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
Contact: Karen Mallet
Fox Chase Cancer Center