A report published in the Internal Medicine on Monday reports that about 75% of men diagnosed with low-risk prostate cancer received more aggressive treatment than required though the condition could have been safely ignored for years. The findings also reveal the ongoing difference of opinions on the amounts of prostate-specific antigen’s required to trigger further treatment and diagnosis.

At present, 4.0 nanograms per milliliter of prostate-specific antigen is used to determine if the patient should undergo biopsy or some other follow-up. Some experts suggest that this cutoff should be decreased to 2.5 nanograms per milliliter. If the cutoff takes place, then it is estimated that the number of men to have abnormal levels of PSA will be doubled to 6 million and more cases of aggressive procedures will occur.

Grace-Lu-Yao, a cancer epidemiologist, along with other colleagues studied the records of 123,934 men above 25 years of age, who were recently diagnosed with prostate cancer between 2004 and 2006. 14% of these men had below 4.0 PSA levels. 54 percent had low-risk disease with less risk of progression that can be safely monitored. Even then, 75 percent were subjected to aggressive treatment that included radiation therapy and radical prostatectomy. 66% of individuals above 65 years age had aggressive therapy even though nothing more than a watchful waiting is necessary for low-risk disease. The percentages in both the cases were similar compared to the group of men with levels of PSA between 4 and 20.

Aggressive treatment of such kind can create many complications including incontinence and impotence.

According to the data by American Cancer Society, more than 192,000 new men were diagnosed with prostate tumors in 2009 and more than 27,000 cases resulted in death. 90% of the men with prostate cancer were diagnosed for this condition before the tumors spread to other body parts and 100% of them survived for five years. It is interesting to note that the 5 year survival rate increased to 99% in 2003 even though it was 69% in 1975.

The authors of the report emphasize that doctors need to identify the tumors that can progress and those with less probability of progressing.

Source:

Archives of Internal Medicine