Prostate cancer does not always require aggressive treatment
A study that began several decades ago shows that many men with Prostate cancer can delay treatments such as surgery or radiation therapy without reducing your chances of survival. Instead of removing the prostate or being exposed to high-energy radiation, these patients can actively monitor their disease after cancer diagnosis; Because invasive treatments have long-term side effects such as urinary incontinence, erectile dysfunction and other urinary problems, bowel disorders and sexual function.
Dr. Fredi Hamdi, professor of surgery and urology at Oxford University, regarding this issue CNN “The good news is that if you are diagnosed with prostate cancer, don’t panic and give yourself time to make a decision,” he says. Hamdi goes on to point out that his advice is only true for patients with low or medium-risk prostate cancer, and patients with high-risk cancer still need urgent and aggressive treatments.
Live Science He writes in his report that during this study, which began in 1990, patients were under active surveillance and the level of a specific protein in their blood was measured regularly. This protein is called prostate specific antigen (PSA) and its level in the blood increases with the progression of prostate cancer. “Currently, active surveillance of patients can include additional measures such as magnetic resonance imaging (MRI) of the prostate and genetic testing,” wrote Dr. Oliver Sartor, medical director of the Tulane Cancer Center in a commentary on the study.
The researchers followed the participants in this study for 11 to 21 years after being diagnosed with prostate cancer. They ultimately concluded that all patients faced the same risk of death regardless of the treatment they received. In general, 45 participants, or 2.7% of them, died of prostate cancer. 12 of them (2.2%) had undergone surgery and 16 (2.9%) had received radiation therapy; 17 people (3.1%) were also under active surveillance. Such small differences are not considered statistically significant.
During a follow-up period of approximately 15 years, approximately 330 men (60% of participants) who were in the control group eventually underwent surgery or radiation therapy; But it seems that waiting for them to receive these treatments had no effect on their risk of death. In addition, 133 members of the control group never received any treatment such as radiation therapy, surgery, or hormone therapy and are still alive.
15 years after the diagnosis of prostate cancer, the disease had progressed in 9.4% of the patients in the active surveillance group, 4.7% of the patients in the surgery group and 5% of the participants in the radiation therapy group. Dr. Stacey Loeb, a prostate cancer specialist at NYU Langone Health, believes that the control group might have done better if the study had been done with today’s surveillance methods. Loeb, who was not involved in this study, to Associated Press “We now have many ways to detect the progression of cancer before it spreads,” he says.
In a part of his commentary, Sartor also mentions this important point that almost the majority of patients in this trial were in the group of low-risk and intermediate-risk patients, and today they are considered suitable candidates to be in the monitoring group. According to him, only a small part of the participants in this study are considered high-risk and need immediate treatment.
According to CNN, high-risk prostate cancer only accounts for 15% of all diagnoses; Therefore, in most cases, this disease is faced with a low or medium risk. The authors of this study finally conclude that for low-risk patients, the risks and benefits of treatments such as surgery and radiation therapy should be carefully weighed; Because sometimes the damage caused by aggressive treatments is more than their benefits.