Findings Support Deferred Prostate Cancer Treatment

-- Eric Metcalf

Thursday, September 3, 2009

THURSDAY, Sept. 3 (HealthDay News) -- Some men with prostate cancer may safely defer treatment for years without a higher risk of metastasis or cancer mortality than those who receive initial treatment, according to research published online Aug. 31 in the Journal of Clinical Oncology.

William V. Shappley III, M.D., of the Beth Israel Deaconess Medical Center in Boston, and colleagues analyzed data from 3,331 men in the Health Professionals Follow-Up Study who were diagnosed with prostate cancer. Treatment was deferred by 10.3 percent, of which 51 percent remained untreated over an average 7.7 years of follow-up, and the rest were treated an average of 3.9 years after diagnosis.

The researchers found that younger age and higher prostate-specific antigen at diagnosis were among the predictors of eventual active treatment. The deferred treatment and immediate treatment groups had similar rates of development of metastases and death due to prostate cancer.

"The Shappley et al study helps physicians reassure patients, particularly those above the median age for detection, that active surveillance is a safe strategy and one that burns no bridges. Delayed treatment remains an option should the cancer ever prove the need. The evidence is mounting, the advocates of surveillance are finding their voice, and the economic incentives are changing. I am optimistic that we can break our cultural addiction to immediate treatment for all and move toward discriminating, selective, and more socially responsible behavior in this challenging disease," writes the author of an accompanying editorial.

A co-author reported financial relationships with several pharmaceutical and other companies.

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Specialties Cardiology
Diabetes & Endocrinology
Internal Medicine
Family Practice

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