Prostate cancer is the most common cancer in older men but since it tends to grow very slowly, many patients never suffer complications from the disease before dying from another cause. So, for many years, the conventional wisdom on treatment for patients in their 70s and 80s has been no .treatment -- so-called watchful waiting. But a new study from the Fox Chase Cancer Center in Philadelphia, Pennsylvania, indicates that older men survive longer if doctors begin aggressive treatment.
Dr. Yu-Ning Wong reviewed data collected by the U.S. government on more than 44,000 men from 65 to 80 years old. "We looked at how long these patients lived and found that men that were not treated in their first six months past their diagnoses lived approximately ten years," she reports. There was a different finding with the other group: "we found that men who did receive treatment lived longer and were approximately 30 percent less likely to die in the time interval past their diagnosis."
Wong emphasizes that the men who did not get treatment after their diagnosis did live, on average, for another decade. But she says that advances in care and treatment of other diseases of aging are changing the medical decision-making standard for older men. "Men are living longer," she points out. "We're having more advances in primary care and there are plenty of primary care and care of cardiovascular disease and other conditions and we've improved our treatment with radiation therapy and surgery."
Part of that improved treatment, she says, is minimizing the side effects, but she adds that, "there are potential changes in bowel and bladder function or sexual dysfunction following treatment with either of these procedures." Wong recommends that older men with prostate cancer talk with their doctors about the other conditions they may have in order to decide how aggressively to treat the cancer with radiation or surgery.
Researchers in other countries are looking at the relative benefits of prostate cancer treatment versus watchful observation, Wong says, and the results of these studies are due in several years. Yu-Ning Wong's study appears in the Journal of the American Medical Association.