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New research makes prostate cancer treatment decision harder

September 16, 2016 By Jerry Newberry

New research makes prostate cancer treatment decision harder

New research shows the survival rate for prostate cancer is high, and advocates for a monitoring program.

New research from England has found that men who are diagnosed with prostate cancer and choose to monitor the disease instead of having surgery or radiation, are just as likely to survive for at least 10 years as those who opt for immediate treatment, according to cbsnews.com.

And that is calling into question whether the methods of screening and treatment are necessary, or if they lead to large numbers of unnecessary surgeries.

The survival rate among the men in the study was 99 percent, regardless of which option was chosen, prompting Dr. Freddie Hamdy, the study’s leader from the University of Oxford to say there has “been no hard evidence that treating early disease makes a difference.”

“Because we cannot determine very well which is aggressive cancer and which is not,” adds Hamdy, “men and clinicians can both be anxious about whether the disease will progress.  And that pushes them toward treatment.”

Doctors welcome the results, but caution that it will be a struggle to convince men that have been diagnosed with prostate cancer that a wait-and-see program is the right way to go.  Chief Medical Officer for the American Cancer Society, Dr. Otis Brawley, said he would suggest monitoring, but it was a challenge to explain to people that certain cancers just don’t need to be treated.

Brawley, who was not affiliated with the study, offered, “Our aggressive approach to screening  and treating has resulted in more than 1 million American men getting needless treatment.”

The findings from the study were taken from data involving over 82,000 men in the United Kingdom between the ages of 50 and 59, and who had prostate specific antigen (PSA) tests.  PSA test results can signal the presence of prostate cancer, but sometimes also signal harmless conditions, such as natural enlargement of the prostate which occurs as men age.

From the group, a sub-set of 1,463 men were randomly selected to receive either surgery, radiation, or active monitoring, including blood testing every three to six months.  During the ten-year evaluation period, 112 subjects being monitored saw their cancers worsen, while 46 of the original group had surgery and an additional 46 received radiation.

The take-away is that with such a high survival rate, no decision has to be made immediately, and the researchers say that may help reduce the number of unnecessary surgeries, but they also call for additional research over a longer period of time to see if the rates remain constant.

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