Treatment can often be avoided or delayed

  • A new long-term study found that men with prostate cancer had a 97% survival rate at age 15, regardless of whether they received prostate cancer treatment.
  • Determining your reaction when faced with a prostate cancer diagnosis can be difficult, but this study suggests that the decision doesn’t have to be so terrifying.
  • Men who decided not to seek treatment were twice as likely to eventually metastasize, but this did not reduce survival.

Men diagnosed with prostate cancer have two options. He may choose to seek treatment or pay attention to the often slowly progressing disease.

A new study presented this month at the European Urological Association (EAU) conference in Milan, Italy, reports the results of a study comparing the outcomes associated with each of these options. This study is the longest running study of its kind.

Their disease course varied somewhat depending on their decisions, but even the men whose cancer had metastasized survived.

The study followed 1,643 British men aged 50 to 69 who were diagnosed with prostate cancer between 1999 and 2009. PSA blood test.

As part of the study, participants agreed to be randomly assigned to actively monitor their disease, radical prostatectomy, or radical radiotherapy.

the study is New England Journal of Medicine.

The PSA or prostate-specific antigen blood test itself is somewhat controversial.

The study’s first author, Dr. Freddie Hamdy, explained that after the PSA test, “further testing, including prostate biopsies, may snowball.” If cancer is found, it is likely to be localized and low risk, he said.

“The test could unnecessarily turn healthy people into ‘cancer patients,'” warned Dr. Hamdi. “

With this in mind, US Preventive Services Task Force on Prostate Cancer About ten years ago, doctors advised against including PSA screening in blood tests. Since then, however, the diagnosis of advanced prostate cancer discovered by other means has been significantly increasedand many doctors have resumed ordering PSA tests for their patients.

Prostate cancer most (but not always) grows slowly and takes years to spread or metastasize beyond the prostate.

The three most common medical responses to a prostate cancer diagnosis are:

  • Active monitoring — Closely monitor cancer through PSA tests and routine prostate biopsies, and transition to aggressive treatment only if symptoms develop or the cancer grows.
  • Radical prostatectomy — The entire prostate and possibly cancer is removed.
  • Definitive radiation therapy — Treatment of the prostate with radiation to kill the cancer.

Both radical prostatectomy and radiation therapy are often associated with lifestyle-altering side effects, such as erections, urination, and bowel dysfunction.

“Today, radiation and surgery are not the only options,” said Dr. Adam Ramin, who was not involved in the study.

“The advantage is that in many cases, it can actually turn prostate cancer into a chronic disease, much like diabetes and high blood pressure,” said Dr. Ramin.

He noted that there are many men who may be good candidates for a treatment option called local therapy. We target cancer through a variety of means.

The study found that men who opted for active monitoring were twice as likely to see progression or metastasis, but few died during follow-up.

Among men who participated in active monitoring, 9.4% of cancers metastasized compared with men who underwent prostatectomy (4.7%) or radiation (5.0%).

For men with metastatic cancer, Dr. Ramin says chemotherapy has changed little over the years, but hormone-manipulation-type treatments and androgen suppression therapy.

“Ten or 15 years ago, we were on one or two types of hormone therapy,” he said. “There are now many of them working through different mechanisms.”

Dr. Benjamin H. Kang, who was also not involved in the study, added:

“New systemic therapies useful for metastatic disease include (177)-lutetium-PSMA-617, a radioactive substance that selectively binds to specific proteins on the surface of prostate cancer cells, destroying the cells. It’s a drug.”

“The two most important factors are what we call the stage and grade of the cancer. How advanced the cancer is, it means how aggressive the cancer is. said Dr. Ramin.

Dr. Ramin said molecular studies performed on biopsied tissue could potentially provide better prognostic indicators in assessing whether a person is a good candidate for active monitoring. rice field.

One finding is that, due to advances in diagnostic technology, many men who were diagnosed as being at low risk of metastasis a few years ago are now being diagnosed as being at intermediate risk.

Dr Hamdi told EAU in a press release:

“Unlike many other cancers, it is clear that a prostate cancer diagnosis should not be a cause for panic or hasty decision-making.

Patients and clinicians can and should take the time to weigh the benefits and possible harms of different treatments, knowing that this will not adversely affect survival. “

Dr. Kann says another factor is the person’s overall health and apparent life expectancy.

Further, Dr. Hamdi said: medical news today, the choice depends on the man’s ‘priorities in life, other medical conditions (if any) and fitness, and the measurement of ‘trade-offs’ between benefits and potential harms of treatment, particularly sexual function, urinary incontinence, and May depend on intestinal symptoms. “

Source link

Leave a Reply

Your email address will not be published. Required fields are marked *