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Outcomes Vary for Prostate Cancer Patients Choosing Surgery; Overall, No Treatment Proven Superior
Date:2/4/2008

tly to expanded use of the Prostate Specific Antigen (PSA) blood test. But the risk of dying of prostate cancer remains about 3 percent. Therefore, considerable overdetection and overtreatment may exist. The U.S. Preventive Services Task Force, a panel of outside experts convened by AHRQ that makes independent evidence-based recommendations, maintains there is insufficient evidence to recommend for or against PSA testing for routine prostate cancer screening. PSA tests can detect early-stage cancer when it is potentially most treatable but also lead to frequent false-positive results and identification of prostate cancers unlikely to cause harm.

AHRQ's new report, based on a review of 592 published articles, compared eight prostate cancer strategies: complete surgical removal of prostate and related tissue; minimally invasive surgery to remove the prostate; external radiation; radioactive implants; destruction of cancer cells through rapid freezing and thawing; removal of testicles or hormone therapy; high-intensity ultrasound; and no immediate treatment, also known as "watchful waiting."

The report, compiled by AHRQ's Minnesota Evidence-based Practice Center, is intended to provide unbiased, evidence-based information so that patients, clinicians and others can make the best treatment decisions possible. Among its conclusions:

-- Not enough scientific evidence exists to identify any prostate cancer treatment as most effective for all men, especially those whose cancers were found by PSA testing. However, more than 90 percent of patients reported they would make the same treatment decision again, regardless of the treatment they received.

-- All treatment options cause health problems, primarily urinary incontinence, bowel problems and erectile dysfunction. The chances of bowel problems or sexual dysfunction are similar for surgery and external radiation. Leaking of urine is at least six times more likely among surgery patients th
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SOURCE Agency for Healthcare Research & Quality
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