A new review of U.S. data on prostate cancer finds that despite established guidelines, a growing number of men who should not be getting aggressive treatment are getting it anyway.
Men with low-risk tumors and a life-expectancy of less than 10 years -- for instance, men in their 80s or 90s -- are not candidates for so-called curative therapies like radiation or prostate surgery because there's little evidence it would benefit them.
Yet the proportion of men in that category receiving curative treatment rose between the late 1990s and late 2000's, the study found. "In our society, cancer is probably the most feared disease.
The problem with prostate cancer is that most patients have a very non-aggressive form of cancer," said Dr. Cary Gross of the Yale School of Medicine in New Haven, Conn.
According to Gross, the study's senior author, the team expected to find that people less likely to benefit from treatment would receive fewer treatments, not more, over time. "What we found was the opposite of what we expected," he said.
"These trends are actually moving in the opposite direction." According to the American Cancer Association, there will be about 242,000 new cases of prostate cancer diagnosed in the U.S. in 2012.
They project about 28,000 men will die from the disease this year.
Dr. Charles Bennett, a practicing academic oncologist specializing in prostate cancer from South Carolina, wrote about his own experience of being diagnosed and treated for prostate cancer in the same issue of Archives of Internal Medicine.
Bennett wrote that at age 50 he decided to have prostatectomy, which is the removal of all or part of the prostate, after a blood test revealed increased prostate-specific antigen levels and a biopsy confirmed he had cancer. Five years after his surgery, Bennett writes that his right arm and leg are weak, making his former practice of jogging five miles daily impossible.
http://bit.ly/y6yC5f Archives of Internal Medicine, online February 27, 2012.
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