The advice to detect and treat cancers at the first opportunity may not apply to older men with prostate tumors, according to the latest study.
With a government-backed group advising that most men no longer need regular screening for prostate cancer with the prostate-specific antigen (PSA) blood test, researchers now say that older men who are diagnosed with the disease should not always get surgery or radiation treatment.
That’s because for most men, having a low to moderate risk of prostate cancer is not a major red flag for early death. The cancer is typically so slow-growing, that many of these men will die from other causes, which means the benefits of treatment do not always outweigh the risks. Surgery, radiation and radioactive seed implants can cause disorders such as erectile dysfunction and urinary incontinence. And since it can take many years for the effects of the treatments to emerge, the survival advantage is low in most cases in which the tumors aren’t aggressive.
In the new study, published in the journal Annals of Internal Medicine, led by researchers at the University of California Los Angeles (UCLA) Department of Urology looked at the 14-year survival of 3,000 men diagnosed with prostate cancer between the years 1994 and 1995. Older men with low to intermediate cases of prostate cancer, who also had at least three other health problems like diabetes, hypertension, congestive heart failure and arthritis, were significantly more likely to die from a cause unrelated to their cancer.
The 10-year risk of dying from these other causes among men aged 61 to 74 was 40%, and for men over 75, it climbed to 71%. The 14-year risk of dying from low or intermediate risk prostate cancer was 3% for men between 61 and 74, and 7% among men over 75. For men with high-risk prostate cancer, the risk of death from the cancer was 18% at the 14-year mark.