Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Older, sicker men with early-stage prostate cancer do not benefit from aggressive treatment

13.05.2014

Treatments may result in additional health issues

Treating older men with early-stage prostate cancer who also have other serious underlying health problems with aggressive therapies such as surgery or radiation therapy does not help them live longer and, in fact, can be detrimental, according to a study by UCLA researchers.


This is Dr. Timothy Daskivich.

Credit: UCLA

The study followed the cases of more than 140,500 men aged 66 and older diagnosed with early-stage prostate cancer between 1991 and 2007 from the Surveillance, Epidemiology and End Results (SEER) Medicare database. Men who also suffered from multiple major medical conditions such as a history of heart attack, chronic obstructive pulmonary disease (COPD) and diabetes in combination did not live any longer after receiving aggressive therapy compared with men receiving no treatment. Additionally, these men were at risk for side effects such as impotence, urinary incontinence and bowel problems that can result from surgery and radiation treatments.

The research team used the Charlson index when looking at the men and their health problems. The index can be used to predict the 10-year mortality for a patient who may have a range of other health problems, called comorbid conditions. A prostate cancer patient with diabetes may score a 1 on the index, while a man with multiple or more severe health problems might score a 3 or higher.

The retrospective study, which followed the men for 15 years after diagnosis, found that prostate cancer patients with Charlson scores of 0, 1 or 2 who were treated with surgery or radiation therapy had a lower risk of dying of prostate cancer compared with men receiving no treatment. However, men with scores of 3 or higher did not have a reduction in risk of death from cancer with aggressive treatment because they did not live long enough to benefit from it and were more likely to die from something else, said study first author Timothy Daskivich, a UCLA Robert Wood Johnson fellow.

The study appears in the May 13, 2014 early online edition of the peer-reviewed journal Cancer.

"In the past, we've relied on the basic argument that older and sicker men are much more likely to die of other things besides their prostate cancer that exposing them to aggressive treatment and its debilitating side effects is a poor gamble," Daskivich said. "Now we've shown that aggressive treatment of these men is ineffective. This information will help these men better maximize the quality of their remaining years."

Daskivich said that prostate cancer patients who have several comorbid conditions could use these findings to decide whether or not to treat their disease.

"These findings will also benefit the doctors who are trying to counsel these men on whether or not they should receive treatment," he said. "The guidelines suggest the men with life expectancies of less than 10 years shouldn't be treated aggressively, but life expectancy is difficult to measure accurately. This data clearly defines a subset of patients who should avoid therapies that will only cause them problems they don't already have."

Prostate cancer is the most frequently diagnosed cancer in men aside from skin cancer. An estimated 233,000 new cases of prostate cancer will occur in the United States in 2014. Of those, nearly 30,000 men will die. For reasons that remain unclear, incidence rates are about 60% higher in African Americans.

"Aggressive treatment of men with multiple major comorbidities poses both an unnecessary health hazard to these men and an undue burden on our overtaxed health care system," the study states. "Because all aggressive local treatments for prostate cancer may confer side effects that can substantially affect quality of life, aggressive treatment of men who are unlikely to benefit often creates new health problems – impotence, urinary incontinence, bowel dysfunction – while not achieving the primary objective of increasing cancer-specific survival."

###

The study was supported by the National Institutes of Diabetes and Digestive and Kidney Diseases (HHSN276201200016C 0, American Cancer Society (124225-PF-13-014-CPHPS), and the Urology Care Foundation.

For more than 50 years, the urology specialists at UCLA have continued to break new ground and set the standards of care for patients suffering from urological conditions. In collaboration with research scientists, UCLA's internationally renowned physicians are pioneering new, less invasive methods of delivering care that are more effective and less costly. UCLA's is one of only a handful of urology programs in the country that offer kidney and pancreas transplantation. In July of 2013, UCLA Urology was once again ranked fourth in the nation by U.S. News & World Report, a ranking it has held for the last 15 years. For more information, visit http://urology.ucla.edu/.

Kim Irwin | Eurek Alert!
Further information:
http://www.ucla.edu

Further reports about: Health UCLA aggressive early-stage prostate receiving therapy urology

More articles from Health and Medicine:

nachricht Recommended blood pressure targets for diabetes are being challenged
24.08.2016 | University of Gothenburg

nachricht Putting prevention in their pockets
23.08.2016 | University at Buffalo

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Streamlining accelerated computing for industry

PyFR code combines high accuracy with flexibility to resolve unsteady turbulence problems

Scientists and engineers striving to create the next machine-age marvel--whether it be a more aerodynamic rocket, a faster race car, or a higher-efficiency jet...

Im Focus: X-ray optics on a chip

Waveguides are widely used for filtering, confining, guiding, coupling or splitting beams of visible light. However, creating waveguides that could do the same for X-rays has posed tremendous challenges in fabrication, so they are still only in an early stage of development.

In the latest issue of Acta Crystallographica Section A: Foundations and Advances , Sarah Hoffmann-Urlaub and Tim Salditt report the fabrication and testing of...

Im Focus: Piggyback battery for microchips: TU Graz researchers develop new battery concept

Electrochemists at TU Graz have managed to use monocrystalline semiconductor silicon as an active storage electrode in lithium batteries. This enables an integrated power supply to be made for microchips with a rechargeable battery.

Small electrical gadgets, such as mobile phones, tablets or notebooks, are indispensable accompaniments of everyday life. Integrated circuits in the interiors...

Im Focus: UCI physicists confirm possible discovery of fifth force of nature

Light particle could be key to understanding dark matter in universe

Recent findings indicating the possible discovery of a previously unknown subatomic particle may be evidence of a fifth fundamental force of nature, according...

Im Focus: Wi-fi from lasers

White light from lasers demonstrates data speeds of up to 2 GB/s

A nanocrystalline material that rapidly makes white light out of blue light has been developed by KAUST researchers.

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

The energy transition is not possible without Geotechnics

25.08.2016 | Event News

New Ideas for the Shipping Industry

24.08.2016 | Event News

A week of excellence: 22 of the world’s best computer scientists and mathematicians in Heidelberg

12.08.2016 | Event News

 
Latest News

Hans Clevers to receive the Körber Prize 2016

25.08.2016 | Awards Funding

An effective and low-cost solution for storing solar energy

25.08.2016 | Power and Electrical Engineering

PRB projects world population rising 33 percent by 2050 to nearly 10 billion

25.08.2016 | Social Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>