Researchers followed patients for 10 years and found no difference in death rates between men who were picked at random to have surgery or radiation, or to rely on "active monitoring" of the cancer, with treatment only if it progressed.
September is Prostate Cancer Awareness Month, and one Duncan man who was diagnosed with it is educating men to take charge of their health by learning the risk factors for the disease.
Between 1999 and 2009, 82,429 men aged 50 to 69 across the United Kingdom, who were tested and 1,643 diagnosed with localised prostate cancer, agreed to be randomised to active monitoring (545), radical prostatectomy (553) or radical radiotherapy (545).
The decade-long study led by Oxford and Bristol universities shows men with localised prostate cancer may not have to endure treatment and its side effects. Surgery and radiotherapy reduce the risk of cancer progression over time compared with active monitoring, but cause more unpleasant side-effects.
This active surveillance, as doctors call it, requires regular clinic visits for physical exams, biopsies, and blood tests for prostate-specific antigen (PSA) levels, rising levels of which can indicate worsening disease.
Presumably, these cases could have been caught earlier and treated effectively if the men had been screened. Screening should occur generally between the ages of 55 - 70, and start earlier if a man is African-American or has a family history of prostate cancer. Part of this is due to the persistent idea that PSA screening should be done on all men over 40-an issue we just looked at this week in "Despite thumbs down from professional groups, mass prostate cancer screening events continue, often with misleading promotions". The other patients were treated with radiation. However, we learn that it was "nonetheless a very low number", and an American Cancer Society physician says "the truth is, it's 6 percent versus 3 percent at 10 years... it is much less than even I thought it would be". Researchers hailed the results as good news, saying they had been expecting a survival rate of 90 percent.
The Pennsylvania Prostate Cancer Coalition's campaign, "Don't Fear the Finger", is encouraging men to seek out preventive prostate cancer screenings by seeing a clinician on an annual basis for a digital rectal exam, a simple screening that can detect this very preventable and treatable disease.
The study-the first of its kind to investigate this question using a randomized controlled trial, is a big deal-and, encouragingly, received the attention it deserves from USA news media, making headlines in many major publications. "And that pushes them toward treatment". However, prostate cancer is still a common and risky disease that is diagnosed in almost 200,000 men in the USA annually, and 29,000 men die because of it each year.
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It is too early to determine now how harmful the effects of reduced prostate cancer screenings will be over time, but it could ultimately lead to more advanced cases and potentially more deaths. Although the treatment didn't extend life during the first 10 years, a survival benefit might yet emerge in the next five or 10 years, the researchers said.
Prostate is the second leading site of cancer among males in large Indian cities like Delhi, Kolkata, Pune and Thiruvananthapuram; third leading site of cancer in cities like Bangalore and Mumbai.
"We need something to allow us to identify men with aggressive disease earlier", said Dr. Malcolm Mason, a prostate cancer expert at the charity Cancer Research U.K. He said the study confirmed that for men in the early stages of the disease, there is no wrong treatment decision. But after six years, twice as many men in the surgery group still experienced urine leakage and problems with their sex life, in comparison with those in the active monitoring and radiotherapy groups.
"So why was there a statistical difference in metastases and disease progression?"
Between 1999 and 2009, 82,429 men in the study aged 50 to 69 had a PSA test.
Quality-of-life scores did not differ significantly across the three groups with respect to anxiety, depression, general health, or cancer-specific quality of life.
The study, backed by the research wing of the NHS - the National Institute for Health Research - then followed the men for 10 years.