Low-risk prostate cancer patients face overtreatment

Many low-risk prostate cancer patients are being overtreated and might fare better if doctors monitored the cancer until treatment was necessary, a new study reports in the August 16 issue of the Journal of the National Cancer Institute.

Past recommendations for early-stage prostate cancer patients involved prostate removal rather than monitoring the cancer's progress until treatment is necessary. But more recently, cancers are being detected at earlier stages, and reports that low-risk patients are being treated aggressively have made researchers suggest such treatment may not be the best solution. New studies suggest that aggressive treatment does not improve survival benefits and may harm patients' health.

John T. Wei, M.D., of the University of Michigan in Ann Arbor, and colleagues identified 71,602 men over age 70 diagnosed with prostate cancer between 2000 and 2002. They determined how many men were treated with various therapies, including surgery and radiation, and how many times the "wait and see" approach was used.

The authors identified 24,825 men with lower-risk prostate cancers, 13,537 of whom underwent immediate treatment with radiation or prostate removal. Assuming waiting for treatment would have been the best approach for these cancers, the authors found that 10% of patients were overtreated with prostate removal and 44% with radiation therapy. Wei and colleagues suggest waiting until treatment is necessary may reduce overtreatment for patients with low risk prostate cancer.

They write, "Efforts to reduce overtreatment should be a clinical and public health priority."