Older patients should carefully consider options.
Older prostate cancer patients with other underlying health conditions should think twice before committing to surgery or radiation therapy for their cancer, according to a multicenter study led by researchers from the UCLA Department of Urology.
The study reports 14-year survival outcomes for 3,000 men diagnosed with prostate cancer between 1994 and 1995. The results suggest that older patients with low- or intermediate-risk prostate cancer who have at least three underlying health problems, or co-morbidities, are much more likely to die of something other than their cancer.
“For men with low-to-intermediate–risk disease, prostate cancer is an indolent disease that doesn’t pose a major risk to survival,” said the study’s first author, Dr. Timothy Daskivich, a UCLA Robert Wood Johnson fellow. “The take-home point from this study is that older men with multiple underlying health problems should carefully consider whether they should treat these tumors aggressively, because that treatment comes with a price.”
Aggressive treatments for prostate cancer, including surgery, external radiation and radioactive seed implants, can result in major side effects, including erectile dysfunction, urinary incontinence and bowel problems. Also, the survival advantage afforded by these treatments does not develop until approximately eight to 10 years after treatment.
In many cases, Daskivich said, either “watchful waiting” or active surveillance — monitoring the patient’s cancer very closely with regular biopsies and intervening with surgery or radiation if the disease progresses — is better than hitting the disease with everything in the treatment arsenal.
The study appears May 21 in the early online issue of the peer-reviewed journal Annals of Internal Medicine.