Navigation Links
Age plays too big a role in prostate cancer treatment decisions
Date:12/21/2010

Older men with high-risk prostate cancer frequently are offered fewer and less effective choices of treatment than younger men, potentially resulting in earlier deaths, according to a new UCSF study.

The scientists found that men above age 75 with high-risk prostate cancer often are under-treated through hormone therapy or watchful waiting alone in lieu of more aggressive treatments such as surgery and radiation therapies. Instead, say the researchers, old age should not be viewed as a barrier to treatments that could lead to potential cures.

"There is a disconnect between risk and treatment decisions among older men," said senior investigator Matthew R. Cooperberg, MD, MPH. "Patient age is strongly influencing treatment decisions, so we sought to understand whether age plays a role in risk of the disease and survival. We found that under-treatment of older-men with high-risk disease might in part explain higher rates of cancer mortality in this group. There is also pervasive over-treatment of low-risk disease in this age group. Overall, treatment needs to be selected more based on disease risk and less based on chronologic age."

The study is published by the "Journal of Clinical Oncology," and is available online at http://jco.ascopubs.org/content/early/2010/12/02/JCO.2010.30.2075.full.pdf+html?sid=fe9ef2e4-1379-4e7b-ab6c-c33796334de4

Prostate cancer is the most common form of cancer in men and the second most common cause of cancer death after lung cancer. This year, an estimated 217,730 men will be diagnosed with the disease, and 32,050 men will die from it, reports the American Cancer Society. Moreover, prostate cancer is the most common malignancy among older men: 64 percent of new cases in the United States this year were diagnosed in men older than 65, and 23 percent in men above 75.

Yet most studies delving into optimal treatment options focus on men younger than 75. The new UCSF study is among the first to explore the relationship between age, disease risk and survival among prostate cancer patients.

The researchers studied men in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) database, a longitudinal, observational disease registry of men with prostate cancer who were recruited from urology practices throughout the United States. At the time of the study, the database contained information on 13,805 patients.

The scientists found that older patients are more likely to have high-risk prostate cancer at the point of diagnosis, and less likely to receive potentially curative local therapy. Yet when older, high-risk men received more aggressive treatment, they had a 46 percent lower death rate compared with patients treated more conservatively with hormonal therapy or watchful waiting.

The finding, the researchers say, suggests that underuse of aggressive therapy may in part explain the higher death rates of older men with the disease.

"Age does not independently predict prostate cancer survival," said Peter R. Carroll, MD, MPH, chair of the UCSF Department of Urology and co-leader of the prostate program at the UCSF Helen Diller Family Comprehensive Cancer Center. He is a co-author of the paper. "Our findings support making treatment decisions on the basis of disease risk and life expectancy rather than on chronologic age."

The researchers note that the U.S. Preventive Services Task Force specifically recommends against screening men age 75 or older, but that position is based on studies on younger men, and furthermore does not account for health status or other diseases that the patients may have which would affect life expectancy.

"Older men with high-risk disease frequently die of prostate cancer and under-treatment might be a factor in their deaths," said Cooperberg, a prostate cancer specialist in the UCSF Department of Urology and the Helen Diller cancer center. "The notion of age as a primary determinant should be reconsidered. Patients with aggressive local disease should be offered a chance of aggressive therapy that might cure them regardless of their age."

Traditionally, Cooperberg said, physicians have feared the risks of surgery on their older patients. But for older patients with localized, high-risk disease and a life expectancy of more than 10 years the researchers recommend that surgical treatment and radiation be considered.

"Surgery and radiation risks do go up with age, but it may be that we are focusing too much on risk than on benefit," said Cooperberg. "We need a better balance between risk and benefit."


'/>"/>

Contact: Elizabeth Fernandez
elizabeth.fernandez@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert

Related medicine news :

1. Poorly understood cell plays role in immunity against the flu
2. Breakthrough design opens door to full screen Braille displays for the blind
3. Sisters of Bon Secours Plays Active Role in Bringing Healthcare to Regions of Peru
4. Protein plays a critical role in the development of aggressive breast cancer
5. FDG-PET/CT plays a definite role in detecting colorectal cancer recurrences
6. Population health plays a bigger role in geographic differences in Medicare spending
7. Mount Sinai discovers bone marrow plays critical role in enhancing immune response to viruses
8. Gene related to aging plays role in stem cell differentiation
9. REM sleep deprivation plays a role in chronic migraine
10. More Evidence Virus Plays Role in Chronic Fatigue Syndrome
11. Fat distribution plays a role in weight loss success in patients at risk of diabetes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/23/2017)... ... 23, 2017 , ... Better education to coaches and parents ... work today at the American Orthopaedic Society for Sports Medicine’ s ... to prospectively document the association between sports specialization and lower extremity injuries in ...
(Date:7/23/2017)... ... July 23, 2017 , ... “Squiggy’s Outdoor Adventure”: a turtle’s backyard ... the creation of published author, Paula Christian, a wife and mother to three amazing, ... family, who center their lives on God. She loves to tell stories to ...
(Date:7/21/2017)... ... , ... "As a doctor of lung medicine managing chest diseases for more ... said an inventor from Center Valley, Pa. "My idea is to improve the device ... the patent-pending PLEURAL SAFE-t-STAT CATHETER KIT to offer an efficient means of draining pleural ...
(Date:7/21/2017)... ... July 21, 2017 , ... The Karen Miller Agency, a ... in the greater Birmingham area, is joining the Chris Hammond Youth Foundation in ... the region. , The Chris Hammond Youth Foundation maintains athletic facilities in rural ...
(Date:7/21/2017)... ... July 21, 2017 , ... Bernard R. Bach, Jr., MD, orthopaedic surgeon at ... Orthopaedic Society of Sports Medicine (AOSSM) , received the 2017 Robert E. Leach Sports ... Toronto, Canada. This prestigious award is given annually to honor those who have made ...
Breaking Medicine News(10 mins):
(Date:7/14/2017)... 13, 2017 It should come as no surprise ... is in the midst of a crippling opioid epidemic. According ... the number of overdose deaths from opiate-based medications has quadrupled, ... a million dead from 2001 to 2015". During this time, ... has similarly quadrupled, drawing a compelling link between prescription and ...
(Date:7/13/2017)... 2017 RK Logistics Group, Inc. was awarded ... its Fremont, CA headquarters facility where ... and San Jose for hi-tech, pharmaceutical ... , with its Fremont Innovation District, is excited to ... powerful resource to the hundreds of biotech, pharma and biomed ...
(Date:7/12/2017)... -- CarpalAID is a revolutionary new product that relieves painful carpal ... tunnel syndrome affects more than 8 million people a year. Women ... The common methods of treating CTS are painful surgery, the use ... gloves. ... CarpalAID is a clear patch worn on the palm of the ...
Breaking Medicine Technology: