As reported by The New York Times, May 4, 2005.

Study Backs Caution in Treating Some for Prostate Cancer

By The Associated Press

CHICAGO, May 3 (AP) - Men with low-grade localized prostate cancer who forgo aggressive treatment are unlikely to die of the disease even after 20 years, researchers in Connecticut say.

Their findings are the latest to support a cautious approach in treating some prostate cancers, although there is still debate about how to determine who is at highest risk.

Prostate cancer is the most common major cancer among men; if they live long enough, many men will eventually develop it, large numbers of them with no symptoms. But common treatments, notably surgery or radiation, can leave patients impotent or incontinent.

The new research, led by Dr. Peter C. Albertsen of the University of Connecticut, is described in Wednesday's issue of The Journal of the American Medical Association. It involved 767 Connecticut men who, varying in age from 55 to 74, were found to have cancer that had not spread beyond the prostate.

Some received hormone therapy to halt the body's production of the male hormone testosterone, which fuels prostate cancer. Others were treated by observation, sometimes called "watchful waiting." Each subject was followed for 10 to 20 years, having received the diagnosis at some point from 1971 to 1984.

Prostate cancer ended up killing 228 of the men, mostly within the first 15 years after diagnosis. Most who died of the disease had had high-grade tumors, those with cells that looked very abnormal under a microscope. A vast majority of the men with nonaggressive tumors either died of other causes or survived.