News Release
May 3, 2005
Embargoed until Tuesday, May 3, 4 p.m. EST
Contact: Carolyn Pennington, 860-679-4864
e-mail:
cpennington@uchc.edu
“Watchful Waiting” May Be Best Option for Low Grade Prostate Cancers
UConn Health Center Research Published in May 4 Issue of JAMA
FARMINGTON, CONN. – A new study by University of Connecticut Health Center researchers finds “watchful waiting” may be the best option for patients with localized prostate cancer.
“The appropriate treatment for newly diagnosed prostate cancer has been controversial,” according to Dr. Peter Albertsen, professor and chief of urology at the UConn Health Center.
Because prostate cancer typically grows so slowly, often the treatment of choice for older men is simply surveillance, rather than an aggressive treatment such as surgery or radiotherapy.
New research authored by Dr. Albertsen and published in the May 4 issue of the Journal of the American Medical Association sheds new light on this issue and may help make treatment decisions easier for some patients.
The study found that men with low grade prostate cancers have a minimal risk of dying from their disease during 20 years of follow-up. Men with high grade prostate cancers face a high probability of dying within ten years of diagnosis, while men with moderate grade disease have an intermediate risk of dying from prostate cancer over 20 years.
The annual mortality rate from prostate cancer appears to remain stable beyond 15 years from diagnosis. “These results do not support aggressive treatment for localized, low grade prostate cancer,” says Dr. Albertsen. “Surveillance is really the best option for those patients.”
The study looked at the medical histories of 767 men with clinically localized prostate cancer who were first diagnosed when they were between the ages of 55 and 74 years of age. The men were treated with either observation or hormone withdrawal therapy.
Albertsen’s research contradicts a recent study by Swedish researchers who found a three-fold increase in prostate cancer mortality rates for men who survive more than 15 years following diagnosis. The discrepancy in findings could be due to differences in how the patient’s disease was classified and how their cause of death was determined.
Both studies agree that men with well defined tumors rarely die from their disease and that men with poorly defined tumors frequently die from their disease within five to ten years of diagnosis, often despite aggressive interventions.
“Counseling men who have moderately defined disease and a life expectancy greater than 15 years poses the greatest challenge,” according to Dr. Albertsen. “A majority of these men will die from competing medical hazards over a period of 15 to 20 years. Until better prognostic markers are developed, clinicians will continue to recommend aggressive treatments at the time of diagnosis.”
One in six men will be diagnosed with prostate cancer, the second most common cancer in men after skin cancer. Ninety percent of those men will have localized cancer which may lead to the dilemma of whether to treat the cancer at all and if so, how aggressively?
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