An analysis of Surveillance, Epidemiology and End Results (SEER)-Medicare records for 44,630 older men suggests surgery or radiation therapy for early-stage prostate cancer increased the lifespan of men between 65 and 80 years old compared to observation, sometimes known as "watch and wait." Published in the Dec. 13 issue of Journal of the American Medical Association, the study supported a benefit of treatment even for men whose disease had a low risk of spreading, and even if they were elderly men (75 to 80 years old).
"Studies have shown that low- and intermediate-grade prostate cancers may grow slowly, and many patients may never suffer complications from their disease. This makes decisions regarding treatment complicated for patients and their families," said lead author Yu-Ning Wong, M.D., a medical oncologist at Fox Chase Cancer Center who authored the study with colleagues at the University of Pennsylvania. "In our study, we looked back at existing data that tracked long term outcomes of elderly men whose cancer was at low and intermediate risk of spreading. After accounting for all of the observed differences between the groups, we found that men who had either a radical prostatectomy or radiation therapy within six months of their prostate cancer diagnosis were 30 percent less likely to die than those who did not undergo treatment during this time period," she said.
Researchers confined the study sample to men with small tumors (clinically designated as T1 or T2) with well-differentiated (corresponding Gleason score 2 to 4) or moderately differentiated (corresponding Gleason score 5 to 7) prostate cancers, who were diagnosed between 1991 and 1999.
Of the 44,630 patients included in the study, 12,608 (28.3 percent) were not treated while 32,022 (71.8 percent) were actively treated. In the treatment group, 88 percent lived five years or longer and 66 percent lived 10 years or longer. In the non-treatment group, 78 percent lived five years or longer and 51 percent lived 10 years or longer. The benefit of treatment was still present after adjusting for differences between the treatment and non-treatment groups, including patient demographics and tumor characteristics.
Since the study was a retrospective analysis of existing data (observational) rather than a randomized controlled trial, the authors noted that treatment and non-treatment groups may differ in measured and unmeasured ways that are associated with differences in survival.
"Observational studies such as ours should be interpreted with caution, since men who were offered treatment, or specific types of treatment, may have been ‘healthier' than men who were not offered treatment, which raises the possibility that the treatment benefit may due to the selection of healthier men," Wong noted. "We performed extensive statistical adjustments to account for these differences and still found that treatment was associated with longer survival."
Wong emphasized that observation is a reasonable choice for many men since some prostate cancers grow slowly. Studies have shown that in recent years, only between 7 and 17 percent of men in the U.S. with low-risk localized prostate cancer choose observation rather than treatment.
Longer survival alone is not the only factor in choosing treatment over observation, Wong pointed out. "The risks of treatment have decreased as options have improved including more targeted radiation therapy that reduce side effects and less invasive surgical techniques, but both may be associated with bowel, bladder and sexual dysfunction. Patients should talk to their doctors about their risks of side effects associated with radiation, surgery and observation before making treatment decisions."
"Our study is just one piece of an extraordinarily complex puzzle, and many other researchers are examining different aspects of prostate cancer biology and treatment. Patients should consider enrolling in clinical trials and other research protocols to help us better understand how prostate cancer grows and which patients most likely to benefit." Wong concluded.
Karen Mallet | EurekAlert!
WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf
First form of therapy for childhood dementia CLN2 developed
25.04.2018 | Universitätsklinikum Hamburg-Eppendorf
The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.
Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...
A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.
The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
25.05.2018 | Event News
02.05.2018 | Event News
13.04.2018 | Event News
25.05.2018 | Event News
25.05.2018 | Machine Engineering
25.05.2018 | Life Sciences