Should Prostate Cancer Always Be Treated?

More older men getting potentially unneeded treatment

Should Prostate Cancer Always Be Treated?

The decision on whether to actively treat prostate cancer in certain patients can be controversial.

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Some doctors question the wisdom of giving advanced treatment to some older patients. These patients may have a low risk of dying from the cancer itself — and little chance the treatment will provide benefit.

Dying with prostate cancer rather than from it

Now a study reveals that an increasing number of older men are getting advanced treatments for prostate cancer, despite that small chance the treatment will be of any help.

Andrew Stephenson, MD, did not take part in the study but treats prostate cancer at Cleveland Clinic.

“The majority of men who have prostate cancer will die with their disease rather than of their disease,” says Dr. Stephenson. “Treating these relatively low-risk patients may only be subjecting these men to the side effects of treatment.”

That’s why it’s important to have a conversation with your doctor about the risks and benefits of advanced prostate cancer treatment.

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Study finds more older men opting for treatment

University of Michigan researchers studied advanced prostate cancer treatment options among nearly 50,000 men over age 65, over a five-year period.

They found the number of men with low-risk disease who opted for advanced treatment technologies increased from 32 percent to 44 percent from 2004 to 2009.

Two treatments in particular—intensity modulated radiotherapy, or IMRT, and robotic prostatectomy—saw significant growth.

Why these treatments may be a problem

Researchers say these findings may indicate a problem because this patient population is unlikely to benefit from these treatments — which are also costly.

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Side effects are a factor, too, says Dr. Stephenson.

“Don’t underestimate the side effects of therapy,” Dr. Stephenson says. “In many cases, though the treatments are often successful, there are important side effects that many men experience with respect to their urinary, bowel and sexual function.”

“Unfortunately, they may have to live with those side effects the rest of their lives.”

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