More evidence to wait to treat cancer of the prostate (Reuters)

NEW YORK (Reuters Health) - for older men with low risk of prostate cancer, a new study adds to evidence that carefully watching instead of immediately treating tumour may be a reasonable option.

In a study of 650 men, which averaged 66 years, most were able to go for 5 years without treatment for prostate cancer, the report in the Journal of Clinical Oncology.

"The underlying problem is that we are over-treating prostate cancer, because we are not a perfect method to identify the people who will never be adversely affected by cancer," said Dr. h. Ballentine Carter, Professor of urology and Oncology at Johns Hopkins University School of Medicine in BaltimoreDans Maryland.

"In General, the large number of (prostate) cancer is slow-growing variety that a person can live with for years," Carter, who co-authored the study, told Reuters Health.

Tests of PSA (prostate-specific antigen) screening prostate cancer to find cancers that would never caused problems, said Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society, which was not part of the study.

A PSA test fee 20 $ to 30 $, has said Carter.

Ease of use of the test to screen men has led to concerns that the low risk cancers are arterial growing, particularly of older men more die of another cause likely before the cancer of the prostate never becomes a problem.

Previous studies have shown that screening for prostate cancer is not help men live longer, and do not treat the disease does not in the high rate of mortality. (See the stories of Reuters Health of 18 June and 15 September 2010).

Based on these issues and other results, U.S. Preventive Services Task Force recommends not men aged over 75 screening and said there is not enough evidence of whether it is useful for younger men.

For men over 65 who are tested and diagnosed with low-risk prostate cancer, "the first question is not how I'm going to deal with, but if I'm going to treat or not," Carter said.

Ultimately, about a third of men in the study had treatment. The majority - about 8 of the 10 - postponed it for 2 years, while 6 out of 10 for 5 years. There was no deaths due to cancer of the prostate in the study.

The researchers used active surveillance, which means check PSA levels and annual biopsies. In this approach, if the tumor is found to be progressed, a man will then be to undergo treatment involving surgery or radiation.

These treatments can lead to urinary or bowel incontinence and erectile dysfunction. Most men will have one or more of these side effects, but many decrease with time, in accordance with the foundation of Prostate Cancer.

Surgery ranges from $ 20,000 to $ 30,000, whereas radiotherapy can cost $ 20,000 to $ 100,000, depending on the type, said Brawley.

Researchers following more than 650 men, with an average of 66 years, who had been diagnosed with prostate cancer very low risk. They followed men as long as 15 years. At the end of the study, approximately 400 participants had no treatment for cancer, and was about 250.

Each year, 157 of 100,000 men are diagnosed with prostate cancer in the United States. Of this number, 25 - or about 1 in 6 - will die of the disease, according to the National Cancer Institute. The average age of diagnosis is 67 years and the average age of death from prostate cancer is 80.

"If delay us the processing, the results will be the same down the line (processing) when the initial diagnosis." Which seems to be the case, ", said Dr. Maxwell Meng, associate professor in urology at the University of California at San Francisco."

But we can predict what guys will have treatment or not? "We are not as good as now," said Meng, who has not worked on the current study.

Men with prostate cancer need to learn more about the different types of treatments and talk to a number of doctors, Meng told Reuters Health.

"Some cancers do not need immediate treatment," he said. "It may be safe see if it is (the patient) wants to do."

SOURCE: http://bit.ly/dNR6e5 Journal of Clinical Oncology, online on April 4, 2011.

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