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CANCER: More evidence not all prostate cancers need treatment
In a study of older men who had died from causes other than prostate cancer, almost half were found to have prostate tumors.
And up to half of those tumors detected on autopsy would have qualified for treatment had doctors known about them while the men lived, though none had been the cause of death.
That suggests that a wait-and-see approach might be better than treatment for many prostate cancers.
Medicare currently covers a yearly PSA test for men over 50 who qualify.
Zlotta and his colleagues selected a Caucasian population of Russian men similar in lifestyle and risk factors for prostate cancer to U.S. men in order to look at how common the cancer is in older men who have not been routinely screened.
For comparison, he said, “we chose an Asian population in Japan because clinically detected prostate cancer and mortality are much lower among Asian men compared with Caucasian men and their lifestyles/diet are dramatically different.”
Almost 40 percent of the Russian men, had tumors of the prostate, compared to 35 percent of the Japanese men, according to the results published in the Journal of the National Cancer Institute.
One in four tumors in the Russian men were deemed serious and would likely have been treated with surgery or radiation in the U.S., compared to one in two tumors in the Japanese men.
In the United States, about 239,000 men are expected to be diagnosed with prostate cancer in 2013, but far fewer – less than 30,000 – will die of it, according to the American Cancer Society.
That’s still more than will die of the disease in Japan, despite the American men getting more screenings and treatments – a curious inconsistency researchers do not understand and Zlotta called the “million dollar question.”
Prostate cancer screening does ultimately reduce the number of painful advanced cancers and deaths from the disease, but it also picks up smaller cancers, and treating those aggressively could lead to unnecessary side effects, Loeb said.
Prostate removal costs about $13,000, and may lead to impotence or incontinence.
SOURCE: bit.ly/13o6lTY Journal of the National Cancer Institute online July 11, 2013
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