that monitoring patients and treating them as soon as their disease worsens or spreads could be the best approach.
It’s another breakthrough in the diagnosis and treatment of prostate cancer, with scientists last week developing a blood test that could detect it with 91 percent accuracy.
The American Cancer Society expects nearly 300,000 new prostate cancer diagnoses by 2023. The disease will lead to an estimated 34,700 deaths.
Many men who suffer from the disease – most of them over the age of 65 – are offered two primary treatment options.
One is radiation therapy, where a diagnosed man receives either external radiation via rays from an X-ray-like machine or internal radiation, where a seed-like object that oozes radiation drug is planted in their prostate.
In some cases, a person may also take a daily course of pills that apply the same radiation.
This treatment comes with serious side effects, including hair loss, fatigue, memory problems, blurred vision, headaches, and more.
It works by damaging DNA in the body’s cells — preventing cancer from multiplying and growing — but it’s a crude and imprecise method that damages surrounding healthy tissue.
Some men opt for a prostatectomy instead, an operation that removes all or part of the organ.
It involves months of recovery, can’t stop the spread of cancer, and often leaves a man with sexual and urinary health problems for the rest of his life.
But doctors are beginning to take a wait-and-see approach to early-stage prostate cancer, hoping it will be better for the patient’s well-being in the long run.
In the latest study, published Saturday in the New England Journal of Medicineresearchers collected data from 1,643 men diagnosed with prostate cancer.
Each had a relatively mild case with no detected spread of the cancer.
The population was split into three groups based on the treatment they received at the start of their battle against the disease.
Of the group, 553 received surgery and 545 underwent radiation. A third group of 545 people received neither.
Instead, the latter group was regularly monitored by a doctor for the course of the disease.
If their cancer reached a later stage or spread to another part of the body, they were offered appropriate treatment.
After 15 years, 17 of the 545 people in the monitoring group died, or 3.1 percent of them.
This was equivalent to the 12 or 553 people from the surgery group who died — 2.1 percent — and the 16 members of the treatment group — 2.9 percent.
While death rates were the same, 9.4 percent of people who were monitored had their cancer spread – called metastasis.
This compares to only 4.7 percent in the group who had surgery and five percent of people who received radiation therapy.
Cancer is more deadly when it spreads, but researchers noted that the metazization had little impact on mortality in these cases.
“Radical treatments reduced the incidence of metastasis, local progression … by half compared to active monitoring,” researchers wrote.
“However, these reductions did not translate into differences in mortality after 15 years, a finding that highlights the long natural history of this disease.”
By waiting for the cancer to get worse before starting the more rigorous treatment, they saved many people from grueling treatment.
Despite the similar mortality rates, only 60 percent of the active monitoring group discontinued treatment over the 15-year period.