For some men with prostate cancer, the best treatment is no treatment, study finds

Last year, about 192,000 American men were diagnosed with prostate cancer. For 16% to 40% of them, the disease is deemed to be so low-risk that no immediate medical intervention is necessary. Instead, they can undergo “active surveillance,” which means regular PSA tests, physical exams, and periodic biopsies to monitor the cancer’s growth. Treatments, including surgery to remove the prostate and different types of radiation, can be put off until the cancer gets bigger – if it ever does. Most treatments result in at least one adverse effect (such as erectile dysfunction and urinary incontinence). However, only about 10% men who have the option of delaying treatment opt for active surveillance.
A new study suggests that too many men are passing up a good thing.
Researchers from the Dana Farber Cancer Institute in Boston and elsewhere examined the pros and cons of active surveillance in a hypothetical group of 65-year-old men who just found out they have localized, low-risk prostate cancers. Using data from other studies, they assumed that those who opted for immediate treatment reduced their risk of dying from prostate cancer by 17%.
But when they factored in the side effects from treatment, those patients weren’t necessarily better off. Using a measure called quality-adjusted life years, or QALYs, they found that patients who opted for radiation treatment – either external beam radiation or brachytherapy – had slightly more than 10.5 QALYs. Those who had surgery had 10.2 QALYs, which works out to four fewer months in the “preferred health state.”
Source:Chicago Tribune