Although the men had low-risk cancer, more than 75 percent of them underwent surgery to remove their prostate or had radiation therapy, DiPaola's group found.
More than 90 percent of prostate cancers are found before the disease has spread to other parts of the body, and these men have a five-year survival rate of almost 100 percent, the researchers say. Since 1975, the overall survival rate of men with prostate cancer has increased, from 69 percent to almost 99 percent in 2003, they added.
Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, said one problem with this study is that whether patients had another serious medical condition, other than prostate cancer, such as heart disease or diabetes, is not mentioned.
"What needs to be done is to look at people's risk profile, not just based on the PSA and the kind of cancer that was diagnosed, but also based on their overall health," he said. "There is no data, to date, to understand the natural history of untreated low-risk, low-PSA, prostate cancer in healthy men in their 60s and 70s whose life expectancy is exceeding 10 to 15 years," he said.
D'Amico thinks that healthy younger men with low-risk prostate cancer may opt for aggressive treatment, while older men in poorer health could benefit from active monitoring. "For men 60 and 65 in good health, I think, treatment is warranted," he said.
For another expert, the problem of overtreatment starts with over-screening.
Dr. Otis Brawley, chief medical officer of the American Cancer Society, said that "there are huge problems with PSA screening." Most men who have prostate cancer will die from some other condition and do not have to have their prostate cancer treated, he added.
"PSA screening is so good it diagnoses far too many men with prostate cancer, and is so bad it misses a lot of prostate cancer," he added.
There are a lot of uncertainties regarding prostate cancer and pr
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