Many With Low-Risk Prostate Cancer Get Aggressive Therapy

by -- Eric Metcalf
Updated: Jul 26th 2010

MONDAY, July 26 (HealthDay News) -- Most men diagnosed with prostate cancer who have a prostate-specific antigen (PSA) threshold below 4.0 ng/mL undergo aggressive local therapy despite having low-risk disease, according to research published in the July 26 issue of the Archives of Internal Medicine.

Yu-Hsuan Shao, Ph.D., of the Cancer Institute of New Jersey in New Brunswick, and colleagues analyzed data from 123,934 men in the Surveillance, Epidemiology, and End Results system who had newly-diagnosed prostate cancer.

The researchers found that 14 percent of men had PSA levels below 4.0 ng/mL. Most men (54 percent) with PSA levels of 4.0 ng/mL or less at diagnosis had low-risk disease, but more than 75 percent underwent radical prostatectomy (RP) or radiation therapy (RT). Men with screen-detected cancer and PSA below 4.0 ng/mL were 1.49 times more likely to receive RP, and 1.39 times more likely to receive RT, and were 33 percent less likely to have high-grade disease than those with non-screen-detected prostate cancer.

"Our results demonstrate that 66 percent of men aged between 65 and 74 years with low-risk disease and a PSA value of 4.0 ng/mL or lower received either radical prostatectomy or radiation therapy. These findings suggest that many contemporary men receiving treatment for localized prostate cancer are unlikely to benefit from the intervention. Furthermore, it has been documented that men who receive any treatment have increased risk of treatment-related adverse effects. Therefore, it is critical that patients be counseled about treatment-associated adverse effects and benefits when they are deciding about therapy," the authors write.

A co-author disclosed financial relationships with Sanofi-Aventis and Blue Cross/Blue Shield.

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