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The best treatment for prostate cancer might be no treatment

Each year, about 17 percent of men in Oregon and nationwide will be diagnosed with prostate cancer. Upon receiving this news, most men opt for aggressive treatment options, despite the accompanying long-term side effects of that choice. However, a new study suggests that may be the wrong choice.

Called the Prostate Cancer Intervention Versus Observation Trial, the study indicates that prostate tumors tend to grow so slowly that other health problems will take their toll first. In fact, the risk of dying from prostate cancer is only about three percent. Because of its slow growth rate, the study advocates for monitoring, rather than aggressive treatment of prostate cancer, which might result in surgical errors or complications from the radiation.

The study is based on 731 men who had been diagnosed with prostate cancer. Researchers randomly assigned the men to prostate removal or observation only. Overall, 47 percent of the men in the surgery group died during the study, compared to 50 percent of the others.

After ten years, 5.8 percent of the men who received surgery had died from prostate cancer or its treatment, compared to 8.4 percent of patients kept under observation. In fact, more than one in five of the men who underwent surgery experienced a complication of the surgery, including one death.

Aggressive cancer treatments, such as surgery or radiation, often have devastating side effects or complications. Yet the study found that slow-growing prostate tumors might not cause problems to most men in their lifetimes. For such patients, the best treatment might be simply letting the tumor alone — provided doctors continue monitoring the growth of the tumors by bringing patients in for regular checks.

This conclusion might be hard to believe, considering that prostate cancer is the second-leading killer in men. Each year, 28,000 deaths are attributed to it. The technology for screening men for prostate cancer has also become increasingly advanced, permitting detection of ever smaller tumors. More than 240,000 new diagnoses are made each year.

Source: Reuters, “More men with prostate cancer ‘team’ wait on treatment,” Genevra Pittman, July 31, 2012

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